Wednesday, February 15, 2006
Off my game
Did my first "ask" yesterday since I've been back. Didn't go well. It was worse than a no would have been, because the family was noncommital-they wouldn't give me a straight answer. To make it worse triage sent out the orientee to watch me. And she's great! The type of person who, immediately after meeting, you want to be just like them. Good personality, lots of energy. I felt unkempt and uncouth next to her and didn't even blame her for felling that way.
Probably it wouldn't have made a difference how I asked the family, but I felt very passive when I did it. And they were very passive about giving me an answer. There was a culture thing, too, going on. They were not from the US originally. They kept saying,"He's not healthy enough to donate." Over 2 days I tried 3 times to get an answer but they just wouldn't give me a yes or a no. Finally, they just shook their heads no.
Last week I spent 2 days on a case and the patient coded(see "Like Wading Through Taffy"). Then I had 2 days on a case I was SURE the family was going to say yes. At the end of the second day they said no because they felt that if the patient wanted to donate, she would have told someone, because that's the kind of person she was. Since she had never mentioned it, they felt she didn't want to donate and they wouldn't go against what they perceived to be her wishes. I mean, there's really no debate when it comes to following the person's last wishes. It's not like they had a skewed conception of what donation entailed, like people who think we're gonna mutilate the body or that they have to pay for it, etc.
I'd be lying if I said my pride wasn't hurt. Dammit, I should be able to get a consent, at least one out of three, not 3 swings and misses. It's not about me, though, and that's where the guilt comes in. In "It's a Wonderful Life" Zuzu says, "Every time a bell rings, an angel gets its wings." In my job, every time someone says no, another person dies. Today, that responsibility hit me hard. What could I have done different? How could I have gotten them to say yes? Then I'll have the Monday morning quarterbacks telling me what I should have done differently (pride, again). One of my coworkers put it succinctly. The people that need organs can't come and tell families how badly they need that organ, so we have to speak for them. I just wish they'd all say yes.