Stories from the Stethoscope: April 2021

Early into my private practice career, I received a call from the Emergency Department. A new patient who was scheduled to see me the following week was just diagnosed with a heart attack. I accepted the admission and headed to see him. Mr. Johnson was currently pain-free but not doing well. As we began to get to know each other over that initial hour, I learned a lot about him and his family. He just moved to the area from Vermont. He was retired and moved into a beautiful retirement community that just opened in the area. He chose this facility because he is the sole caregiver for his wife. She had significant dementia and needed close observation. He planned to spend his remaining years with the love of his life in a protected environment. She still remembered who he was but did not remember anyone else. He then shared that he had a significant heart condition and ran out of his medication. He had not taken any medication for days and was waiting for his appointment with me, the following week to renew his prescriptions.

As we talked, he began to understand the gravity of his decision. He became emotional about his wife. He could not comprehend how his wife would cope without him over the next few days. Unfortunately, his status deteriorated. The lack of protective medications for his heart caused significant damage. He was transferred to the intensive care unit and unfortunately, he died a few days later.

This preventable death had devastating consequences. His wife deteriorated quickly. Without the love and emotional support of her husband her dementia rapidly changed. Within a month, she needed to be placed on a locked dementia unit with close nursing oversight. She passed away soon after.

I have shared this story with patients countless times over the years. I tell all my patients that they should never run out of medication for their blood pressure, diabetes, and blood thinners. Even if they are overdue for an appointment, I will prescribe a few days at a time to ensure they come to the office and do not miss their therapy. Yet as I have matured the lessons from this story have grown.

We need to plan and think about the variables we can control. Taking your medications is one of them. How do we ensure we take all the steps needed to keep ourselves healthy? I cannot help thinking about all the time, effort, money, and energy that went into planning their move. Did they enjoy each other and embrace the moment of now? Or did they wait for the next phase of life to really enjoy themselves? Was tomorrow supposed to be better than today?

We spend so much time putting off gratification for reasons that many times do not make sense. The pandemic has only made this more obvious. I was finally able to see my parents after 20 months. It was much-needed therapy for all of us. (I am emotional just typing these words.) I have also begun to call friends I have not talked to in a long time while I drive home just to say Hi and share a laugh.  We need to look for those opportunities to smile and embrace them.  Don’t put them off.

Thank you, Mr., and Mrs. Johnson for letting me share your story about the value of taking your medications to minimize harm. I also want to thank you for allowing your story to grow in value with me, as I will continue to work towards reducing all the opportunities in life that I shouldn’t go without.