Dr. Wohl's Violin: A Family Doctor's Last Act of Kindness

It began as a typical afternoon in the coronary care unit. While trying to finish my charting so that I could get home for dinner with my family, I was paged to the CCU resident's office. In the cluttered office, I found a medical resident nervously pacing the floor. When I walked in, he brightened up and immediately launched into his presentation: “Dr. Gottlieb, we have a tough case. This is a 25-year-old white male with terminal acute myeloid leukemia who was on home hospice. But when he finally arrested, his father panicked and called 911. Now the kid's on a vent, and his father is at his bedside around the clock. The kid's totally brain-dead—I mean really brain-dead, a vegetable—but when we try to talk to his father about turning off the vent, he looks like he'll explode and he starts yelling ‘Don't you talk to me about turning off the respirator! Billy is my only child! Can't you see he's still alive?’ The parents are divorced, and they don't talk to each other; the father is calling the shots. We were hoping that you could talk to the father—help him to understand that the kindest thing that he could do for his son at this point would be to turn off the respirator and allow him to pass on.”

I sat down in the resident's office and a nurse brought in Billy's father, whom I'll call Mr. Verizano. He was a big, angry, frightened bear of a man. When he lumbered into the room, I motioned for him to sit down in one of the chairs facing me. The nurse left. I asked Mr. Verizano to tell me about Billy.

“He's all I have, Doctor. They say he's …