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The Nature of Clinical MedicineThe Return of the Clinician$
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Eric Cassell

Print publication date: 2014

Print ISBN-13: 9780199974863

Published to Oxford Scholarship Online: November 2014

DOI: 10.1093/acprof:oso/9780199974863.001.0001

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A Story about a Patient with Aortic Stenosis, and a Commentary

A Story about a Patient with Aortic Stenosis, and a Commentary

Chapter:
(p.51) Chapter 2 A Story about a Patient with Aortic Stenosis, and a Commentary
Source:
The Nature of Clinical Medicine
Author(s):

Eric J. Cassell

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199974863.003.0003

In this chapter a fictional case is presented of an elderly woman with heart failure secondary to aortic stenosis but with Alzheimer’s dementia. The attending physician is well-known and reputable. The patient’s intrusive, bossy daughter is wealthy and on the hosptial’s board of directors. The daughter believes, supported by another cardiologist and the surgeon, that the patient should have her valve replaced. The attending physician has doubts about this because he believes the dementia will probably worsen from the surgery. Many actors are involved and discussed-physicians, consultants, surgeons, hospital director, patients, family, and even diseases and hospital politics. Other cases going on concurrently are used to highlight the issues. The chapter shows that there is much more to clinical medicine than the patient, the doctor, and the disease.

Keywords:   aortic stenosis, heart failure, attending physician, cardiologist, consultants, hospital politics, family, disease, physicians

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