The hospital lights were dimmed; the sounds from the hallway were hushed: Whispers; swishing sounds from cotton scrub pantlegs that covered hurrying legs; squeaking from rubber soles; snippets of television programs from other patient rooms. In the private room where I sat at my nephew’s bedside, holding his hand, the tv was off. It was well past midnight, and he was still tossing about and moaning with pain. For as long as I had been with him that night, he had received no pain medications, yet the family had been told that the doctors could do no more for him – the cancer so recently diagnosed was going to take his life. He was 32 years old.
“Marylee, PLEASE, do something!” he cried out, crushing my hand in his agony. I promised that I would, and went out in search of a doctor. I was grieving, angry, and definitely not willing to be put off with a pat on the back and sympathetic words. I saw a resident who had been called to the floor for another patient, and stopped him. “Why is (my nephew) not receiving any medication for his pain?” I demanded to know. I was told that the doctor knew his case well, and “they” had determined that because they needed to prevent him from becoming addicted to the morphine, he was being given a milder, less addictive medication.
In my memory, I see my hands grabbing and wadding up the lapels of his lab coat, pulling him face to face with me. Since I was not arrested for assault, it probably was what I desperately wanted to do, and that memory is stronger than what actually took place. I clearly recall my words, because they haunt me to this day. I spat them out, nose to nose with the doctor, one pain-filled word at a time: “He…is…DYING! It doesn’t matter if he becomes addicted, it only matters that he not spend another second in this pain when you can stop it. DO…IT…NOW!”
He appeared stricken, momentarily at a loss. Then turned on his heel, walked to the nurses’ station and wrote something in a chart. Within minutes, my nephew was receiving the pain relief he needed.
I believe it was later that night, but the memories begin to run together past that point. I do treasure a conversation we had in the early hours of one morning, when he was resting comfortably enough to talk. He told me that he most hated the fact that he was not going to see his little two-year old boy grow up. We spoke of that for some time, then he said “I have lost all of my choices. I have no control over my life anymore.”
Even at that point in my life, I had enough experience to know that this was not true. I talked about that with him, ending with “no matter what happens to you in life, even if all your other choices are gone, you still can choose your attitude, the way you want to think and be remembered by those who love you.” At his funeral a few short weeks later, his colleagues, friends and family were talking about what a blessing it had been to visit him in those last weeks. How he had inspired them, and touched them with his loving and brave living of the final moments of his life.
None of us – family, friends, or George himself – would have had those treasured moments had he not had surcease from pain enough to deal with the things that were important to him.
In the years to follow, many state and Federal agencies with regulations regarding opioid therapy would suspend these rules in cases where allowing a patient to live and die with dignity was the greater good. Other regulations regarding dispensing of opioids and pain medications would continue, and efforts of the FDA, the AMA and individual physicians would provide for relief for those who needed that assistance in order to cope with the challenges of living with pain.
Dr. Baldi is unfortunately only one example of those who are being charged with murdering patients who OD on opioids. What is so striking about this case is that the prosecutors went ahead with this trial, demanding a death sentence IN THE FACE OF THE FACT THAT AUTOPSIES ON ALL SEVEN PATIENTS SHOWED THAT NOT A SINGLE ONE OF THEM HAD ANY MEDICATION IN THEIR SYSTEM THAT HAD BEEN PRESCRIBED BY DR. BALDI!
I am relieved that the jury consisted of people who possessed enough reason to find him not guilty on all charges. I am only surprised that it took them two days to come to this conclusion. Still, it is a travesty of justice – a betrayal of the very meaning of the word – to destroy a man’s life because of a political battle between politicians and physicians as to who is best suited to prescribe patient care. As recently as the year of my nephew’s death it was still illegal to practice medicine without a license, yet today insurance companies and politicians feel free to make these untrained and unenlightened decisions free of any sanctions. Physicians, on the other hand, are finding it more and more risky to practice medicine.
A Death Penalty, because your patient took too much medicine (which you did not even prescribe for him). Really??? What about parents who carelessly leave guns and ammunition where their adolescent children can take them and destroy their classmates and teachers, or their siblings, or neighbors? Oh, that’s right – It isn’t their fault what other people do with the weapons they provide, or at least that is how it appears.
It is true, though, that if I fail to follow directions provided by my physician and abuse the drugs he has prescribed for me, or any other drugs, it is my decision and mine alone. He does not bear the guilt for what I choose to do.
What about patients who do not OD on medication, or who do not abuse their medications in any way? They, too, are suffering because of the misguided “war on drugs” that has become a “war on physicians” as well as a “war on patients.” Why patients? Because more and more physicians are becoming too wary of being singled out for punishment if they prescribe the pain medications their patients need. And it is not only law enforcement that threatens our physicians – not long ago a beloved physician in Kentucky was murdered by a drug-seeking patient. It is not easy to be a physician these days. Some doctors have told me that they have begged their children NOT to go into the profession of medicine.
Let’s look at the real problem here. Addiction is real. Drug-related crime is real. Drug cartels that launder their profits and use some of the “cleaned” money to support politicians of their choosing, are real. Even people with MD degrees who misuse the privilege and set up pill mills are real (I refuse to call them physicians). There are solutions to all of these problems, and none of them include punishing real physicians to try to make political points.
If you want solutions to these problems, work with the people who know what they are doing, and find the answers. It will take guts and determination, but it can be done. Meanwhile, if you really must destroy someone, make certain that you aim for the guilty party.