Thursday, December 27, 2012


  As I said in last blog , I often see patients who are sick , or remarried or have complex family issues . The story that I am going to tell is not unusual, but was unexpected in this family , at least I thought so .
   I saw this 78 years old patient for allergies and asthma . He was fairly stable , except when he would get bad sinus infection . Then he would get lot of coughing and fever and even shortness of breath as he also had mild asthma . He was OK but then his healthy looking wife was diagnosed to have brain tumour and then continued to get worse . She died in very short time . It was a shock to him and me too. He had a friend and she helped him during his wife's illness .Within short time after his wife died ,he married her .She was same age as him and was married twice before . Her both previous husbands had died . She had no children of own . They were married and then both of them continued to come to me .As he got older , his health continued to deteriorate . He was diagnosed to have Parkinsonson's disease and then congestive heart failure . He was getting more short of breath. He was 84 years old and was not a candidate for any surgery . The new wife had sleep apnea and mild asthma .She was doing quite well . . But he was not well. I had admitted him few times and even when he came for follow up , he was unable to walk much without getting short of breath .
I had talked to them about respirator and CPR and other things , like 'life support '. He had told me that he did not want to be prolonged , but wanted to "give it a try .". This is always very difficult as doctors don't have 'crystle ball to know ' as to what is going to happen in future.
     Then it happened .He was admitted to the hospital with shortness of breath . He was in ICU. I saw him and talked to him and his wife . We decided that we wanted to do everything for now . In next hour or so he was put on respirator .He had pneumonia and congestive heart failure . The new echo cardiogram showed that his heart was quite weak . In next few days he continued to go down , with problem with blood pressure and urine out put and then with oxygenation . I was talking to the wife , who was medical power of attorney . I was not aware of any children . I had not seen any one even when his 1st wife died ,so I was surprised when I got a call from "his son". I talked to his current wife to whom he was married for  atleast 6 years . We were talking of withdrawal of life support as he was not doing well and he did not want to be just left alive if there was no hope . She agreed and then I got the phone call .The son wanted to come before he died . When I talked to the wife , she told me that this son had never called or kept in touch except when he wanted money . Over period of time he had given him thousand of dollars with the promise that he would return and he had never returned any . We postponed the withdrawal for one day and when the son arrived we ended up doing the withdrawal of life support . He died in less than 15 minutes .
      The son was quite mad that the father had left nothing to him in his will . He tried to challenge it and nothing got changed . He called me and wanted to know if his father was in 'sound mind ' I do agree that I have only one side of the story , though I feel that it is quite accurate . I am not sure where was the love . I do believe that the marriage was due to necessity and I do believe that the 'love ' did develop latter on , but I don't think that that the son had any love , other than for his money .

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