Death of a patient

I was awakened this morning by a 6:30 a.m. phone call from one of my office nurses who asked if I had seen the morning paper. Obviously, I hadn’t. She said that Mr. Evans* had died in an auto accident on the way home from my office yesterday. I was shocked!

It is never easy having one of my patients die. I still couldn’t stop going over and over in my mind what I might have done differently yesterday when I saw him in the office even though eye witnesses to the accident told the police that Mr. Evans had pulled out in front of traffic. Only 2 months ago he had successfully undergone cardiac bypass surgery replacement of his aortic heart valve and a carotid endarterectomy. He also had diabetes although he didn’t take his diabetic medicines faithfully.

I had checked him over quite thoroughly yesterday and even recommended that he be hospitalized because his glucose level was quite elevated. He convinced me to let him go home after an extra shot of insulin and a promise from him that he would take his medicines faithfully. I thought he would be okay since his examination was normal and he had no signs of infection or ketoacidosis. I also made him promise to check his glucose level frequently and call me in the morning to report his condition. Maybe I should have called his wife to drive him home. We all second guess ourselves. I don’t think I would have handled his medical situation any differently, but I just wish there was something I could have done.

I called Mrs. Evans this afternoon to extend my sympathy. I think of these conversations as my most difficult job, but something I have to do. It doesn’t seem to get any easier over the years, but it’s good for me and the family. Mrs. Evans explained to me that her husband unfortunately often pulled out inappropriately at stop signs or stoplights. I still wish it hadn’t happened.