By Jim deMaine

I felt sad when I went to make rounds in the hospital.

One of my patients, a colleague, had been readmitted in poor condition for recurrence of a primary lung sarcoma.

I spent a few minutes examining Dennis and chatting.  He then, with a quizzical look, said, “Jim, I’m going to have to sue you.  I know I’m dying.  My wife Alice and the kids are still pretty young.”  He saw my look of surprise and added, “You know, I don’t have much life insurance or other very significant funds for them to live on.  It’s nothing personal.  I know you’ve given me good care, but my wife is upset and tends to blame you for the outcome.  I guess the hospital and others will be named.”

There wasn’t much more for me to say at the time except, “Dennis I can find another attending for you if you’d like.”  He replied, “No, I want to stay with you.”

Dennis was a well liked family doctor.  About five years earlier a “coin lesion” was discovered on a chest X-Ray.  This 2cm spot in the right upper lobe had a smooth rounded border and didn’t contain calcium.  A CT scan showed no enlarged lymph nodes and no other spots elsewhere.  A needle biopsy of the spot was not diagnostic.  We knew the spot was new because an X-Ray five years earlier was normal.  He hadn’t traveled to an area where Valley Fever or other fungal infections were common.

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