Walking a Fine Line with the Patient’s Family Before Surgery

Dr. Jack Murano was sitting in his office with the patient’s family in front of him. Their father was in the ICU awaiting a complex heart operation. The older man’s heart was not good, and his cardiologists couldn’t do much more for him. Heart surgery was his last resort, and Jack was willing to do it. Risks were high, however, and had to be discussed with the family. He liked to talk to them in his office rather than in a crowded ICU waiting room or, what’s even worse, at their father’s bedside.

They were probably in their 40s, his son and daughter, overwhelmed by the ordeal their father was going through. Their mother was long gone, so the father’s health problems resonated even more. They were nicely dressed, but quiet and visibly overwhelmed by the circumstances.

Jack started by introducing himself, although there was no need for it. He said how long did he know their father and how good a patient he was. It was all designed to break the ice, he thought. They still looked nervous. The son was sitting deep in his chair and his sister was on the edge with hands folded on her knees. They both looked like they were ready for any kind of news.

Jack described the gravity of their father’s condition and the fact that all the other ways of helping him were exhausted. The only thing left was to do surgery. Short of that, his days were numbered. Surgery, however, in his situation was risky. Besides having a weak heart, he used to be a smoker and with diabetes the kidneys were failing too. Jack was trying to be as gentle as possible, but couldn’t hide the grave news. He gave proper percentages, explained, that so many things had to go right for their father, and himself, to achieve planned results. The chances for complications were high and, really, anything could happen.

“I cannot promise you that there will be no setbacks. But I can promise that I will be with him all the time. And I will do my best to get him out of the possible complications.” He thought he painted an accurate picture. He thought he covered all the bases.

“Do you have any questions?”

The siblings looked at each other and the daughter asked:

“But he will be alright, doctor?”

Jack couldn’t believe. He just spent half-an-hour explaining how critical the situation was and how minimal without being completely hopeless their father’s chances were.

“As I said, I can’t promise you. But I will do everything to pull him through the operation.”

They again looked at each other. And then the son spoke.

“When do you think he will go home?”

Jack sunk deeper in his chair. They didn’t get it. Despite being so methodical, he didn’t get through the fogginess of their stressed minds. How can they even give consent for their father’s surgery?

“We are not there yet,” he answered. “We have to get him through the surgery first.”

“So I have to notify my wife back home.” He was from out-of-state.

When they left, in the elevator coming down, son asked:
“Do you know what he was talking about?”

“Kind of, but I didn’t believe him.”

“Right, me neither. The last time we saw Dad was during Christmas, and he looked so good!”

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