Action/Reaction

Let's say that your grandmother, whom you love more than anything in the world, gets sick and can't suddenly move her right arm or leg..

So, you take her to the hospital @ 2 am and get her the doctor to examine her.

The doctor examines her and decides that the reason is a blood clot of some sort…

..so he gives her some anti-clotting fluid or whatever, and she gets better for 12 houres..

..and then she starts homerraging blood from her anal cavity.

You realize that the doctor apparently gave her too much of the anti-clotting fluid, and they realize it too, so they fix that, and decide to give ehr a blood transfusion to make up for the blood she lost….

..only, instead of using the drip system to tarnsfer the blood over a few houres, a genius doctor decides to transfer an entire liter of blood in less than one hour.

This influx of blood causes some sort of fluid increase in her lungs, and she ends up getting lung adema.

She is 94! And she had to go through all of this over the span of 4 days. It's a private Hospital, the best care supposidly money can get you, so naturally there are no excuses.

Now, what I don't understand is, why is everybody so upset that I ended up assaulting both doctors who have been messing up my beloved granny for 4 days, and beating one of them- the one who made the one liter transfer decision- to pulp? I mean, I didn't break any of his bones. All he got is a couple of bruises, a black eye and about 12 kicks in the stomach. For the kind of horrible care he gave her, well, in any respectable decent country his medical license would be revoked and I would've sued him till his last penny for making a 94 year old woman go through this. Now, given that this isn't the case since this is Egypt, I figure him getting beat up by me is a fair equivelant. Hell, given that he didn't need one liter of blood transfusion, I reckon I let him off easy. No? I mean, any doctor that makes 3 life threatening mistakes over 4 days to an elderly women in her 90's, well, that's just someone who needs his ass kicked, right? And I didn't even get to beat him as much as I wanted, the damn nurses and other doctors had to intervene. The fuckers!

Ok, before you say it, I know, I know. Violence never solves anything, this wasn;t the rational thing to do, blah blah blah. Sorry, when it comes to to those I love I am not a rational person. I am sorry. I am not a violent person, and I almost never get into fights, but, ehh, she is my granny, you know? Seeing her bleed all over the place because the doctor is an idiot, well, it doesn't bring out the rational human being in me. And honestly, this doctor, for what he did, deserved it. It's a miracle that she is still alive, and ever since I beat him up, and the entire hospital saw what will happen to the next guy who messes up her treatment, well, she has been feeling and getting better. So maybe it wasn;t the most rational thing to do, but it deliverd results.

Oh well… 

She is coming out of the Hospital tomorrow. Thanks for everyone who prayed for her or kept her in their thoughts. I really appreciate it! 

Now all I need is some sleep! 

Comments

  1. A doctor in the States screwed up with my mom’s diagnosis and acted like a real ass. You did what I felt like doing and I can’t hold that against you.

  2. Rage makes it hard to think clearly, so no one can blame you for your reaction.

    Doctors can be incompetent dicks.

  3. Sorry, I’m a doctor, probably just a little biased, so I won’t say exactly what I think of you.

    What I will say, is that I deal with people like you everyday, and trust me, I don’t perform any better becuase someone shouted on me (never got beat up, did get punched a couple of times). You don’t have any idea the kind of strain we go through everyday, and yes, we make mistakes, we are only human afterall.

  4. howard_coward says:

    Two comments:
    1. We must remember like in any profession, half of doctors are below average.

    2. How come you’re not blogging from the hoosgow?

  5. I understand your rationale. The last time I took my grandfather to the emergency room at 3AM, I had several cop cars following me, chasing me with lights and sirens going. When I pulled over at the emergency room entrance, I was met by gun barrels. But, I got him the care he needed, so if they had taken me to jail, it would have been worth it.

    If a person isn’t willing to put their own safety aside for those they love, then they have no idea what love actually is. You did good, SM.

  6. This is great. A good ass-whooping si sometimes the best punishment, and it doesn’t drive up the cost of medical care like in the US. How is it punishment to a doctor to just have his malpractice insurance go up, when we will just pay for it anyway? The world needs more ass whooping.

  7. I do not approve of this incredible overreaction. Sometimes bad decisions get made and frequently they lead to other bad reactionary decisions. Jumping the doctor who has to face these kind of decisions frequently during his workday seems to me completely stupid.

    Could it be Sandmonkey that you are in fact exhibiting the same violent reaction that you so criticize in your fellow countrymen? When the ultra religious fanatics are burning down embassies and shooting down tourists… do they not justify their actions in a similar way. The old “we need to teach them a lesson they won´t forget” way of thinking?

  8. annamouse says:

    Hopefully this Dr who made all of the mistakes isn’t anywhere near your Grandma anymore! I’ve felt like delievering a swift kick to the shin a time or two with a few @$$hole Dr’s I’ve ran into or perhaps one a little higher but being a 5’2″ smaller female doesn’t give me that option. It really fries me that somehow they equate size with maturity. I am not a child.

  9. Melissa in NorCal says:

    I love you SM, but I agree with Sig. Doctors “practice” medicine. They are people and they make mistakes. I don’t believe they were trying to hurt your dear grandmother. They take an oath to cause no harm. It could be that some of these mistakes were done according to procedure, but her body reacted differently because of her age. I hope you apologize to the doctor at some point. Regardless, I’m glad she is doing better and I will pray for you.

  10. Very bad Sandmonkey. That doctor made mistakes while trying to save your granny, he wasn’t trying to kill her. If you thought he wasn’t helpful you should have asked him to stop treating her and use instead your, seemingly
    extensive knowledge of medicine to treat her.

    You shoud have been in jail by now.

    One wonders whether you cared of your grandmother or, in a confused way, of your image as macho-man and ‘protector’.

    sorry for having been your friend, good luck and good bye

  11. Golan,

    My own mother is an MD. I know what kind of pressure doctors get under and I appreciate that. I don't advocate violence against doctors who make the occasional mistake in their work, cause, well, we are human and we all do. But when you do 3 life-threathening mistakes in 4 days, especially to a frail old lady, well, it almost feels deliberate. If he couldn't handle her case, he should've just walked away. He didn't. I wish he would've. I am sorry you had to deal with what you dealt with, but i am positive you wouldn't have committed such gross negligence as this doctor did.

    Sig, It was an overreaction. It was completely irrational and wrong. I am not disputing all of it. I am not like that when it comes to me, but when it comes to those I love, well, let's just say that I am too over protective of them. I am not proud of what I did. I wouldn't advocate it. Hell, if someone else had done it, I wouldn't condone it! I saw someone I know being hurt over the course of 4 days by the decision of the same person suppsoed to relieve their pain. Hell, I saw this person afflict 2 new afflictions on top of her original one. I reacted. Not exactly bragging about it.

    Seneca,

    well, here is how it ended just an hour ago: He didn't file a police report, given that he felt supremely guilty for the mistakes that he made. I for my part, apologized to him, cause I do recognize that I was technically in the wrong. Whether or not it felt deserved on my part, that's different. What we want to do and what we allow ourself to do shouldn't be the same thing. No one is going to jail, despite what you may wish.

    And no, I don't think that my actions stemmed from wanting to defend my image as a macho-man and protector. I think they stemmed from an extremly emotional irrational place, fueled by spending 4 days watching my grandmother suffer needlessly. I am not big into kicking asses and taking names or smacking fools just for living! Hell, had he done the first thing right, I would've hugged him, and had he fixed his first mistake the second round I would've chalked it up to the we are all human category and moved on. Instead he messed it up again and I lost it. I again don;t think I was right to do so, and I did apologize to the man. I just hope not a single one of you is ever put in the same situation that I was in.

  12. I am suprised that you can beat up doctors in Egypt without going to jail. Sandmonkey, the next time you are kicking a doctor in the stomach don’t forget to finish him with chutebox style head stomps :)

    Back in the day my grandfathers cousin caught one of those fevers that used to kill people back then but do not anymore for some reason and the doctor told his dad (my grandfathers uncle) to quarantine his kid at his house. His whole family caught the fever and died so he (grandfathers uncle) murdered the doctor (payback) and was eventually hung (payback for payback).

  13. As salaam alaikum.

    I am a Canadian Muslim writer — I just happened to surf onto your site today.

    Come by my blog insha’Allah if you have an interest in poetry, reflections, fiction etc…

    Ma’as salaama,

    nuh ibn

  14. Punk ass Yahudi says:

    Sorry, I am all for non-violence (hell I have an MA in it) but this doctor got what he deserved. Mistakes are mistakes and they happen, but this dude seemed like a lazy moron. Maybe next time he will think about the consequences of his laziness and irresponsibilty a little more.

    Golan, I have all the respect in the world for doctors, but you can’t really speak for all doctors in the world — can you?

  15. SM wrote : ” I … apologized to him, cause I do recognize that I was technically in the wrong.”

    Good (if it was honest). This (apart from praying) was the only thing good that you have done in the last 4 days.

    Now, as Jesus would have it, “all forgiven if you truly regret, nobody is faultless, now go on with your life and sin no more”

  16. another doctor says:

    From what you said, your grandmother had an embolic stroke, a blood clot to the brain. The doctor put her on a medicine that saved her from having a major neurological disability and possibly saved her life, and then she developed gastrointestinal bleeding (GI bleeding). GI bleeding is a known complication of the medicine for dissolving clots and anticoagulation. In fact, bleeding into the brain is a big problem. They adjusted (stopped) the dose because she bled. Getting the dose right and keeping it right is tough problem; it can be like driving on ice.

    Because she bled, she became acutely anemic and hypovolemic. This can cause problems with the low blood pressure. To correct this, they gave her a transfusion. Because she is elderly, the rate of the transfusion caused her to develop fluid overload and pulmonary edema. Depending on how bad this is, it might be treated with diuretics, oxygen and sitting her up, or even putting her on a respirator if severe.

    Not knowing how she was doing before the transfusion, it is hard to categorically state that the transfusion was too fast a prior. A younger person may not have had any problem with the transfusion.

    From what you have presented, giving the fluids too fast is the only one that looks potentially like a mistake. As far as I know, they saved her life twice, a mild case (if it was mild) of pulmonary edema beats being dead. Not knowing the medications, etc. it is very difficult to judge from a distance that they did anything wrong. You may be entirely correct that all there errors were made, but you could also be entirely wrong and even with the best of care, these event would have happened.

  17. Hi Sandmonkey,

    I understand you overreacted. It’s a good thing no charges were filed, but what you did was understandable. I hope your grandma feels better soon!

  18. fuck them…those doctors were almost fatally negligent and if this were a real county, they could even be facing criminal charges. good for you.

  19. Melissa in NorCal says:

    I’m glad you apologized SM. When I was in surgury, they wouldn’t allow any of my family present because they knew I would be in a lot of pain and had to be awake for the whole procedure. They told me that my family couldn’t be in there, especially the men, because they’ve been attacked before and know that people do crazy things when love ones are at stake or in pain. I was in excrutiating pain for a few moments (seemed like an eternity), but am doing great now. I’m glad my dad didn’t punch out the doctor for my embarrassing display of acknowledging pain. Take care my friend. :)

  20. I think many life-saving decisions involve an element of risk. It is possible that, from now on, this doctor will be so afraid of taking risks, that some patients will not make it through the crisis.

    Independently of Sig, my first thought as I read your post were the burning embassies during the cartoons affair (how odd is that?). I could understand this kind of rage had the doctor tried to deliberately kill your grandmother, which certainly was not the case.

  21. Smarty has a good point: many a time the West has supported liberals only to see them turn into thugs once they attain power…If SM was truly a moderate, he would have assaulted only one of the physicians.

  22. Your grandmother had a blood clot; they gave her medicine to break up the clot – it was too much, she hemorrhaged. Ever individual is different, the amount of medicine given to her to break up the clot may have been fine for another person of her size and weight, but for her it was too much. If she was excessively bleeding out of an orfice, the doctor probably believed she needed blood immediately, especially, if they could not control the bleeding.

    Your are a dumbass for beating up the Doctor; I hope you felt better. I bet you shamed your grandmother. Think before you decide to beat someone; the only reason you did so was because you could. You wouldn’t try to kick the ass of someone much bigger and stronger than yourself; you would have been forced to think things through and would have been thankful that you did.

  23. SM apologised, Doctor accepted and didn’t press charges. All is good, everyone forgiven people. I was taught to forgive and forget, maybe some of these posters should have a little time to think about forgiveness. I know what Christianity says, what does Islam say about forgiveness?

  24. Sam, #16 covered pretty much everything. Your mom will have told told you, at her age your grandmother isn’t going to recover. So, hold onto her left hand and remind her of all the fun times that you two had as you grew up. She’s still in there though she won’t be able to speak. But she can remember along with you.

  25. i agree with sig and all the others that were truly surprised by the outburst. My dear father died under care that was lacking in oh so many ways. I spoke with lawyers but was told we had no case, so sueing is not so easy in america.
    also, i did think of the tempers seen in cartoon riots etc. it got me thinking.we. in america are generally prone to high crime rates due to no gun laws.In
    eGYPT? Myabe the laws allow the well off to skate? Glad she is better tho.

  26. WTF Sandmonkey!
    How could you beat someone up who was taking care of your grandmother?
    Truely despicable behavior. Did you know that medical professionals are at the top of the list of workers who are likely to be assaulted?
    I agree with the previous writer, who said that you were behaving like the Jihadi’s. Don’t let the syncophants relieve your conscience, you fucked up and should attone to the doctors who you attacked. Perhaps a little volunteering in the local emergency room would give you a little insight and help pay your moral debt.

  27. chellebelle_mn says:

    Sorry cant side with you here. You were 100% wrong. And you were also selfish, you effectively made this about you, not about the person that mattered in this situation, your grandmother. Thank God she is getting better but at some point you need to realize that she is 94 and will die soon and that most of us dont go out like we woiuld like, a heart attack in our sleep. Death like birth is messy and painful.

    I am sorry that this happened, but did beating up the doctor stop one bit of your grandmothers pain? My only hope that she was too out of it to see this shameful behavior. Frankly, you should be in jail.

  28. chellebelle_mn says:

    Glad you see you were wrong but you belong in jail in my humble opinion and would likely be here.

    This was a surpremely selfish act more about your pain than your grandmothers. I just hope she was too out of it to know of your shameful act. Doctors are human beings and make mistakes and dealing with my grandmothers various ailments, I have learned that geriatic medicine is very very difficult. As someone pointed out, they saved her life 2 times.

    She is 94 and will die sooner than later. We all imagine we will die peacefully in our sleep but the reality is, death is usually painful and messy, just like our birth. Death is not an end, its just a transition. When she makes that transition, focus on how she lived, not how she died.

    And thank God you have her for a bit longer.

  29. SM , i prayed 4 ur grandma alot and i really wish her speed recovery , just try and make her happy , fill her life with joy . u can show her that u care in various ways other than violence , make her smile and this will make u forget all the sleepless nights take care of her and urself

  30. Wow…

    Brings back some horrible memories I don’t want to think about…but I do…

    I nearly got arrested at least 2-3x during a period my son was very sick…what a nightmare of a time…

    Clotting is horrible…and more common in the ME than in other places in the world. Tell you Mom the MD to child into things like Factor V Lieden…Gene Mutation 20010, and the Protein C and S and some other factors…it could run in the family and you might want to know about it…possible…your mom should be aware of these things and you can quickly Google and find out about it…V Leiden and 20010 are more common in the ME…

    Hospitals can be insane places…there is heroism and negligence…saints and sinners…the same bell shaped curve that affects all of us…

    Maybe one big lesson here for everybody that reads here…no matter what you field…your work can be a religious act that serves and focuses on a human being…or you can be a flaky or negligent or exploitive piece of shit…you choose.

    I am a Jew…but I love what Jesus said, “you cannot serve man and money”. When any business, hospital or computer repair, gets too focused on the bottom line…you take on too much volume and lose sight that what you do makes somebody’s life…and consequently the lives of all those around that person….worse (though you can do the same for the better).

    Losing your temper is usually a bad thing…not always…SM you got off real lucky on this one dude. Been there though…lead out of hospitals and schools by big black security guards (way are they almost always big black guys around here). One was laughing with a “I don’t blame you look”.

  31. Sadie you are nuts! “high crime rates due to no gun laws” is wrong wrong wrong! The cities in America with the highest murder rates have the stricted gun laws the cities with the lowest murder rates have no gun laws. Think before you speak! It will make you look smarter

  32. I’m not a doctor, but Chamomile tea helps. Or, you could try my Aunt Frans old Irish recipe: mix a bottle of bourbon, a bottle of honey and a bottle of lemon juice…I think she used that as cough syrup? but it gets me to sleep..just a small amount, of course…for you to sleep that is.. Your family is in my prayers

  33. My 80+ yr old granny got POOR medical attention and advice and she’s been gone a year on 4/1. I wanted to kick a lil dr butt for all of their screw ups…I wanted to do right by her but felt helpless to do so. So good for you for taking care of business!!! Glad your grandmother is going to b OK and that she has more time to spend with the ones that she loves and that love her. My granny didn’t get that chance due to just plain ol’ apathetic and incompetent care. Who cares about her age?? Is that an excuse to get bad medical care?? NO!!! Sure, your grandmother is 94…but that doesn’t mean that she shouldn’t recieve the same quality care as everyyone else. I feel like you got in a shot for me when I didn’t!!

  34. BrooklynJon says:

    #16 summed it up. From where I sit, I don’t see a whole lot of medical error in this discussion. Had the rapid transfusion not been given, your old and frail grandma may have had a complication of the anemia. Such a complication would not have been so easily reversed as pulmonary edema. And a dose of the blood thinner sufficiently low so as not to cause bleeding may not have cured her stroke.
    The fact that the patient is old and frail does not make it more upsetting that these untoward events occurred. Rather it makes it more likely. That’s life. If you don’t want to run the risk of your beloved having a medical complication, you should have kept her at home and taken care of her yourself. Then you could have felt morally superior, while your grandmother’s neurologic deterioration became permanent.

    Shame on you, SM. Shame, shame.

    Personally, I’d have filed charges.

    You owe the doc more than an apology.

  35. Egypeter says:

    Next time you wanna fight, why don’t you try scrapping with me big guy! I’m only about 155 pounds but I could go a couple of rounds with you.

    Think of me as “Cindarella Man” :)

    Oh, and btw, next time, take your anger out on a jihadi/ikhwani and not a doctor; we need those guys, we don’t need the Ikhwanis.

    Happy Easter everyone.
    Kola sana we into tayabeen.

  36. SM, first of all, I’m glad that your grandmother is coming out of the hospital and I pray that she’ll be all right. That’s the most important thing.

    Secondly, unless you have reason to believe that the doctor was actually trying to hurt your grandmother, what you did was wrong. The fact that a doctor is inept or just makes a series of dumb decisions isn’t grounds for beating him.

    I’m sure that stress, fear, anger and exhaustion played a role in your reaction. That makes it to an extent understandable, but not okay.

    Thirdly, to people above who are trying to tie this to the broader situation in Egypt: listen, guys, you’re trying too hard. Unless you’ve had a close relative ****ed up, especially by those who are supposed to be helping him/her, you can’t imagine how angry that makes you feel. This has nothing to do with the behavior of street hooligans or militants. SM is neither.

    If you want to tie this to the overall situation in Egypt, folks, what you should really be considering is the doctor:patient ratio in Egypt. You can look back at the GapMinder thing that SM mentioned recently for an (partial) answer. In 2000, the figure reached an all-time high of 2:1000 (not that much less than the USA’s 2.3). It then crashed until it hit a low of 0.54 by 2003, the same as it was in 1975. Where has it gone in the 4 years since? Guesses?

    What does this tell you? The population is growing, the best doctors are probably moving abroad, and those who are left are dealing with perhaps 4 times as many patients as before.

    They’re going to make mistakes, and that’s going to hurt people who don’t deserve to be hurt.

  37. Doctors suck you did the right thing.

  38. Doctors suck man. You did the right thing.

  39. Canadienne Errante says:

    Wow. I blinked. I’ve been reading Sandmonkey for over a year, and I couldn’t believe that he finally lost it. After all, this is the place where he loses it.

    But I had some thoughts. The first one is that in the USA, medical doctors are the new priesthood. People give them top authority: “Now, now, dear, you know what Dr. Soandso said.” They are also perceived at the top of the heap, insofar as it is attainable. (You don’t have to start out rich to become one.) TV shows are made about them–those brave, handsome, rich, doctors, under so much pressure. Even if they have zero bedside manner and are nasty people, if they are competent, they are heroes, e.g. House. Thus, to a Western readership, beating up a doctor is almost sacrilege. Also, beating anybody up here has massive legal implications.

    The thing is, Sandmonkey is not in the USA, he is in Egypt, which I do not know much about. My questions are as follows: How much clout do medical doctors have in society? Are they competent according to Western standards, or do they get their place at medical school through nepotism? Do people beat each other up more on a regular basis in Egypt? If I went to the market, would I see a woman whacking a merchant with her purse because he tried to rip her off? Also, given the horror stories we read in Sandmonkey’s column about the way some Egyptian men treat women, I am rather suspicious of how much care an Egyptian man would give an old woman who wasn’t related to him. On the other hand, I am under the impression that Egyptian men do, on the whole, feel deeply protective of women who are related to them. So my hypothesis is that Egypt is a country where men are very nervous about allowing other men to have power over their female relations, and go absolutely bananas when those other men abuse that power or use it stupidly in a way that hurts the female relations.

    In short, maybe Egyptian Sandmonkey, who strives to incorporate the better of Western values and his Boston education into his life, is at heart an Egyptian, and we should cut him some slack.

  40. Adrian from Denmark says:

    Hej Sam
    It’s really great that your grandma made it, and that’s the most important thing of all.
    Gratulations :-)

    Emotional outbursts (I’m nice to you now ;-) ) do happens, especially after such stress for several days, but now, after it’s all over I would recommend you to retrospect a bit and ask yourself what you expected from the doctor.

    My medical knowledge are limited, but I know enough to say that being 94 years old and get a bloodcloth and still survive and being functionable human being, one have to be goddamn lucky, or having had a very good medical treatment.

    If I was you, I’d wear my most shamefull face I could find in my robe, and then I’d give the doc and other staff a REAL appology for that behaviour, and not just a “Oh, if I really have to apologize, then be it” show.

    Anyway, once again, I’m happy for you and granny that she made it :-)

    Cheers
    Adrian

  41. Arnie in NYC says:

    I think it is likely (mind you I said *likely*, for after all, I was not there) that the only mistake the doctor made was not to have you sign an iron-clad consent form: to the effect that he was going to treat a 94 year old woman about to expire (or be completely incapacitated) with an impending stroke; and that complications and side effects of treatment (in a 94 year woman!) are the norm rather than the exception; and that there was no guarantee of success.

    Sandmonkey, I have been reading you for years and there is no one on the internet that I respect more. That said, I would have to say that you probably owe the poor physician more than an apology.

    Your grandmother, who is 94, probably loves you as much or more than you love her. But, Sandmonkey, you have to recognize that she has a chronic, terminal, fatal disorder — one in which the 5 year survival rate in the very best of circumstances is less than 1% (if I remember the insurance actuarial tables correctly). No amount of love can turn aside the inexorable movement of time leading inevitably to death. Your denial of this fact and perhaps your frustration with that denial was likely (again likely, I don’t know) taken out unjustly and unfairly upon the poor physician.

    What I do know is, if the series of events you described took place where I live and work, and if I were the physician, (forget the hospital security guards) I would run to the nearest smartest high-powered New York lawyer and I would sue you for the money earned for your earliest paper route to the tip of your independent retirement account.

    Arnie in NYC

  42. Next time do what I do. Look it up on the internet and self diagnose before going to the doctor! Sure, I’m every doctor’s nightmare- but who gives a shit.
    I went to the doctor with a 20 page article from a medical journal and demanded that my son be tested for CF, kidney failure and a whole range of oother things. If I hadn’t done that the doc would never have sent him for an ultrasound and I would never have known that my boy only has one kidney and a diverticulated bladder. Thankfully the CF was negative.
    One doc tried to rush me to hospital with appendicitis. I refused and checked it out on the net first. I was right. It wasn’t appendicitis but an ovarian cyst.
    You have to go to the medical journals (not shonky websites) and do a bit of research. Doctors are human, their training is limited- they can only guess what is going wrong based on observed symptoms. So I like to make sure that I am armed with enough info to either agree with, refute or question what they’re saying.
    SM- I’m glad your Teta is OK now. I know how frustrating it can be with doctors in Egypt. I’m not gonna tell you that you were wrong to hit him because I don’t know what was going in your head and I can only imagine what I would be like if I had to go through what you did.
    But the important thing is that Teta is OK.

  43. BrooklynJon says:

    Usual,

    Sorry about your son. Appendicitis and Oviarian cycsts are very hard to distinguish from one another, as they are next to each other, and give similar (though different to the discerning eye) symptoms. The problem is that a ruptured appendix (brought about through a delay in treatment) is catastrophic, while an unnecessary appendectomy which I recall you Aussies call “appendicectomy” – is generally regarded as pretty harmless (in fact, in a number of fields which limit access to medical care for a time, prophyllactic appendectomy is required). I was taught in my medical training to err on the side of the Appendectomy. In fact, the dogma was that 15% or your operations for appendicitis should reveal a normal appendix. Recently, with advances in CT scanning and ultrasound, it is possible to make a quick “radiologic diagnosis” (which is also not 100% perfect, but closer), so perhaps that 15% number should be revised downward. Suffice to say, if you took the time to research it, and ruptured your appendix while googling, you’d be singing a different tune.

    Canadienne Errante,
    “in the USA, medical doctors are the new priesthood. People give them top authority”
    You had me rolling on the floor with that one. Nothing could be farther from the truth. Spend a day with me at work, or for that matter, just read the comments here, and you’ll quickly be disabused of such notions of respect and deference.

    BJ (um, MD)

  44. Aardvark EF-111B says:

    still ticking THOUGH what they did, another reason why i believe in (upper force) after all…….

    get well soon…..

  45. My mom was a nurse, and she was always aware of the fact that doctors (and nurses) can screw up big time. She told me about these screw-ups often. Having a medical professional in the family can sometimes make someone more suspicious of doctors, not less, because you’re aware of the fact that they make mistakes.

    That tendency towards suspicion, added to love plus the need to protect someone dear to you can cause same major misfirings in anyone’s brain. It’s very hard to refrain from reacting violently if you think someone is inflicting unnecessary pain on someone you care about. In that situation, it’s hard to rationally evaluate whether that pain is medically necessary or unavoidable.

    So, now that you know that this is hard to control, it’s probably best to take precautions to curb this reaction. Count to 10, remove yourself from the scene for a while, have a hot toddy or some camomile tea. If the doctor’s presence annoys you, avoid him and talk to his supervisor or the nurses. If he’s incompetent, the nurses will probably know it, and they may have some ideas to help deal with him.

  46. Doctors are in general, a bunch of egotistical morons. I always self-diagnose, and it always pisses the morons off, but never pisses a good doctor off, because a good doctor respects intelligence and due diligence.

    Sandmonkey, you just did what everyone else would want to do, but wouldn’t do – still a dumbass thing to do though.

  47. Sorry to hear about your grandmother. You have had an interesting interesting person to read till now, but I’m going to have to take you off my reading list. Your grief enobles you, but your immaturity and violence do not.
    I am a doctor. Reading your story makes it clear you are not, and haven’t the medical knowledge to accurately judge the performance of your grandmother’s doctor. And far too little wisdom to arrogate to yourself the role of judge, jury, and dispenser of rough justice.
    I infer from your story:
    - Your elderly grandmother had an ischemic infarction of brain, most likely in the distribution of the left middle cerebral artery.
    - To help, she was given heparin, a blood thinning drug. The drug must be given IV, has a very low therapeutic index, and can be difficult to manage. It is usually managed by serially checking a blood test called a PTT. If the PTT goes over about 100, bleeding is thought to be more common. Bleeding from the GI tract is common with this drug, and is a feared side effect.
    - She initially improved, but then had rectal bleeding. You do not state her PTT at the time of the bleeding.
    - She was given blood–you say one liter, but I think more likely one or two units, which is less than a liter. If indeed a whole liter, then she indeed had a river of rectal blood to replace.
    - She developed pulmonary edema after the blood transfusion. This suggests she had compensated congestive heart failure from the start, which the extra blood volume exacerbated.
    Was there a mistake? I’m not sure from reading your note. 94 year old people are delicate, and trying to help often causes more problems. Was the physician apologetic? Well of course! He tried to help, and his help caused more problems. Was he incompetent? Anything’s possible, but I’m not convinced from your note. More accurate details are needed, and you obviously don’t have the expertise to judge. Could something have been done differently? Sure! The doctor called at 2 am could have just said “I can’t help–God will decide” and go back to bed.
    Your note does not convice me that the doctor gave bad care. But I am convinced you are criminal.

  48. Being sick and in ill health is what sucks. Having doctors with knowledge and readily available medicine is a blessing that most people in this world do not have.

  49. Roman Kalik says:

    *shrug* To all doctors here, the pressure which Sandmonkey had to go through is not a pleasant experience. Yes, he grossly overreacted, but he didn’t grossly overreact enough to be judged so harshly by you. Perhaps you should try to better understand what the family of patients are going through, rather than trying to show how a dose of common sense was needed. The doctor who treated (and saved) Sandmonkey’s Teta seemed to be a great deal better at understanding his reaction than you have been.

  50. Roman Kalik says:

    That said… Sandmonkey, you will go to that doctor again and you will apologize. You owe it to him, you owe it to your grandmother, and quite frankly you owe it to yourself. And you will thank the man for what he did, because he went against very bad odds and he put in his best. And it was enough. You owe that man the little satisfaction he deserves for doing a *very* mentally-taxing job well.

    Medicine is not perfect. No doctor is God, not even the most experienced one in the best private clinic.

  51. another doctor says:

    I hope your grandmother is doing well and can go home soon. I am not sure how much the doctors will tell you about your grandmother’s conditions seeing how you beat one of them up. (They are probably afraid of you.) What is below is very generalized and may not apply to your grandmother at all. There are a myriad of possibilities – I am just making an educated guess and writing a very brief explanation about 2 common ones.

    From what you have said she maybe still at a risk for another stroke. The 2 common sources of the embolus or clot are either from her carotid artery or her heart because of atrial fibrillation. Due to her advanced age it is unlikely that they would not want to perform surgery on her carotid artery or performed an invasive procedure to try and fix the atrial fibrillation. This leaves anticoagulation therapy or blood thinning as a major component of her treatment. The blood thinning will put her at risk for bleeding again. They may not want to put her on an anticoagulant because of the risk of bleeding is too high or try and find the source of the bleeding. There is a good chance that they will never find of the source. If they do, there may be multiple locations making it difficult to treat or another serious problem like a tumor. This is like being between Scylla and Charybdis in her treatment options, either risk bleeding or risk a stroke.

    http://en.wikipedia.org/wiki/Stroke
    http://en.wikipedia.org/wiki/Atrial_fibrillation

  52. please stop, I feel ill now

  53. Your anger is understandable, anger doesn’t always lead to violence but not everyone has the same level of self-control. What’s inexcusable is your lack of remorse having had time to calm down. You say you’re sorry but you still stay the doctor deserved a beating for causing your grandmother discomfort while he battled to save her life.

    I hope your granny makes a full and speedy recovery and marches you back to the hospital to apologise sincerely this time.

  54. I spent 2005 and 2006 navigating the medical system, particularly in the US, as a patient.

    Some points :

    1. Most doctors are decent people who do try their best. I am forever grateful to the senior doctor who took a personal interest in my case ie my earlier medical diagnosis and medical insurance were totally screwed, and I’m still PAYING for the MISTAKES.

    2. Doctors are quite likely to defend their own kind, particularly if it is from the same medical center. See comments in previous note. I ended up dealing with a late-stage cancer instead of an early stage one, and I was without insurance partly because the attending physician was on holiday, and the replacement told some white lies, which were later crucial to the insurance deadlines.

    3. Doctors get very busy, and they forget to check on you or walk away in the middle of simple procedures eg changing bandages.

    4. Some doctors are not meant to be in the medical profession, particularly if kindliness, humility and attention to detail are required. This is about a particular specialist who was obnoxious, overconfident (misdiagnosed after refusing to review prior history and just performing a simple physical exam) and caused me so much grief (lies => dropped insurance => forced to reveal medical condition to new employers to appeal for help =>lost my career => still wondering how to get a job and get insurance).

    Some doctors at the 3rd medical center where I was eventually treated commented that I could probably sue and live very comfortably …

  55. I’m agreeing with what Zvi, Roman, Adrian, BrooklynJon and Another Doctor said, and while I can damn sure understand throwing a punch when you’re angry, a sustained beating to “get results” really just comes across as the symptoms of the police state you’ve been reporting to us rubbing off on you. Yes, a genuine atonement is in order, because if you want us to believe you’re willing to assault someone when someone you care for is helpless, wronged and damaged, you would’ve gone to physically help those girls you heard screaming in the building at the police riots a few weeks ago. I recall you being justifiably and righteously emotional at that time as well.

  56. When we are going through the most trying times is when we need the most self control.

    The doctor was trying to do a good job, administering the right treatment in a situation with an extremely high risk of side effects, on a patient who was elderly, and therefore quite frail.

    Sandmonkey did overreact and is lucky not to be in jail. If I were his granny, when I was feeling well enough, I would march Sandmonkey by the ear to the hospital to issue a sincere and heartfelt apology to the doctor who he beat up (and who likely saved his granny’s life).

  57. The time when we need the most self control is when we are going through the most trying times.

    The doctor was trying to do a good job, administering the right treatment in a situation with an extremely high risk of side effects, especially because the patient was elderly, and therefore quite frail. Depite the complications of treatment, the doctor who Sandmonkey beat up likely saved his granny’s life.

    Sandmonkey did overreact and is lucky not to be in jail. If I were his granny, when I was feeling well enough, I would march Sandmonkey by the ear to the hospital to issue a sincere and heartfelt apology to the doctor who he beat up.

  58. Sorry for the near-identical double posting. Internet connect seemed to be faulty… Was just slo-o-o-o-w…

  59. BrooklynJon says:

    Nelle,
    It’s not you. We’re all sufferring with the slow posting of comments. Have faith!

    BTW, to those who have commented that there are a lot of stupid, arrogant, irresponsible, unprofessional and petty docs out there, let me be the first to agree with you. I personally went to med school a zillion years ago because I wanted to be a medical malpractice attorney and get rich suing doctors. My family has been harmed by negligent and arrogant docs, and then had the negligence covered up.

    BUT

    There are also those docs like me who are smart, caring, and (of course) humble. :-)

    So please don’t paint us all with a broad brush. Some of us are doing our best to do good but with imperfect tools. And when we, or our tools, fail us, the consequences are much, much greater than when someone in another occupation fails.

    And let me also assure those who think we’re overpaid, that given the cost of tuition, the fact that we don’t get our first job until we’re 30, and the typically 60-80 hours a week we have to work, if you actually do the math, you see that it’s never to your economic advantage to go to med school.

    PS, SM, I’m glad your grandma’s doing better. Buy the doc a fresh fruit basket or something.

  60. Thanks, BrooklynJon.

  61. This brings back some memories. A patient died on me once when I was an intern, the guy had an acute myocardial infarction which rapidly progressed to heart failure and there was very little I could do since his brother brough him in a long time after the initial attack. I did all I could to save the guys life, and still felt terrible after. Then this bafoon (the patients brother) comes to me and punches me straight in the face, I fell to the ground and he started kicking me in the stomach until some nurses and other patients intervened.

    Just a moment before I was trying to console myself so I could get on with my shift, and then this guy comes and all of a sudden I got the feeling that I’ve killed a person. I was overwhelmed with guilt (It was the first time a patient died on me). I cursed medicine and the day I decided to persue it as a career appologized to the resident doctor and headed out of the hospital followed by a couple of intern friends. We sat down in the cafe for half an hour and they knocked some sense into me, and I went back to my shift as if nothing ever happened. The senior resident reprimanded me for leaving my shift. It was a hell of a night.

    I understand the feeling of a person who’se lost or is about to lose someone and insuing anger and how he’d like to take it out on any one. But still most of the doctors I know do what they can.

    I’m glad I wasn’t a doctor at the hospital you took your grand mother to SM. May she recover soon Inshallah.

  62. SM,

    Ditto what #16 another doc said. Medicine is not an exact science–most treatments have risk involved and some have grave risks with unenviable odds. Until you earn some degree in healthcare or have to make difficult decisions about other people’s health, knowing all the inherent risks, you should not be jumping to conclusions out of emotion.

    I’m curious. If you mum is an MD then she knows about all this. What is her appraisal of this situation?

  63. So, never mind that life expectancy in Egypt is about 71 and your grandmother at age 94 has outlived nearly all of her generation or that medical care of the frail and elderly often present many unexpected difficulties. Even the best doctors in the world cannot perfectly predict the outcome of every part of prescribed care as the internal conditions of patients are subject to ongoing change.

    Your grandmother may have avoided death’s door many times over the years, but she is not immortal and no doctor can make that so. Assaulting doctors will not change that eventuality, neither did your assault on the doctor improve your grandmother’s health one jot. Get real, keep it real.