As I explained in the preface to Surviving Your Doctor, all of the clinical vignettes in this book represent real people and their medical histories. Instead, the stories are derived from composite memories and impressions over my clinical career.

However, below is a true story, names changed. One that may be worthy of your attention.

It was a blustery day, made worse by a sudden downpour, as Mark M. McGuire, M.D., an executive at a major pharmaceutical company, ran from the parking lot to the hospital entrance. His wife had just given birth to a beautiful girl who unfortunately had a pelvic kidney, a situation where the kidney is located down toward the pelvis. This situation can lead to kidney damage, due to backflow pressure in the kidey. So yesterday the pediatric urologists performed a procedure to help alleviate the obstruction. ‘Standard practice’, Dr. McGuire and his wife had been told. The procedure required general anesthesia and a breathing tube placed in the baby’s trachea. The operation was performed by an experienced surgeon at one of the top hospitals in the country, a hospital whose very name connotes excellence.

Mark arrived at the pediatric ICU to check in on his new daughter. He had been told that she would be there for a few days – ‘Just a precaution”, because when an infant is intubated (a breathing tube placed) there is a risk that the tiny trachea might swell up and obstruct breathing.

But his baby was not in the bed she was placed in last night after the operation was completed. Dr. McGuire walked quickly from incubator to incubator the ICU, searching for her. She was not there. Now he was really worried. He checked with the charge nurse, and was told that they had to move the baby to the urology ward because the bed was needed for a sicker child. ‘She’ll be fine there, the nurses are excellent,’ the nurse called out as Dr. McGuire left the ICU.

When he arrived at the pediatric urology ward, he walked with the nurse to his child’s room. The nurse carefully washed her hands, then looked at Dr. McGuire, who was pulling up a chair next to the tiny incubator that served as his daughter’s bed.  The nurse, sensing Dr. McGuire’s anxiety, told him that the baby would be ‘just fine’ on the ward. Left alone at the bedside, he affectionately rubbed the child’s forehead. He noticed something. His daughter seemed to be straining at breathing. At first he was unconcerned – Before she left the room, the nurse had checked her.

But as he watched, his anxiety grew. He wasn’t a pediatrician, and he hadn’t practiced medicine in the last five years since taking the job at the pharmaceutical company, but he thought his baby was straining to breathe, looked a little blue, and seemed to be tiring.

He rang for the nurse. No one came. A few minutes passed. He walked outside, and called, in a voice just short of a shout, “Nurse!” 

“What’s the matter?” came the answer from the break room.

“My daughter is having trouble breathing.” The nurse and he walked into the child’s room. The nurse took a good look at his daughter, and said, “I’ll get the urologist on call.” She was as far as the door when Dr. McGuire took another look at his baby. He wasn’t a pediatrician. Maybe he was overreacting. Then he shouted, “No, call a code.” 

Calling a code means a patient is in a serious, life-threatening situation that requires immediate attention.  A specialized team drops everything and runs (literally) to the room.  Hospital staff don’t call a code lightly.

The nurse, already at the doorway, turned around. “I can’t do that.”

McGuire walked towards her. He was now a few inches from her face. “I’m a doctor. Call a code. Call a code!!”

The nurse stopped and looked back in the room, calculating, Dr. McGuire thought in retrospect, the cost of calling an unnecessary code versus the repercussions if he were right.

She called the code.  Minutes later the code team arrived and administered steroids and epinephrine to the infant.

The doctor running the code turned to the nurse and said “Great work calling the code. If you had waited, we’d have lost her. The baby will be fine now. We’ll move her back to the ICU.”

The lesson: His child’s surgery was done by one of the best pediatric surgeons in the country. The procedure was carried out at a well-known and highly reputable hospital. And it was a low-risk procedure. Yet, had Dr. McGuire not insisted on calling a code, the story would have ended differently.

So, if you or a loved one are in a hospital, you must pay attention all the time – to every detail.  Relax when you get home.