Monday, July 29, 2013

The Doctor's Dilemma

I was speaking with a friend about Downton Abbey and Lady Mary Crawley's dilemma with the Turkish gentleman who, given his age, must have had a fatal arrhythmia during intercourse. It reminded me of a similar, little known , but celebrated circumstance in Lotus City in the mid 20th century when I began practice there. The city was very small at that time and medical practices were both tight and longitudinal so families were often attended by the same physicians from cradle to grave. As a result of this, patient and doctor loyalties were high. The doctor of whom I speak, attended, for years, two carriage trade families who lived in the same neighborhood as him. One night he received a midnight call from the wife of a prominent business man, in a panic, that a friend of hers had died in her bed. The man who died, a lawyer, was also the doctor's patient, a widower who had enjoyed a meal, and later, congress with the lady since her husband was away on business. Unfortunately good living had rendered the older lawyer somewhat unfit for such action. Faced with such a situation and the eruption of scandal involving two of his patient's families and also their issue, the doctor's dilemma arose. The man had clearly had a heart attack at the time. As a result the doctor and the lady, fueled no doubt by adenaline, carried the man to the doctor's car and transported him to his house and put him in his own bed with new pajamas and tucked him in. He then made a house call in the morning and called the coroner. The question of course is, what was the moral imperative that contended with the legal requirement of the doctor? A physician has a duty to the country, his colleagues and to his regulatory body to obey the law. He also owes a duty to the welfare of his patients at some cost, if necessary. He risked his medical practice by illegal transport of a human body from the place of sudden death in order to cover up the truth. However, dead is dead and a bed is a bed! What was the harm? It would have been easier for the doctor to avoid criticism by a self- righteous tack.  He took a chance! In a small city where everyone knew everyone's business, they thought,  the secret was kept for years. Succor for the innocent of the families I suppose, and avoiding the trials and near disasters that befell Lady Mary.

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