Wednesday, February 3, 2010

No Love For A Father

The nurse hung up the phone, shaking her head.

"I can't believe the nerve of some people," she said, clearly aggravated by the phone call. The phone call, she explained, was from a gentleman inquiring about where he should check-in when he brings his father to our ER in a few weeks.

"In a few weeks?" the nurse asked, making sure she heard right. She did.

The gentleman explained that they were moving their father from the West Coast back to our side of the country, to be closer to family, after the father's third wife recently died. The caller had heard that it would be a much quicker process for their father to get into an assisted-living facility if he came through the ER.

"Honestly, sir, that is not a reasonable expectation, unless your father is ill and needing treatment. We are an Emergency Department," she said, enunciating Emergency, "not a place to bring your healthy father for placement."

Her words fell on deaf ears. Around 1 a.m., almost two weeks to the day of that phone call, another one of our nurses walked into the nurses' station, looking incredulous.

"Get this," she said, "this family in Room 22 brought their father directly from the airport to our Emergency Room to have him placed in an assisted-living facility. And," she continued, "they're pissed that they had to wait three hours to get called back from the waiting room."

It was a busy night but, eventually, I was able to make my way to their room. Their story was somewhat familiar with me, but I wanted to learn more.

"Hello, folks," I said, introducing myself to the patient and his family, consisting of two sons and a daughter. All local folks. All dressed in sophisticated clothes and very well-kept. I tried not to be judgmental as I continued. "What brings you to our emergency room tonight?"

"How many times do we need to repeat this?" asked the one son, the obvious spokesman. And obviously obnoxious. "We need you guys to get Dad a place to live here in town."

"At this hour?" I asked, looking at my watch. "It's 2 a.m., I don't think that's going to happen, sir."

"Well," said the son, "we've been waiting since 10 p.m. It's not our fault that it's now 2."

"Even at 10, sir," I said, staring at the spokesman, "I doubt we would have been able to accommodate you." Turning my attention to the patient, I continued. "Sir, are you hurting anywhere? Do you have any injuries or health problems that seem worse to you tonight? Anything that warrants you coming to our ER?"

The patient shook his head no. It was obvious that this was not his planning. I looked back to the son and cocked my eye. He just shrugged his shoulders. After obtaining more history from the patient, I performed a thorough physical. It was stone-cold normal. Clearly, this patient was mentally and physically stable and the family was simply seeking a short-cut to finding a place for their father to live. Heck, he could even live on his own if he wanted to.

"So, just to clarify this," I said, looking at his three grown children, "you picked your father up at the airport and drove him straight to our ER, at this hour, to be placed in a living facility? Am I correct?"

They all nodded. "But all three of you live locally," I continued, "why aren't one of you opening your home to your father until you can get him into a local facility?"

"We were told by several people, including my family doctor," the son spoke, "that this was the easiest way to have Dad placed." Shame on that family doctor, I thought. "And if you can't get him in a place tonight," the son continued, "then just admit Dad until you can get him in somewhere."

It's hard to get a rise out of me, but these people were doing a darn good job. I took a deep breath and tried to clean up my thoughts of these people.

"Well," I said, looking between the patient and his ungrateful children, "unfortunately, your information is wrong. I'll call our case management team down to discuss the available options for your family, but your father has no medical emergency and I won't admit him for the reasons you want. What your father does have, though," I said, "are three children who live locally that could easily provide for him until an assisted-living facility is available."

The family just looked at me. And I stared right back, alternating between them. I wasn't going to blink first.

"Well, then," the spokesman said, "can you call the case manager down to talk to us?"

I walked out of the room, disappointed in this family's dynamics. I'm sure there was more history between this father and his three kids than I was aware of, but pick-up your father from the airport and bring him right to the local ER to dump him off? I would be ashamed of myself. Why even bother bringing him back here to live if this is how it was going to be?

Our case management team came down and, sure enough, were unable to place this patient directly into an assisted-living facility. The soonest they could arrange for his placement was in three days. Three days? People waited months for placement into a facility, and this patient would be there in three days. I guess it was a good shortcut for this family, after all.

"Three days?" said the son, "what kind of system is this? We can't wait that long. Do we have any other options?" No other options, said case management. No other options, said the nurse. No other options, I said.

The patient got dressed while his family grimaced and glared in our hallway. I seriously think they entertained the idea of leaving quickly without their father, but I kept my eye on them. I was ready to chase them down if they tried such a thing. I knew, just from observation, that they weren't above such a thought.

I have three kids of my own, and I shudder to think where a man could have gone wrong to get this kind of treatment from his own children. Did he spoil them? Did he wrong them so significantly that their refusal to take him in was justified? Or were his kids so caught up in their own lives that they had little time left for their father?

Regardless, the patient went to live with the spokesman son for three days. Three long days, per the son. I could only imagine, though, just how long those days would be for a father who felt no love from his family.

As always, thanks for reading. The next post will be Friday, February 5. Until then, if you haven't yet voted, go to Medgadget Medical Weblog Awards and vote for StorytellERdoc in both of his nominated categories. Your support and votes are appreciated! Big thanks!


Anonymous said...

That is appalling!
I am sympathetic to not wanting to house a parent, but there are other options than what that family did.

AfterGirl said...

Wow, I really can not imagine doing that to my parents. My parents live with me in perfect harmony. So sad, and indeed why did they bring him to their area where he has no friends and obviously no family?

sara said...

This post kills me! OMG! I cannot imagine how warped this family is on multiple levels... good for you for now blowing your top!

Elizabeth said...

That is so sad.

Did you find out who the doctors are that are recommending coming through the ER to be placed in a facility?

terri c said...

I'm sure, as you are, that there is more to the story than what they told you. The father could have been unspeakable in many ways that are not apparent. It sounds as if he was well enough to be in a hotel for a couple days? In any case it's a heartbreaker and well written indeed.

rlbates said...

So very sad.

Jacqueline said...

That made me so sad :(

Heather said...

And yet, it's so common...

The worst part is that as medical professionals, we take an oath to be non-judgmental. You did a fabulous job.

coulrophobic agnostic said...

Wow. Just, wow. My dad just died a few weeks ago at the FAR too young age of 62, and I would fucking give anything to have him back and living here again. He wasn't a perfect parent, but he was still my dad. I would trade places with these people in a second.

...sadly, I suspect they might switch places with me if they could, too.

I mean, shit. He's your DAD. You're not going to have another one.

Nature Nut /JJ Loch said...

WOW. This would make a great novel. I wonder how all of those children came to act like this. Must be quite a history.

My hubby and I have parents in their 80's in various states of physical conditions and we are blessed to still have them with us.

Blessings, JJ/Nancy

NurseExec said...

In our SNF, we have many residents whose children live locally, but never visit. We, their caregivers, become their family. I often wonder why their children never visit. What was so horrible that they abandon their parent forever?

Classof65 said...

My first husband was a sociopath who abused our son and me physically and mentally. I no longer waste my time detesting him, but my son is still angry at his father and has not spoken to him for decades. There is no way he would even want his dad to live in the same state, let alone in his house. My son has been in therapy for years trying to overcome his abusive childhood...

My ex can be quite charming if he wants to be and I'm sure people of short acquaintance think he's great, but they do not know him as we do. Even his brothers and sisters do not trust him or like him. You can't judge a book by its cover.

coulrophobic agnostic said...

I'd be more inclined to think positively of these people if they hadn't taken him to the emergency room in the middle of the night to get him placed. Something about that just screams "entitlement complex with no regard for others." And even if the guy WAS the biggest asshole in the don't do that to the freaking ER staff, and you certainly don't pitch a fit over having to wait hours to be seen.

Tonjia said...

I am sad, but not surprised. I remember the days, before DRG's when families would dump their elderly family members off in the ER on holidays and during vacation time. What a shame that these ungrateful people would humiliate their father like this.

Sometimes I really dont like the human race. I would rather work with dogs.

Tonjia said...

oh and for the record... I dont know where your ER is, but here in western Colorado, our local doctors send
patients to the ER for a plethora of ridiculous things.

Just had one in today who was sent on by their family doc (who just saw them in the office 3 days ago) for the complaint of "feeling weird" for 7 months. Did he tell his PCP about his weirdness 3 days ago? yes he did. Did his PCP do anything about it? No she didnt.....sigh

Rogue Medic said...

As long as there are people like these, we will need prisons.

Dr. Mongo Lloyd said...

Those...things aren't what I'd call "people." The phrase "human debris" comes to mind.

Cathy said...

That is as sad as can be. It makes me want to bring him to my home.

Peter said...

Hi! This story is pathetic but I'm happy the way you sorted them out.

Mind you, I wouldn't be surprised if this man's ungrateful children complained; if only I was there to deal with this, as surely they'd be shown the front door!

Take Care,

Jen said...

I admire your restraint- it must be very difficult to remain outwardly non-judgmental at times. They could well be the children from hell, but he could have also been a monstrous person. I've known enough people who were so badly abused by their parents that they wouldn't give them a piece of bread if they were starving to death, so without knowing the entire story remaining as neutral as possible is probably the best way to play it.

That said, if he was that bad, why on earth would they bring him across the country? And I'm not at all surprised that a family doctor told them to take them to an ER for a placement- regardless of whether it's right or not, it's often the quickest way to get a solution.

t. said...

Infuriating. Galling. Stunning. Sad.

Sadly, the "pop drop" as it's called in my hospital is fairly common here.

Shame on these children. I hope they get NOTHING in the will.

It's this horrific social side of medicine that hurts my heart and soul the most.

GOOD FOR YOU, Doc. I only wish you could've beat them soundly about the head to knock some sense and compassion into them.

SeaSpray said...

Very sad.

Cal said...

This is a sad story and I was thinking that it makes no sense. Why move him across the country to then drive him to the ER from the airport? If you cannot stand your father enough to have him stay at your house, not even for a few nights, why make him move in the first place? And preferring to have him being admitted over hosting him at your home is bewildering. Is a hospital the new hotel? (Hospital beds suck!)

911RN said...

Ahhhh, human nature and the plight of family dynamics. Never ceases to amaze!Just had the flip side of this sad tale (in our ER) with a Mom that had been caring for her profoundly, severely, developmentally delayed,totally immobile, dependent, non verbal son for 23 years. Could see the weariness in her eyes, the fatigue in her body and the sadness in her with the overwhelming responsibilities to his care. If there was anyone that needed respite care it was her... but the love was so overwhelming that she never once complained.Would NEVER think to ask for such a thing! Both Mom and Dad were devoted and doting to "child" that had never been capable of "giving back." Now, that's LOVE! The folks from Dr Jim's story have obviously never known this kind of heartache or devotion to the human condition. Most likely never will...too shallow and too preoccupied with their own needs first.

limeso said...

typical case on 23.dec

Beth said...

The flip side ...

A friend's father-in-law was a convicted pedophile. He had molested his two daughters and several of their friends as young children. Her husband's mother had divorced him when one of the young friends came forward and he was convicted. It took years of therapy for her husband & his sisters to recover from what their father put them through.

My friend had two daughters about the age the girls had been when they were molested, when the father/grandfather reached a point at which he could no longer live on his own. He begged his son to allow him to stay with them "for a little while", until he could get an assisted living or nursing home placement.

After much discussion, they refused. The chance that he would harm their daughters during that time was to great to risk his presence. Instead, when he showed up, they took him in for an evaluation at their ED (their family doctor wouldn't take him as a patient), and he spent 2 days in an inpatient bed, then moved to a nursing home. Had he not been admitted, she was ready to tell him to go live on the street.

After watching her anguish over the situation, I can't judge any more. I don't know the back story to anyone's decision.

Anonymous said...

Don't be so quick to believe that people were told this or that by their family doc/internist/peds. I am one of those docs and roll my eyes at some of the crap that my patients tell the ED doc when they are in - "my doctor said my baby can absolutely NOT have soy formula" - "my doctor said I needed to come in and get my OxyContin here" - um, yeah, SURE I said that.

That being said, I know there are others out there who abuse the ED - not all of us do, though.

Anyone who is dumb enough and so entitled as to bring someone to the ED to be admitted into an assisted living facility isn't probably the best source of information. So sad - I worry the dad would be abused or mistreated by his children.

Maha said...

I can't imagine what the father would have done to warrant such humiliating treatment from his family. My parents and I drive each other mental most of the time but when push comes to shove we all know that we'd be the fiercest fighters for each other.

Happy Vegemite said...

I used to work as an OT. I had one patient in the hospital that was ready for discharge. Daughter felt that he was unable to live alone any longer, even despite the fact that he had a housekeeper that came daily to help with housework and meals. And despite the fact that as an OT I could have arranged for someone to come in daily to help with showering.

So when our hospital discharged him, she booked him into a private hospital as a respite patient because she didn't want to care for him at home.

The reason why she felt that he could no longer live in his own house alone - anxiety. Yep, he could dress himself, care for himself, and even make his own coffee, but he would be too much trouble for her if she had him live with her while he was on the wait list for assisted living.

Should my folks get to the point that they need assistance, but not nursing home level care then I intend on moving to their locale (which is Canada, and I currently live in Australia), to be able to assist them. They have helped me with so much in my life that I feel it is only fair that I help them out too.

Anonymous said...

This speaks volumes about the US health care system and how society is becoming disillusioned by it as well.

mommy-medic said...

I love how lack of planning on their part means it's an emergency for everyone else. I bet they didn't even buy the plane ticket in advance either....