I, a senior internal medicine resident at that time, who admitted my close friend to our hospital, was watching him struggle with not just that out of the blue, serious, very severe pneumonia, but also with what we — his physicians — are doing to his body.
Five major changes in his antibiotic regimen in just 24 hours. 13 different drugs.
Three different — potentially fatal — underlying diagnoses that were contributing to the severity of pneumonia. In the end they all were wrong. It was just a severe pneumonia in the context of his underlying asthma.
No one wanted to miss anything. Everyone was scared as hell to be wrong. Every attending was overcautious.
Volume-driven medicine was everywhere. More drugs, more orders, more tests.
He himself was a physician. A physician who just finished his training in this very hospital. No one wanted to be responsible for the death of this young good-looking doctor whom everybody liked so much.
I stepped aside, decided to be just his friend, to be there for him in the ICU, and tried to mitigate this VIP syndrome that was killing my friend faster than the pneumonia itself.
A pneumonia that in every other patient in this same hospital was going to be treated with a broad-spectrum antibiotic in a straightforward manner.
He was lucky, really lucky that he survived both pneumonia and his physicians who were far away from “first, do no harm.”
And now, exactly 2 years later, I, as an attending physician in that same hospital, am treating another patient with pneumonia whose children – who are physicians themselves – are doing exactly the same thing.
They just don’t see what they are doing to their father. Every day I explain, and every day they do the same again.
As a last resort, I told them today: “I don’t want to be part of this game. I almost lost a very close friend to this, I don’t want to go through the same thing with another patient. It’s your right to choose any physician for your father. But if you want me to be his physician, please stop interfering with the treatment.”
And just a couple of hours later, same old story [or as we say in Persian: Again, the same soup and the same bowl.]