"Good" Patients and "Difficult" Patients Rethinking Our Definitions

A physician-daughter accompanies her physician-father to the hospital when his blood pressure plummets weeks after bypass surgery. She suspects internal bleeding, but the ED team apparently doesn't. Lest she be deemed difficult, she performs a rectal exam herself. Four weeks after his quadruple bypass and valve repair, 3 weeks after the bladder infection, pharyngeal trauma, heart failure, nightly agitated confusion, and pacemaker and feeding-tube insertions, and 2 weeks after his return home, I was helping my 75-year-old father off the toilet when his blood pressure dropped out from under him. As did his legs. I held him up. I shouted for my mother. As any doctor would, I kept a hand on my father's pulse, which was regular: no pauses, no accelerations or decelerations. My mother was 71 years old and, fortunately, quite fit. She had been making ...