 |  |
| Medical Information: Being a Physician for Famous People is Not Fun |
| Nicholas V. Costrini, M.D. Medical Director Georgia Gastroenterology Group, PC |
| Part of the rite of passage for physicians is to have the opportunity or have circumstances demand that we care for famous people. There is the added stress, pressure to perform, and certainly the emotionally augmented concern to avoid the spectacle of a major miscue, error in judgment, or complication of a surgical procedure. History is full of the names of doctors who have become known for their blundering in the care of the great leaders of their day. For example, the docs at the bedside of George Washington have not done well in the history books to be sure. When the Father of our country was 58 years old, he came down with the flu during the severe influenza epidemic of 1790. At one point in his illness his presiding physician pronounced to the New York press that the president was all but dead. Calamity overtook the new nation for several days. When the presidents fever broke and recovery came, the physicians name was a joke in the then New York capitol. Nine years later, Washington developed a severe case of strep throat. The swelling of the tonsils cut off airflow into the trachea. Two doctors concluded that bleeding the former president was the treatment of choice. Following removal of several units of blood, George was even sicker. A third and younger physician urged his superiors to attempt a then radical treatment of emergency tracheotomy (surgically creating a hole in the windpipe to allow breathing). The superiors opted to continue the bleeding in an attempt to remove the infection. The otherwise fit founding Father of our country died after a brief illness following removal of half his blood volume at the hands of two soon to be very unpopular doctors. Needless to say, bleeding as a treatment for anything also died shortly thereafter. I can just imagine what todays malpractice machine would have done to the two physicians involved in that presidential saga. With the above in mind I read with interest that President George W. Bush recently had a screening colonoscopy. He is 56 years old, had no symptoms of colon cancer, and therefore was having an exam as part of a routine physical examination. He was following the recommendations of the medical community for men and women over age fifty. It is also more strongly advised that patients with a prior history of colon polyps (small, benign growths from which nearly all cancers develop) or a family history of polyps or colon cancer undergo screening colonoscopy. It so happens that the president is one of the more than 400,000 Americans who may have benign colon polyps. So, on June 29, 2002 President George W. Bush had a relatively simple examination of his colon. The president turned over the power of his office to VP Chaney for about two hours. The examination took only twenty minutes during which the president was given light intravenous sedation. His attending physician, recorded for all American history students of the future, is one Colonel Richard Tubb. Fortunately, our president had no recurrence of polyps and therefore is with high probability free of the risk of colon cancer. Since colon cancer strikes 150,000 Americans annually with more than 50,000 deaths, it is easy to see the preventive value of colonoscopy. My best wishes go to the president. However, I have a few words for Dr. Tubb. In the news report, it was stated that presidential duties were returned to Mr. Bush a mere two hours following the procedure. It is the Standard of Care that a patient not drive a motor vehicle or conduct significant business for the remainder of the day or for twenty-four hours. Hummmmm. While my regular patients dont drive or work at the office the day I do their colonoscopies, Dr. Tubb figured it was OK for George to run the only superpower on earth and conduct the current war. It gets even better. Following the procedure, our quite fit president engaged in a four-mile walk and then a light workout at the gym. Because of the risk of unrecognized dehydration attending the bowel preparation with laxatives on the day prior to the colonoscopy, the not-so-famous patients are routinely advised to take it easy, avoid the heat, and drink plenty of fluids. Dr. Tubb was flirting with joining the ranks of the physicians who cared for our first president. If G.W.B. had collapsed during his walk, the press would have had a field day; the case for screening colonoscopy for all Americans would have been set back twenty years, and every malpractice attorney in Washington, DC would have stormed Camp David in a sincere effort to see that justice is served. In defense of the medical community, the pressures to serve the special circumstances of the famous are substantial. However, Dr. Tubb and his president-patient could have set a better example by following the Standard of Care designed to keep all patients as safe as possible. You can bet I will have more trouble keeping my post-colonoscopy executives out of the office and off the golf course following this publication of the presidents screening colonoscopy historical day. On the other hand, if presidents, executives, and everyday folks are encouraged to follow the presidential lead for prevention of colon cancer, history may not be too hard on Dr. Tubb.
|
|
|
|||||
|
|||||
