Critical Decision

Critical Decision.

You are in a dilemma. You want to do the right thing but you’re not sure exactly what that is.

But this is a matter of life and death. If you don’t do something about it, then someone would surely die.

You had looked up to him from a distance. As a cardiovascular surgeon, he was neat, precise and super fast. You had seen him carry out medical miracles on hopeless cases. He commanded respect and both junior and senior residents feared him. You couldn’t believe when he handpicked you to be one of his favored residents; those he allowed to assist him during surgery. Then came the ugly divorce. His wife of twenty five years couldn’t cope with him and his workaholic habits anymore. And that was when it started. The tremors. They were more noticeable anytime his hand held the knife.

The other residents who noticed it felt he was getting old. Sixty years old and he was still wielding that knife. But he was a legacy. Doctors came from all over the country to learn from him. The hospital needed him. They couldn’t force him into an early retirement.

It had been entirely coincidental of course. Usually, you didn’t drive round that neighborhood because of its seedy nature. But your cousin had asked you to pick up some things for him from his friend’s house. You had obliged him and it was when you were driving out of the neighborhood that you saw Dr. Littimer. He was wearing a dark jacket and sunglasses but there was no mistaking that stout, erect figure. What troubled you most was his gait. He was staggering. You were wondering if he had some sort of cerebellar dysfunction when he passed out on the ground, dead drunk. You pulled over and ran to him. His breathing was coming in shallow, labored breaths. It wasn’t easy but you carried him to your car and took him home. He came to when you got to his apartment, but did not say anything. You helped him in and he collapsed on his couch fast asleep.

You wondered what would happen the next day but he arrived punctually to work at eight and started his rounds. Apart from the fact that his eyes were a little red-rimmed there were no traces of what had happened the previous night. He never mentioned it to you. But you kept noticing the tremors.

About two weeks ago, he was operating and somehow accidentally nicked a vessel. It was a huge vessel and there was massive hemorrhage. Thanks to your quick movements and thinking as you assisted him, you were able to ligate the vessel. If a resident did that on his watch, he would get a suspension at least. That was not the only problem. You were worried about his judgment especially on clinical details. The previous week, he had taken a patient into the theatre who you personally felt was not fit for surgery.  The patient died on the operating table. The blame had been put on a junior resident who he felt had not prepped the patient well. The other day you watched him as he walked into his car and surreptitiously drank something from a bottle. You were sure it was alcohol.  His mistakes were piling up and mounting.

Someone had to do something but what? Reporting him to the medical council might mean suspension of his license. You might just as well kill the man because surgery was his life. Also if you reported him, you could lose yours.  The man was an icon. No one else had ever caught him drinking. It would be your word against his. Who would they more likely believe? Reporting him to the chief medical director was a no-no. The man bowed himself double anytime Dr. Littimer walked by.  You had jokingly suggested to the man once that perhaps Dr. Littimer needed a break but the administrator had politely disagreed.  However if patients kept dying suspiciously, you would be caught in the middle. If it was discovered that you had been hiding useful information, you would be liable.  You were just fresh from med school, a young doctor who had been given a great opportunity to work in the hospital with a renowned specialist. You didn’t want to prematurely end your career. Perhaps you should wait until some more people noticed it. His tremors seemed to be getting worse at least in your imagination. He was bound to slip up sooner or later. But how many patients were you going to allow to die before his acts were brought to light?