One of my partners recently took care of a child with a retro-pharyngeal abscess.  For the non-medical, this is a serious infection behind the throat that can easily result in loss of an airway.  The child, some 20 months of age, was obviously very ill.

We frequently don’t an have Ear Nose and Throat physician on call at our hospital, and the night that child presented was typical.  So, the only viable option was to transfer the child.  However,  when my partner tried to find an ENT surgeon to care for this child in a nearby town, he was met with this response:  ‘I’m not on call for your hospital.’

Now, I understand not wanting to have ridiculous referrals.  I understand not wanting to increase your already busy workload.  I understand that being a surgeon is very time intensive already, so the doc in question probably didn’t need more work.  But the thing is, it wasn’t a drunk with a broken jaw, an elective tonsillectomy, or even a fish-bone stuck in the throat.  It was a child who might have died.

Well, I guess Hippocrates didn’t cover that scenario.  You know, sick child from another town.  After hours, and all that.

Is this how far we’ve fallen?  See, we don’t have endless options for transfer.  We practice in a semi-rural area.  It isn’t Manhattan.  There aren’t surgeons on every corner.  Trust me, if we could have handled it, we would.

Is this what doctors have become?  Technicians who feel no sense of urgency or obligation to the sick, in fact, to the most vulnerable of the sick?  Is this how we want our children, or grandchildren, treated?  Dismissively?  With a ‘good luck’ and a hearty pat on the back?  With a ‘sorry, but you know how business is these days?’  I hope to heaven not.

That sort of behavior makes me feel angry, and a little sick.  It makes me see how malpractice litigation could get out of hand, or how national health care might slip in the back door.  If we’re so unprofessional that we can ignore a critically ill child on a technicality, then maybe we’ll deserve whatever happens.

Fortunately, the overwhelming majority of docs I know would never behave that way.  Like the intensive care docs who ultimately accepted the child, they do the right thing at the right time, the way we were taught.

We need to call this behavior what it is; childish and unprofessional.  And we need to remind ourselves, every day, of why we do our jobs.  And that we have a duty to the sick and injured, convenient or not.

And we need to remember the words of scripture:  ‘Be careful to be kind to strangers, for in so doing, some have entertained angels without knowing it.’

Have a great weekend!

Edwin

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