Rule No. 1
As doctors we try to follow at the minimum one rule: First, Do No Harm. So it was especially tragic for me when I received a phone call today telling me that Mr. E had died.
He was a 95 y/o man whom I cared for during the week on the medicine floor. He had severe dementia to the point of being nonfunctional. He had severe congestive heart failure and a host of other debilitating conditions. He wasn’t able to move around and was pretty depended on machines and family for life.
After some time in the CCU, he was stabilized and sent to the medicine floors to prepare for discharge. After evaluation, I believed he was relatively stable and that there was nothing more we would be able to do and had discharged him the following day to go home with his family.
Two days later I find out he died the following evening. His family, when I met them, had expressed their wishes that he die in his sleep and that he that his suffering would end. Part of me is happy for him and happy for them.
Still, there are the doubts and the guilt that plague my conscience. Could it be that in my hastiness I broke Rule No. 1?