[HSF] Endocarditis , Septic shock, Drug addict

[Michael Firstenberg]

When I was a fellow, I got called emergently to the MICU on a Sunday morning
for a similar situation - 21 year/old male, tatoos all over the place, track
marks up/down his arm, florid septic shock, wide open AI, complete heart
block, bacteremic, renal failure, coma.  Took him to the OR for the big wack
- was the sickest patient in the hospital for a month, lost a few toes,
dialysis, the jaundice - you name it.

But, he got better - but the point of this post is that we all assumed that
he was a IV drug abuser - turned out he was doing missionary work for some
organization (like CARE, HOPE, etc) building bridges and schools on the east
coast of Africa (i.e. The Lord's work), got malaria was treated with IV
agents and got infected from dirty needles and was flown home when we was
getting sick and ended up in our MICU about a week after getting back to the
states.  So I always hold off on the moral social judgements until I know
the entire story - and even still, everyone has a Mother.


-michael

On 4/18/08, Ani Anyanwu <anianyanwu at hotmail.com> wrote:
>
> James How long was this process of deliberation? Had any prior attempts
> been made to treat his addiction? Was this the first major complication of
> addiction he suffered? Also which country do you work and who pays for
> healthcare (self-pay, taxation, insurance, government)?  Ani
>
> > Date: Fri, 18 Apr 2008 02:19:06 -0700> From: jamesle2007 at yahoo.com> To:
> OpenHeart-L at lists.hsforum.com> CC: > Subject: [HSF] Endocarditis , Septic
> shock, Drug addict> > > We had a 30 yrs old Drug addict, admitted with
> aortic valve endocarditis severe AR in septic schock , recent frontal infact
> and pneumonia .He died as we were deliberating about his surgery.> > Is it
> unethical to deny surgery to such patients on assumption that they and their
> families continue to suffer with his condition of addiction and it is ok if
> he is allowed to die in paece on ventilator . > > > >
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