So you thought all doctors are the same…

Boris Metter
Guest Columnist

The Oath, a set of ethical principles derived from the writings of the ancient Greek physician Hippocrates, has been updated to put patients first. It aims to be a unifying force, superseding national, ethnic, religious and cultural boundaries by focusing on widely shared ethic values.

I was discharged from the Sarasota Memorial Hospital after staying overnight on Friday.

The night before, on Thursday, around 9 p.m., I felt a sharp pain in the chest, left arm and left shoulder.

Was it a sign of heart attack?

My wife Tanya taught pharmacology at medical school in Russia but it was not enough to qualify her as specialist in cardiology.

“Boris, let’s call an ambulance…”

“No, no way! Ambulance sirens along with sirens of police… All 15 floors of our building would be up… And what if I do not have even a mild heart attack? I will become a laughing stock…”

“The only way to find out  is to go to the ER. You do not want to call 911 – O.K. I will drive you. You are old, overweight; you have high blood pressure, pain in the chest, left arm and left shoulder… Your symptoms definitely do not qualify you for laughing stock.”

In the Emergency Department doctors and nurses were very attentive and helpful. I had an EKG, X-Ray; they took several vials of blood for the test.

They did not even waste time trying to verify my insurance (which for the record, I do have)…

A nurse wheeled my bed into a special room.

“You will stay here tonight, and tomorrow your heart doctor will see you and evaluate your EKG. He will decide whether you could go home…”

The following morning, Doctor F. saw me.

“Your EKG is O.K. There is no problem in “my” department”.  I’d have to see you some time next week…”

It happened that I received an appointment for Monday.

The door opened wide and Dr. F. appeared in the room. No usual greetings, like Hi Boris or – How do you feel?

No, no nonsense like that. The doctor was all business. All very imposing – almost six feet tall, wide chest, strong biceps visible under short sleeves of his T-shirt… tan – he looked like a captain in the French Foreign Legion or at least as a staff sergeant in the now famous Team 6…

“So, why did you go to Emergency Facilities at night instead of seeing your primary care doctor the next morning?” (He asked with the cold voice of an interrogator. Bedside manners? What manners?).

“Do you realize that your stay overnight at the hospital cost $70,000!”  ($70,000! Shame on me! How many hungry people could be fed on this amount! Maybe I took somebody’s bed who in fact had a heart attack – Although the bed next to mine was empty for the entire time.)

For your first question, Doctor, my wife and son — both of them were very concerned not knowing whether it was a heart attack or not —  they thought that the only way to find out was to go to the Sarasota Memorial Hospital.

Concerning your second question, Doctor, the short answer is – no.

We did not know the price of a one night stay in the hospital. To spend a night there was not my decision. I suspect that it was Standard Operating Procedure – when a patient presents with sharp pain in the heart and other risk factors (e.g. left arm/shoulder pain, elevated BP, cholesterol, etc), they always keep him overnight.

(By the way, in preparing this writing, I called the Billing Department. They told me that the charge was less than $2,000. But it still does not answer the question – should the one who feels pain in the chest immediately go to the hospital or wait overnight and only then see the Doctor?).

If Dr. F. knew the actual cost of my stay, would it change his grueling attitude?

Not to mention that there is always a correlation between the value of a patient’s life and the price to pay for it.

Does the doctor seriously think that I should go to the emergency room only when I do have a heart attack? Maybe it would be even less expensive if they would wheel the patient directly to the pathologist?  At least there, the heart attack could certainly be confirmed, skipping a couple of “middle-men.”

Wikipedia (although may not be the most viable source, the statistic certainly sounds believable) stated that only 11 percent of people coming to the Emergency Room were diagnosed with having a heart attack, while 18 percent died at home, never seeing the Doctor in the Emergency Room.

But of course, these are only numbers. I guess, their decisions depended on the ethics of their Doctors. Or the lack thereof.

Epicures, a Greek philosopher who considered happiness, or the avoidance of pain, to be the highest good, allegedly wrote an optimistic postulate–“ Patients are afraid of death more than of any illnesses. But while I am alive – there is no death. When I am dead – there is no me.”

A well-known Russian poet (in my translation) wrote :

I am not afraid of death,

Dying is what I am afraid of…

It brings an old joke to mind:

What is the difference between the Doctor and God? The answer is – God does not think that He is a Doctor.

It looks like some doctors have a clear borderline between Them (Doctors) – and us – mere mortals, patients. Up to the point of their retirement they adamantly reject that sooner or later they will become patients.

So, you still think that all doctors are the same?

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