When to Accept Help

By Dr. Alan Peterson

As a family doctor over many years, one gets to know, and in some cases, become one with families and patients.

One such older couple was seeing me for the common medical issues in the elderly– hypertension, arthritis, diabetes, etc. They would always come in together, which many times helps the doctor as well as the patient.

In a regular follow up visit the wife (Madeline) had mentioned a couple of minor vehicle mishaps her husband, Tom, had. She did not drive. I had noticed some minor memory issues in Tom in the past, and Madeline had confirmed she had also. After doing a formal memory test in the office, I felt I needed to make sure Tom was still safe to drive. I explained that at his age memory loss was quite common, but we needed to make sure he was not at risk or those around him with his driving. I told him there was no medicine as yet for his memory. I asked if he would undergo a driving test to see if he was safe to continue driving. I explained that this would be not only in his interest but that of his wife’s (who always rode with him), and those on the road that might encounter him. That would include children on bikes, etc.

He refused. His wife tried to convince him also. I offered him an appointment to see a specialist and/or a counselor, but he wanted nothing to do with those either. He did not think his memory was that bad. 

I told him that I had no choice as a licensed physician, knowing that his memory was failing, but to let the Department of Motor Vehicles of PA know about my concerns. 

It is hard to do this with patients one has known for years. 

The state withdrew his license, as he would not allow his driving to be tested. 

Later that year I was overseeing the residents and saw that he had transferred his care from me to one of them. That resident told me Tom had asked for him to get his license back. The resident told him he could not do that without a driving test. Tom refused again. Later we found that he left our office practice to join another family medicine group. They also told him he must have a driving test. They also offered a specialist and/or counseling. Tom would not have any part of it.  

Sometime later I was looking at the morning newspaper in the office and ran across the headlines of a fatal accident. The names of those killed were Tom and Madeline. Tom was apparently driving. I thought from the description he drove through a stop sign and another hit them directly. 

I was devastated.

I tried to think of what else I could have done and still have been bound by my patient-doctor relationship. What more could I and others have done to prevent this? I could not think of anything. His wife obviously knew this could be a serious issue as he had the earlier accidents. I knew there were other family members and multiple friends that could have driven them places. It’s obviously a major issue though to give up one’s license after driving all of one’s life.  

I went to the funeral and gave my condolences but obviously could not share the reason I thought this had happened. I was very upset that I (we) could not have intervened in a more fruitful way.

I tried to think of what else I could have done and still have been bound by my patient-doctor relationship. What more could I and others have done to prevent this?

I’m certain we all have our own times in which we don’t want to “listen” to others, whether they are physicians or not. 

Frequently, it makes little difference. Sometimes it causes a fatal problem.

May we be granted the insight to know when to accept help and advice, and make positive changes in our lives. 

Dr. Alan Peterson is Emeritus Director of Community and Environmental Medicine of Lancaster General Health. He graduated from Boston University School of Medicine in 1972. He started his Family Medicine residency at Lancaster General Hospital the same year. Upon graduating in 1975, he practiced in a rural clinic in West Virginia for a year. Then, he began seeing patients in a private family practice in Lancaster for the next 3 years. From 1979 through 2014 he was an Associate Director of the LGH Residency Program, seeing patients and teaching family medicine residents in Lancaster and Quarryville. From 2014 until last year, he was a preceptor of the residents at the Aument Family Health Center in Quarryville.

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