Letter to my Dad's GP

[Sheri]

This is long guys, but I woke up this morning feeling the time was now to express my feelings. I'll print this out and mail it Monday, but please give me honest feedback first. Thank you in advance for all your support. Additionally, I hope this letter serves to help other people if you find your loved ones in a similar situation:

This communication is meant to be confidential for Dr. B:

Ronald S. Ott January 8, 1939-August 13, 2007

This letter is almost two years late; however as part of my grief process, the time has come to submit it. On November 16, 2004 my father was diagnosed with small cell lung cancer. As part of his treatment he underwent many chemotherapy cycles of Carboplatin and later Cisplatin. A common side effect of both of these medications is renal failure.

In June of 2007, my father was hospitalized before we had plans to take him to Indiana for cyber knife treatment for his skull metastasis. While hospitalized you injected him with insulin as you knew his kidneys were compromised and his blood sugar was elevated. In essence, he was diagnosed with Diabetes type II. When I asked you in the waiting room if we should take insulin on the trip you responded “no”, let him eat and enjoy himself. You mentioned his condition was terminal, as I was very well aware. In hindsight, you sent him off to die.

When my father first found out he was in renal failure, I asked him if we should tell Dr. M, his medical oncologist. His response was no, this is Dr. B’s “bailiwick”. In America, bailiwick is slang for a person’s specific area of interest, skill or authority. I question if his belief in your “skill” led to his demise. Our first mistake was the failure to refer him to a nephrologist as renal failure is not your specialty. My dad often mentioned how he felt sorry for you as you often displayed sympathy to him for his condition. When I expressed his thoughts on your sympathy to you, you responded: “He is the first patient I have had with lung cancer.”. My dad didn’t need your sympathy; he needed your medical expertise.

On Friday, August 4th of 2007, I brought him an apple pie with vanilla ice cream, his last meal. Saturday August 5th of the same year, we brought him to the emergency room where he presented pulmonary embolisms and progression of his lung tumor. You became involved in his care, told me intravenous Heparin attempts would be futile, he was going to die. As he progressed into his coma, according to your recommendation a feeding tube was also not a viable solution. I was desperate to save him, if only for a while longer.

Perhaps it was a higher intervention but as he lay in his coma for ten days, it never occurred to me to have his blood sugar checked. However, as his general practitioner, it should have occurred to you. I’ve often wondered if your father or loved one was in a coma, knowing he had compromised kidneys, if you would have taken this simple measure.

During the two and a half years he lived with lung cancer, I spent many hours researching for a cure. What I had learned in my studies is that people do not lapse in a coma with pulmonary embolisms or lung tumors. Two hours after his death, I asked my sister “why didn’t we have his sugar checked?” After his death this was a moot point. I have lived with the guilt of the apple pie, my failure to properly advocate for him and your purported incompetence. My only comfort is he died peacefully in my arms.

This communication is not to place blame. The perfect goal of this letter would be that you write back, tell me his blood was checked regularly during his hospitalization and his sugar count was within the normal range. This would assure me, I did not kill him with apple pie and you did everything possible to emerge him from his coma.

If the aforementioned goal is not feasible, it is my hope, you have learned from this experience. Please educate yourself on the treatment of cancer and renal conditions so no other family or loved ones have to live with tremendous guilt. Lung cancer is not always a death sentence. With adequate medical care, people can live with cancer for many years as a chronic disease. It is unreasonable to believe that dialysis or insulin during his coma would ultimately cure him but we could have had more time. Every second I spent with my Dad was a gift. As I mentioned to you in the waiting room, we are all terminal.

Sincerely,

Sher

[SandraL]

Hi Sheri. I think this is a great letter, late or not. It states the facts and does not necessarily lay blame. I believe doctors do not receive feedback often enough for mistakes they have made. And they need it, and sometimes even appreciate it. It helps them to put themselves in patients and family members shoes.

I have had more than one occasion to provide such feedback on my behalf. It not only made me feel better but was mostly accepted and in one case I even received an apology for comments I overheard by a surgeon while he was operating on me.

Hopefully, feedback such as yours, will aid in preventing similar mistakes and will give families more time with their loved ones.

I am so sorry to read about your dad. You obviously loved him dearly. Take care

Sandra

[Patti B]

(((((Sheri)))))

Your letter brought tears to my eyes. Your love for your dad shines through in each and every sentence of that letter. I do, however, feel so bad that you feel guilty about the pie - please do not place that blame on yourself.

I feel the letter is really good and hope that you DO decide to send it. I for one have had to tell my doc "I cannot turn the light switch off at 5 pm and go home - I have to live with this cancer 24/7". And he was SHOCKED that I said that!! I think all too often doctors and health care professionals need to be reminded that our lives and trust is put into their hands. They become way too complacent.

I truly hope that your dads doctor responses to your letter. Sheri, that letter may make him stop and think and help someone else along the way. And I also hope that it helps you to heal and feel better.

Hugs - Patti B.

[RandyW]

All I can say is Right on the Money!!! In hope it rings some answers and some closure to You Sheri.

[KatieB]

I think it's a very well written letter that conveys your feelings well.

Please keep us updated. I hope sending this helps in your grieving process.

[jstdzy]

Sher,

I think it is a wonderful letter and you should send it. As for your guilt, I too feel guilt at times over the death of my Mom. Could I have prevented it? Bought her more time? No one knows the answer to those questions. But I have to ask myself this would my Mom want me beating myself up over it? No she wouldn't and I don't think your Dad would either.

Dana

[Sheri]

Thanks Katie, for making the letter truly confidential for Dr. B. I don't know what I was thinking but I'm glad you were quick on the uptake. Duh, on my part!

Update:

I woke up this morning with second thoughts. I was going to soften the letter or not send it at all. However, Dr. B does have a website with a "contact us" form. Yesterday, before I posted the letter to this site, I did try to send the letter via their web form but when I clicked submit I would go to a "page cannot be displayed" site. Sooooo, I get an email today from the doctor asking that I give him my cell number. I guess he got it after all. So I don't know what I'm going to do now.

[jstdzy]

Sheri,

Maybe you'll get some of the answers you are looking for? Sending prayers your way!

Dana