Tuesday, April 10, 2012

11. A Case of Medical Ethics

[This story is in honor of my many friends who work in cancer registries around the world.  National Cancer Registrars Week is celebrated the second week of April every year.  Yeah, registrars!]
           “Guess what!  Angelina is in the hospital!”   
            I looked up bleary eyed from the data entry I was doing on patient survival records and asked, “What hospital?”
            “Our hospital, silly.  It’s supposed to be a secret, but the word is out that she’s here.”  Sue’s voice vibrated with excitement.
            “You mean Angelina the movie star?”  I didn’t want to mention her last name, because all patient information is confidential and you could get in big trouble if you breach it.
            “Yes, Donna, I mean her.  I don’t know why she’s here, but one of the parking valets at the celebrity entrance told his girlfriend he was sure it was her getting out of a Town Car early this morning.”
               The celebrity entrance is at the back of the main hospital, you have to drive past the trash bin storage area to get to it.  Once you do get to it, it’s pretty nice and there’s no odor, of course.  The public relations people thought the press wouldn’t be looking for celebrity patients at the garbage door.
              We’re one of the largest and top rated hospitals in the entertainment capital of the world so we get lots of patients who don’t want the world to know their medical problems.  Of course, all patients have their privacy protected by federal and state laws and hospital regulations, but the media is only interested in big names.  And Angelina was a big name.
             “That valet and his girlfriend better be careful,” I cautioned.  “Or they’re not only going to be out of a job, they could even go to jail if they leak patient information.”
           “Yeah, I know.  I told Tracy, the valet’s girlfriend, to warn him.  I thought all hospital employees had to go through training and sign confidential agreements. But maybe that’s not true for the parking valets.  They’re just part time and they don’t even come into the hospital.” 
           “Huh, as you just pointed out they do see who goes into the hospital.”
           I’ve heard that most celebrities are disguised and use fake names when they need medical attention.  But even so, it seems tabloids have methods for finding out about celebrity health problems.
           Well, they wouldn’t be getting any information from our cancer registry.  We take our professional responsibilities as seriously as physicians, nurses and other medical staff.  Of course, we never see any patients.  And we only get information on oncology patients.  Most of them don’t even know information concerning their diagnosis, treatment, and follow up is legally mandated to be sent to the state cancer registry and then pooled anonymously into a national cancer data base to provide information that helps in future research and treatment plans. 
            “We’d best be getting back to our own concerns right now.  All these records have to be up to date and accurate for the Commission on Cancer survey next month.”
            “I know, I know.  The earth revolves around the survey.”  Sue twirled her finger around as if it was a revolving planet.  “Don’t worry my files will be perfect.”
            “If we don’t get a good report, heads will roll.  So let’s keep our heads securely fastened to our body.”  I laughed.
            Later, I had a quick lunch in the cafeteria and stopped in the rest room down the hall from the cancer registry.  I was surprised to see a stranger washing her hands at the white porcelain sink.   At first I thought could it be…but I just shook my head and asked, “Are you in the right place?  This floor is not for patients or visitors.”
           The beautiful dark haired woman looked up and stared with huge brown eyes.  “I’m…I’m sorry.  I didn’t know.  I just had to get away.”
          “Are you really who I think you are?” I couldn’t believe I was this close to a world famous actress.
         “No, no, I’m really not.”  She was wiping her hands over and over with a paper towel.  “I just look like her.  And I’m sick of it.”
         “I’m sorry if I offended or bothered you.” I apologized.
          “No, it’s not your fault.  I just have to talk to someone.”  She breathed a deep sigh.  “I’m just a decoy.  There I’ve said it.  So be it.”
         “A decoy?  What do you mean?”  I was bewildered.
         She sat down heavily on one of the orange plastic chairs in the room.  “Because I look like a famous person, I’m hired to act as a decoy when the real person wants to do something without the press finding out about it.  But I’m really just plain Marcie Berta.”
        “OK, but what’s so hard about that.” 
          “It’s not hard.  Like today for instance.  I just had to dress like my ‘double’ would if she was trying to escape notice and be picked up at the ‘double’s” home and then look like I’m trying to sneak into this hospital without being seen.”
             “I don’t understand.  What good is that?”
            “If I act suspicious enough, the press will follow me, and the real person is free to do what she wants.”
           “But what are you doing here in the hospital?”
           “Nothing really.  I just acted like I was sneaking into the hospital, then went up to a patient floor and walked around as if I was looking for someone and finally just took the elevator down here to get away from all the people who were gawking at me.” 
          “So, Marcie, you’re not here for a doctor’s appointment or treatment or anything like that?”  I ran my fingers through my short, rumpled brown hair.
          “Oh, no.  It’s usually a lot more fun doing these gigs. I like acting and that’s what I’m doing.  I’ve never even met the person I’m supposed to be impersonating.  Someone on her staff gives me the appropriate clothes and tells me what to do.”
“Ok, since you’re not a patient, if a staff person did let slip they saw you coming into the hospital it wouldn’t be a breach of medical ethics.”  I felt relieved not having to worry about the valet and his girlfriend.
           “I wouldn’t want anyone to get in trouble for what I did.”  Marcie frowned, wrinkling up her perfect face.  “Usually I go to upscale hotels and restaurants.  That’s sort of exciting.  Places I couldn’t afford to go on my own.” 
           “It sounds like an interesting job.”  I thought of myself stuck in a basement all day compiling patient information.  “So why did you come down here to our underground world?”
         “I just felt awkward, trying to pretend in a place where people have serious problems.  I was trying to find a place where I wouldn’t be in the way or cause any trouble.”
          “Yes, a hospital’s a serious place.  But most of the time there’re happy endings.  Healthy babies are born, people get lifesaving treatment and go home to their friends and families.”
          “What do you do?”  She seemed to calm down as we talked.
          “I’m a cancer registrar.  I keep track of cancer patients’ medical information.  The next time you read any kind of cancer statistics just remember it all starts with someone like me entering information into a computer.  And there are thousands of other registrars doing the same thing.  Our work is the basis of all cancer research and treatment.”  I laughed.  “Even if no one ever knows about us or what we do.”
          Marcie seemed impressed.  “Wow.  That sounds important.”
         “I guess it really is, but not as much fun as what you’re doing.”
         “Yeah, right.  Well, I know one thing I'm going to do now that I've talked to you.”  She declared.
         I was starting to pat myself on the back, thinking I had recruited another person to become a cancer registrar.  “What is that?”
          She stood up showing off her Angelina like figure, raised her chin firmly and said, “I’m going to tell them I’m not going to sneak into any more hospitals.  I just don’t think it’s very ethical.”
                                                      The End