Ownership

6.30PM, and Dr D was leaving his office. The next train was at 6.45, and if he ran he could catch it. In the corridor a medical registrar looked up, her face brightening as she recognised him.

“Ah, Dr D, one of your patients was just admitted. He’s having a flare up I think, not well. He said you knew him. Thought you’d want to know.”

“What’s his name?”

“Ah! I’m really sorry, I can’t remember it now. I saw your letter in his notes though. He said to make sure you were informed.”

 

The request has been made, implicitly. Dr D turned mournfully about and headed towards the medical assessment unit. Should he? It might make a difference, especially if it was a complex case. One glance and he might be able to sort it out in five minutes, save the on-call team a lot of guessing and faffing about. He entered the ward and scanned the names on the white board. None of them rang any bells. He asked the charge nurse, who instantly directed him to bed 6. Dr D pulled out Bed 6’s case notes. He flicked through the correspondence. Two letters, from clinic visits three years ago! Then the patient DNA’d (Did Not Attend) twice before dropping out of the system. ‘One of your patients…’ the registrar had said. Dr D eyed bed 6. He scrutinised the patient from across the ward. Yes, he recognised the face. Eye contact was made. Dr D was committed. He would get the next train; or perhaps the next train but one.

 

Two weeks later.

It was 6.20PM. The next train was still gettable. Dr D hurried towards the main entrance, buttoning up his coat. The same registrar approached him, this time from over his shoulder. She had seen him ahead and hurried, stealthily, to catch up with him.

“Dr D! Sorry. I’m on call again. One of your patients again. You do seem to have a lot! Deteriorated. He came in this afternoon. I thought you should know.”

“Name?”

“Oh! Sorry. I’m awful with names. Derek. David…  something.”

“How well do I know him?”

“I’m not sure, I just saw your initials on the front sheet. He comes to your Thursday clinic.”

“Did he ask for me?”

“No. He’s not up to asking for much to be honest.”

“OK. Look. I’m not bring unhelpful but I’ve got something I need to go to. I’m sure the on-call team can handle it overnight. I’ll come and see him tomorrow first thing, before the main ward round. OK?”

“Yes, of course, whatever you think Dr D.”

“OK. Bye.”

 

He caught the train. As he sat back he wondered who it could be. But not for long. After ten years in the job Dr D had seen many thousands of patients. Each one of them were, in a way, and to some degree, ‘his’. He had a responsibility, albeit shared, for them… but only to a degree. He could not be expected to rush to their bedside as soon as they entered the hospital. To be fair, very few patients had that expectation. It was colleagues, more often. They threw around the term ‘your patient’ with freedom, forgetting that the possessive implied something rather significant… duty. And if the requirements of that duty took shape at inconvenient times, what was he to do? Drop everything? Go back in? No way. The system was safe. There were many good doctors around to assess and treat and explain.

Next morning.

Dr D went to the assessment unit. He scanned the white board. There it was – Daniel. Daniel Spencer. No! Not him! Dr D rushed to the corresponding bed – bed 8. It was empty. The sheets were clean and straight. He found a nurse,

“Where’s Mr Spencer, bed 8?”

“Oh, he died Dr D. At three o’clock in the morning.”

Dr D lost focus. The assessment unit consultant came round the corner.

“Oh, morning Dr D. Sorry about your patient. I didn’t call you, the treatment plan was very clear from your letters. Really sad case. Only 36. He went quite quickly, and peacefully…”

“Did the family…?”

“They asked if you were around, they were very grateful for all you’d done, getting pall care involved, being honest with them. You were seeing him every week or two by the looks of it.”

“I wish I could have seen them.”

“I think the registrar let you know, she said she had anyway.”

“Yes… No… She couldn’t tell me who it was. If I’d had the name…”

“The family were fine. Really. Slight shame it couldn’t have happened at home but they weren’t set up for it.”

“Are they still around? I’d like to speak to them.”

“No, they went home earlier.”

 

Dr D avoided the lift and trudged up the stairs to the ward. He thought about ownership, continuity and duty. But he still wasn’t sure how he would react next time the registrar grabbed him in the corridor.

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