A few weeks ago, a lady was admitted under my unit’s care and co-managed with the general surgery unit. We were looking after her medical issues, clots in the lower limb, while surgery looked after her surgical issues, acute limb ischaemia. She was a special case, and one that I will probably always remember, because she refused to have surgery on her dying limb.
She was at a point where she required an above knee amputation as the cells in her left leg were quickly dying and turning black and she was refusing the surgery. Her family also didn’t want her to have the surgery. Their reasoning hit me in a way that I’m sure hit all the other doctors in a very different manner. They wanted to go to a herbalist for her treatment.
It’s a particularly difficult predicament when you want to respect the patient’s wishes while wanting to give them the best treatment you know there is. When the best treatment you can offer is the one the patient is declining. She wants something else…something completely unknown to you. Worst of all, she wants to leave the hospital to seek out such treatment. My registrar had a 30-minute conversation with her about the risks of leaving hospital care, the risks of her medical condition, and the risks of leaving her surgical condition untreated. She was young, nearing her 50s, and, understandably, she wasn’t ready to lose a leg.
In the end, we couldn’t change her mind. She self-discharged against medical advice and sought out an alternative treatment.
In the minds of many allopathic practitioners, this lady must appear to have made a most ridiculous decision. In every way imaginable, it does seem like it. What she chose to do posed an incredible risk on her life. For me, I felt sad. As I stood by and listened to the back and forth between registrar and patient, I couldn’t help feeling that way. Sad because I wished there was more we could offer her. I wished she had every available treatment in hospital. I wished I had the knowledge to give her all the information she could have.
She promised she would return in 2 or 3 days if there were no improvements. We never saw her again so we don’t know what her outcome was. Maybe things worked out for her. Or maybe things took a turn for the worse. I have no idea. I can only hope that she and her family got what they sought out.
One day. One day I’ll be the kind of doctor who has a better handle of all sides of the healthcare wheel. Integrative Medicine has so much more to offer people. One day.