The problem of medical staff failing to treat patients respectfully is a very old one. Eventually, many doctors and nurses just get used to seeing it. The first time you see it, though, it makes a big impression on you. I can still remember the first such incident that I observed. It has stayed with me for more than 25 years.
I was in the first weeks of my general surgery rotation at a small suburban hospital. The chief of surgery used to take the medical students around to see the patients. Mrs. D. was a middle aged woman suffering from a severe complication of alcoholism, distended and bleeding blood vessels in the gastro-intestinal tract.
Mrs. D. was scheduled for surgery and the chief told us that the surgery was very complicated and the chances of survival were small. The odds were high that in the aftermath of surgery, because of the fragile state of her damaged liver she would be progressively poisoned by waste products from her liver and never regain consciousness. I had this in mind when the resident called me to observe him putting in a central line prior to surgery. A central line is a monitor placed inside the heart after being threaded down an IV in the neck.
I pressed myself into a corner where I would be out of the way. The central line placement was difficult and the resident struggled over and over again. He was sweating and everyone in the room was tense. I could not see the patient’s face from where I stood. It seemed that Mrs. D. was incredibly stoic as she was stuck in the neck repeatedly. Eventually, her voice emerged from beneath the drapes,
“I’m sorry, but I have to pee.”
The nurse looked at the resident, and the resident shook his head no. He was already frustrated and he did not want to stop to let the patient use the bedpan. So the nurse told the patient,
“Just pee in the bed. I’ll clean it up later.”
I was shocked and evidently Mrs. D. was, too. Was it really that much trouble to take a few minutes to let her pee into the bedpan? The patient said she would try to wait.
Again the resident was unsuccessful and again Mrs. D asked for the bedpan. This time she was pleading.
“Please, I don’t want to pee in the bed. I’ve never had an accident before. Please, please just let me use the bedpan.”
By this time, no one was interested in the patient’s distress. She wept as she eventually peed into the bed.
“I am so embarrassed,” she kept saying over and over again.
It only took a bit longer and her central line was finally placed. She was wheeled off to the operating room, weeping. The surgery did not go well. She survived, but she never regained consciousness and died a few days later.
Mrs. D.’s last conscious thought had been embarrassment because no one could be bothered to give her a bedpan. She was going to her death. Everyone in the room knew it, but no one cared enough to honor her dying wish for a simple bedpan.
