Sometimes death goes unnoticed — even at a major midwest medical mecca. This was one of those times.
One morning, years ago in the midwest, a prominent business executive was in the hospital and complained that he could not urinate. He was the patient of a widely published doctor who also was the Chairman of the Department of Medicine. The hospital had a luxury tower — five-star accommodations and world-class medical care. When Elvis Presley had been a patient there for about one month, they closed an entire floor for his anonymous admission. The Chairman of Urology was summoned, but it took a while to discover that he was away at the time, keeping up his image as the TWA professor of the year -- so they found the Chief Resident to go in his place.
In the palatial hospital room, he found a private nurse sitting at a small mahogany table, refining her manicure under a small lamp. The patient’s wife explained how wonderful the nurse was because her husband had been out of pain ever since the private nurse had arrived. She fit the definition of a private nurse at that time -- short skirt, white stockings, heels, red lipstick, and loud perfume under a nurse's cap. Some private nurses are very good, integrate well with the hospital nursing staff, provide special care, and even take vital signs — this one had none of those qualities.
Except for the private nurse's loud perfume, the room was quiet and filled with fresh and abundantly fragrant flowers. For a moment, the Chief Resident thought he was in the wrong place — it felt more like a viewing than a consultation. He stepped over to the patient's bedside and, just like the man’s wife said, he was not suffering -- neither was he breathing. Fixed- dilated pupils and flaccid extremities told the story that this had been dead for more than one hour and less than two hours. And so it was that the Chief Resident found himself in a fancy hospital room with a dead VIP patient, a private nurse who had not taken vital signs for two hours, and the patient’s wife who did not yet know that she was a widow.
The Chief Resident excused himself and walked softly down the carpeted hallway to the nursing station, found the Head Nurse, and quietly whispered into her right ear, “I thought you would like to know that the patient in room 520 has expired.” Her eyes widened as she reached for the Code Blue phone, thought better of it, and quietly turned back to the Chief Resident for the rest of the story. After hearing the highlights, she concluded that there was no need for a fire drill — this man had probably been dead when the request for a urology consultation had been made over an hour earlier. Rather than leaving it to the Chief Resident to break the news to the internationally prominent Chairman of the Department of Medicine, a man he had never met, the head nurse volunteered that it would be better for everyone if she let the doctor know that his most prominent patient was dead. She knew that with a family of this stature, the Chairman would want to come to the room, show great concern and meet with the widow personally.
The Chief Resident recognized the brilliance in her suggestion and did not want to derail a good plan that protected the academic hides of everyone involved. He told the Head Nurse that under these circumstances, he was thinking about not leaving any notes in the medical record. She told him that would be a good idea. And so it was that he slipped away quietly without leaving a paper trail. Some things are better left unsaid -- at a major midwestern medical mecca.
Ever vigilant,
RT
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