Aibu to ask the Consultant treating my Dad to stop saying this!

[Slinkysista]

My Dad is in hospital, he has a serious chronic illness. His COnsultant is less than helpful and has said on numerous occasions 'what he needs is a miracle'! My family and I know well that there is no cure for what Dad has but his COnsultant has such a defeatist attitude and anything that is suggested to perhaps manage his illness a little better is firmly rebuffed. However these comments about a 'miracle' are really getting to me, should I ask her to stop saying it?

Yes please do - awful thing to say! Hopefully it'll stop him saying it to some other poor family too.

Really sorry about your dad x

Yes you should.
And I hope she is giving good reasons why your suggestions won't help.
Point out that even if a postive attitude won't provide a cure it will make the patient's life and illness more bearable.
And that should be part of their job.

Isnt this actually a really terrible thing to be saying??! Really unprofessional and insensitive IMO

Even if there is nothing to be done for your father, this is really inappropriate

I would be livid!

Oh that's bad :(

Yes do say something to her, it could be that she doesn't realise how often she is saying it, or how crass it sounds.

I'm sure she'll probably feel terrible when you mention it, but please do. Goodness knows how many people she's upsetting?

Thanks for responding, I thought it was such an unprofessional remark to be made over and over but then I can't think straight because of what's happening to my dad. She is unbelievably negative when challenged about anything yo do with daddy's care. I would never say some of the things she's said to us to a family that were do obviously in distress.

So sorry to hear about your dad, Slinkysista.

Agree this comment is uncalled for and think this is a moment to wheel out the old 'would you appreciate a bit of feedback?' and let her know that this behaviour is causing the family needless additional distress.

Slinky

Yes, you should. When I was in hosp over the summer, my bed was next to a dying woman's. The consultant came by and was talking to her DH about palliative care (you can't really not hear thru those curtains) and then said something about 'there was another operation they could try, but he didn't think it would work and wouldn't bother with the trouble'.

You could hear the horrified silence through the curtains before the registrar intervened with 'What Mr X means is.....'

I could hear the husband crying after they left; it was awful. People who deal with the terminally ill have got to be more sensitive and I have absolutely no time for this 'they're brilliant in their field but just a bit insensitive'! I doubt they are so wonderful that no specialist with better social skills could be found to do the job, and in this case, it really does matter.

Sorry for what you're going through.

Is the consultant saying this infront of your father or just to the family ? It is a very unprofessional thing to say . Do you think that the consultant thinks that your family are unrealistic in their expectations with regard to treatment of your fathers condition?

Yes she is saying this in front of my lovely, trusting, gentle father! I think she does think we are being unrealistic but my family and I have thoroughly researched and contacted other doctors working in this field who seem to have a more optimistic approach. I think this really irritates her, for some reason she think she wants us to take her word and look no further, she doesn't get the enormity of what she's telling us !
I would rather a slightly less qualified doctor with a compassionate bedside manner was dealing with my father any day. I'm so sick of the excuses 'but she's really a scientist, she looks at facts and stats , she really knows her stuff'. She's unhelpful, cold and lacking in any kind of empathy.
Sorry I just had to vent, I'm so frustrated.

Thanks for your replies ladies/ gents

I really feel for you OP. The way my mother was treated in the days before she died was just terrible.

Unfortunately consultants do seem to inhabit a completely different world. I'm not surprised yours is talking about miracles, most of the consultants I've met consider themselves to be gods. I think it comes from the fact that miracles can be performed with the right medical intervention in cases which would otherwise be hopeless. It also doesn't help that they are treated like gods by all other staff.

I also think some of them have a tendency to think us mere mortals can only understand platitudes - and they certainly can get very offended when they are challenged. If you feel there are treatment options she should be pursuing, you are perfectly entitled to question her about this, as well as asking her to explain her reasoning as to exactly why she feels treatment would be futile.

It may be that although her manner is appalling she is completely right about her decision, and that further treatment may do nothing more than prolong your father's suffering - but you are entitled to an explanation, and to be treated with care and compassion.

If you can't get anywhere with her, you should contact the hospital's PALS office.
www.pals.nhs.uk/cmsContentView.aspx?ItemID=932

Often these people have the brains but a shit bedside manner imo.

OK-false hope, not good-but realistically, how many times do you need to be told that a person probably won´t make it?

Slinkysista - I feel for you. I suspect though, that actually what this Consultant is saying isn't the big problem here.

By all means, tell her that you'd prefer that she didn't say it. By all means, expect that she will stop.

The BIG problem here is that the Consultant in charge of your DF's care is persuing a course of treatment that you think is inadequate. Crucially, you think that there are other courses of treatment that should be considered.

There are many times when patients and their relatives are naive and think that a Doctor's job is to fix the patient. The impression, often, given by media outlets, especially such as Casualty and Holby City, is that sick patient + determined and maverick doctor = well patient. It can be really hard to convey difficult messages gently. Relatives hear 'serious' and think 'it'll be ok'. They hear 'very sick' and think 'well he's in the right place!'. It's a natural defence mechanism, which is actually quite essential to coping with life.

Having said that, if you have read around the condition in question, have conversed with other medics who would potentially try something different, then you have every right to ask for a referral to another consultant, or ask PALS to mediate.

You only have your Dad once. If his condition deteriorates at any time, you will need to know that you did everything you could.

Do be aware though, that medicine really isn't as advanced as we may like to think in areas. Even with the most advanced treatments, there can be a very fine balance between the 'cost' of the treatment (and I mean to the patient, in terms of suffering, not the NHS in case of £) and the 'benefit'. It is a big decision, for example, when a Cancer patient has the choice of palliative care with weeks to live, or chemotherapy for a possible extention to months. Patients have to balance whether they'd rather have good pain management and a clear head for the remaining weeks, or the huge side effects of the Chemo to try and buy a few months. Not a decision to be taken lightly.

Please do talk to PALS, in any event. You are going through enough, without feeling that your DF's doctor isn't doing everything possible. Even if you come to an understanding with the doctor that her manner belied her desire to help your DF, you'll feel better.

Excellent post lougle.

Bravo Lougle

slinkysista it is really difficult to be involved in situations where there is a divergence of opinion as to prognosis/ treatment. I've been both the professional and the relative. Neither side is easy. What matters is raising it... sometimes families can be over optimistic and choose only what they choose to hear. Sometimes as professionals we don't always communicate very clearly. By all means raise this and ask for a second opinion but perhaps prepare to hear news you would prefer not to.

There was a v. interesting study recently about the way doctors die. Many of us with our knowledge of the human cost of modern medicine vs. the transitory benefits choose to avoid life prolonging treatments.

www.guardian.co.uk/society/2012/feb/08/how-doctors-choose-die

I agree, gasman. A very revered Cardiac surgeon had sudden chest pain on a train. He presented at the hospital he had worked at, accurately self-diagnosed, and told the A&E department that he had an Aortic Dissection. He knew, having been the man on the other side of the fence, exactly what the treatment options were, their odds of success and the cost to the patient of trying. He declined active treatment.

I also worked in a NICU unit. The job there was to try to save tiny babies who had been either born too soon, or born poorly, and to enhance to the best of our ability their chances of a normal childhood.

The nurses there saw babies of all gestations, all conditions, etc. It amazed me (as a new to NICU nurse) when several of the nurses would, in conversation, declare that if they were to go into labour before a certain point in their pregnancy, they wouldn't even call an ambulance or go to hospital. The reason being, that they had seen what great lengths were needed to support the life of a premature baby, and had seen the less positive as well as more positive outcomes. For them, it was enough to know that they wouldn't want that for their child. I couldn't 'get there' (I was pregnant at the time), but I could understand their view.

I'll never forget seeing a family in deep denial about a relative (vague) and Drs not quite getting to the point of broaching DNR status. The patient died, but his passing could have been so more peaceful if communications had been better.

At the same time, i'll never forget the patient who was admitted in the middle of the night for 'TLC' with the sad assurance that there were only a few hours to go before last offices. The Sister got a massive shock when her dying patient sat up the nex morning and requested Cornflakes for breakfast with a hearty smile Turned out the stroke hadn't been quite as devestating as they thought!

I do know that if it was my Father, I would want to be sure of all the facts, and all the options.