Three patients in a row today with low blood pressure. For sure, they needed to be hospitalized; none of them (or their families) wanted to go. You can see that they understood the gravity of the situation, they nod their heads at the explanations – bleeding from the gut, possible malignancy, infection (sepsis). Their faces did not show much distress or worry. It looked like they had already made up their minds.
I could understand that the elderly lady vomiting blood was reluctant to go because it was near the all important new year holiday season. But I didn’t understand why the lady with severe anemia (of unknown cause) did not want to get it sorted out. The family of the patient* with sepsis decided to keep their options open – wanting to observe the situation and possibly reconsider hospitalization.
With their minds more or less fixed on not going to hospital (that’s why they got me in for a housecall in the first place), convincing them otherwise is very hard. Supporting them with what they want is all that can be done. Injections to stop vomiting (blood), anti-acid medications for presumed gastric bleeding, antibiotics for infection, etc.
I’m not sure what their outcomes might be – whether the families might convince patients to eventually visit the hospital. But we can only do so much. Outcomes can’t be controlled.
*the patient had dementia, and so the family had to decide for him
The Housecall GP 