Home > Medical > The Patient’s Wife Hates Me

The Patient’s Wife Hates Me

“You work hard all your life and when it comes time when you need help, you get tossed aside like an old rag”  That’s what the patient’s wife said to me when I told them I had to discharge them tomorrow.  My patient is dying of a terminal cancer, all his wife wants is an extra two days in the hospital.  She needs to work; they have nobody else.  It would be more convenient if he could be discharge two days later.  She could have the house cleaned and be there when he arrived from the hospital.  Sounds reasonable.  I said he couldn’t stay the extra two days.  He was medically stable for discharge.  I explained that his vitals and labs had all returned to normal.  The electrolyte disturbance he was admitted with had been corrected.  He was eating and walking more.  The therapists have all cleared him for discharge.  Hospice would be there to set up services and provide equipment for him when he got home.  All of this felt like yelling into the wind.  I could see the disappointment in her face.  The wife said, “Getting old is bad.  You work hard all your life and when your health fails, no one is there to help you.”  She felt abandoned, hurt.  She asked again if they could stay longer.  I had already done my homework.  I scoured the chart for every possible reason to keep the patient longer in the hospital.  Again, I said “no.”  I sat there in silence with both of them.  I contemplated whether to explain my position further.  I wanted to say, “Look, we’ve set up all these services for him.  We haven’t abandoned him.”  Most of all I wanted to say, “I’m sorry for failing you.”  Instead, I asked if they had any further questions.  Sensing defeat, they said “no”  I excused myself and left the room.

Oftentimes doctors and patients disagree on when they should be discharge.  Most patients want to leave ASAP but others want to stay longer.  The problem is Medicare or private insurance won’t pay for hospital days when patients are medically stable.  The patient can refuse to leave but they’ll end up paying for those extra days.  Charges will likely be in the tens of thousands of dollars.  Most families can’t afford to pay this.  The responsibility of determining medical stability is up to the physician.  I’d like to think that most docs provide compassionate care but they also can’t make up things up to keep their patients hospitalized longer.  Medicare fraud carries fines and jail time.  None of this matters to the dying patient and his wife.  He just asking for understanding and a little more time.  I have lots of the former but none of the latter for him.  What bothers me a great deal is that my patient doesn’t think I have either for him.

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