Attention: Linda Koeppen, Director

Phone Log: Carol Weimer
June 3^rd, 2002

Transcription of a call placed to Dr. James Tracey, Miami Valley Hospital, on Monday, June 3^rd at the request of Mrs. Joyce Boorman and her son, Nathan Boorman: ¹³

Nurse: Good Morning, Drs. Mayer, Clark, and Tracey’s office.

Carol: Hello, this is Carol Weimer calling for Dr. Tracey please.

Nurse: Dr. Tracey is with a patient; may I take your number and have him call you back?

Carol:  I would really appreciate if I could talk to him now. This is the fourth time I’ve called and he has not returned my call.

Nurse: And what is this about?

Carol: This is about one of his patients. I’m calling from Hospice of Dayton.

Nurse: Let me see what I can do.

Dr. Tracey (sounding abrupt): Hello.

Carol: Hello Dr. Tracey, this is Carol Weimer from Hospice of Dayton. I’ve been asked by the family of Glen Boorman to contact you.

Dr. Tracey: Yes, Ms. Weimer, I’ve already talked with Mr. Boorman’s family and we have agreed to forgo your services at this time. Thank you anyway.

Carol: Ah, well, Dr. Tracey, I just spoke with Mrs. Boorman and her son a few hours ago and they told me again that they would like to have Hospice become involved with Mr. Boorman’s care.

Dr. Tracey (exhaling loudly): Ms. Weimer, I have been through this with the Boormans and do not wish to rehash it with you. I am Glen Boorman’s physician and I will oversee his treatment.

Carol: Dr. Tracey, are you aware that the involvement of Hospice does not preclude your treatment of Mr. Boorman? You would still be his primary attending physician should you and the family choose so.¹⁴

Dr. Tracey:Well then, I see no reason for the interference of Hospice with my patient and I chose not to use their services. Thank you and have a nice day.

Carol (hurriedly):Excuse me Dr. Tracey, please don’t hang up. Can you tell me if you consider Mr. Boorman’s illness to be terminal? ¹⁵

Dr. Tracey (sighing): Yes, Ms. Weimer, Mr. Boorman’s treatment options are nearly exhausted but it does no good to tell the patient and family that. Now, my office is very busy today.

Carol: And do you understand, Dr. Tracey, that the role of Hospice is to deal with every aspect of the patient’s final days, including counseling and support for the patient and his family members? Does your office normally provide counseling and support services? ¹⁶

Dr. Tracey:(pause) Are you implying that my office does not meet the needs of the patient?

Carol (slowly): Dr. Tracey, if you were not an excellent doctor and completely trusted by this family, they would not have told me of their wish for you to continue to be the physician in charge of Mr. Boorman’s care and treatment. They’re not seeking to eliminate or replace you as the primary physician here, (pause) only to make their loved one’s final days the most peaceful and comfortable that they can be.

Dr. Tracey: As Mr. Boorman’s doctor, I do not see the need for Hospice to be involved.

Carol: I understand your objections Dr. Tracey, but you should know that Hospice of Dayton has been doing this for twenty-five years. We were founded in 1978 by a local nurse named Betty Schmoll¹⁷ and our only goal is to provide quality palliative care and support for the family and friends of our patients. We see the whole person, and seek to meet their physical, psychological, spiritual and practical needs in any way we can. In addition to that, we see the patient and his whole family as a complete unit to be cared for.¹⁸ (pause) You must admit that is simply more than even the best doctor’s office can do.

Dr. Tracey: Perhaps I and my staff provide more help and support for my patients than the average physician.

Carol: After talking with you Dr. Tracey, I’m quite sure that you do. However, in addition to our paid staff of professional nurses, doctors, social workers, and counselors, Hospice of Dayton currently has 380 active volunteers. That is nearly one volunteer for every patient. Some of the things that we do down here besides pain management and seeking to make the patient as physically comfortable as possible, include massages, art therapy, pet therapy, holiday celebrations and social events for the whole family, running errands for the caregiver, helping with household chores and hosting support group meetings. I’m sure you are an excellent doctor, Dr. Tracey, but I doubt you have ever done a patient’s laundry, come to their house and cooked breakfast for them, or washed and styled their hair when they, or their caregivers, were simply too exhausted to do those things.¹⁹

Dr. Tracey: Well….of course, I can’t do all that but….

Carol: Dr. Tracey, really, you should consider the family here also. In many ways they are the ones that benefit the most. All of our services are completely free for them and we provide support services and counseling for up to 13 months, longer if they feel they need it.²⁰ In the past year alone, I’ve seen two weddings and a birthday party for a twelve year old girl held here, numerous wine and cheese parties for the families, an egg hunt at Easter, dinners for Thanksgiving and Christmas and a summer camp for the children and grandchildren of our patients.²¹ That is not to mention the day to day things that volunteers do to make the patients and their families happy and comfortable. (pause) Just today some one was able to locate a certain type of rabbit for a patient. Apparently, it was something that the patient had eaten as a child and a family member wanted to make it for them one more time.

Dr. Tracey: You certainly are convincing Ms. Weimer.

Carol: Yes, Dr. Tracey, I apologize. I have taken a great deal of your time but I am very passionate about Hospice and the work we do here. May I mention one more thing to you?

Dr. Tracey: Yes, I suppose….

Carol: If Hospice was involved, Mr. Boorman and his immediate family would have a great deal more autonomy and control over the circumstances that he spends his last days in. Rather than dying in the hospital, quite possibly alone, Mr. Boorman could die at home surrounded by his loved ones. Hospice would come into the home and provide the family with all the help they might need.²² If, however, he or his family chose to admit him to the inpatient unit, he would be in a lovely private room. His room would have floor to ceiling windows with a beautiful view and a birdfeeder right outside. The room would be decorated and filled with fresh flowers every day and on his bed would be a big, soft comforter and down pillows. His family would be surrounded by caring personnel that was available twenty-four hours a day and would prepare them for what was going to happen and stand by them throughout the process.

Dr. Tracey: Well, Ms. Weimer, you could sell a stereo to a deaf man. Seriously though, (pause) while this all sounds wonderful, I am not a doctor who wants to give up on his patients. I cannot in good conscience tell Mr. Boorman to relinquish the fight and go some where to die. I’m a doctor, Ms. Weimer, my job is to heal.

Carol: What may I ask, Dr. Tracey, are Mr. Boorman’s odds for recovery (pause) in your estimation, of course?

Dr. Tracey: Slim, probably none at all to be honest, but as we know, the odds are sometimes beaten.

Carol: Well, that would remain the same whether or not Hospice became involved. Hospice is not a death sentence or a way of “giving up on” some one. While it’s true that our patients must be considered terminal for Medicare approval, fully five percent will recover from their illnesses enough to be discharged from Hospice care.²³ I have seen miracles here, Dr. Tracey.

Dr. Tracey: Yes, well, uh hum (long pause) and the Boormans told you that this is what Glen wants?

Carol: Yes, Dr. Tracey. I spoke with Mr. Boorman directly and he expressed a strong desire for our services. (pause) And really, that is what matters isn’t it? What the patient wants. Shouldn’t some one who is facing a terminal illness have the right to decide for himself what their final days will be like? Given the chance, Dr. Tracey, wouldn’t you want the dignity and respect of deciding for yourself?

Dr. Tracey: Hm…well, of course. Okay, fine, send the paperwork to my office.