The swastika-donning patient who refused his lactulose
As a third-year medical student rotating on the internal medicine service at the VA Hospital, I took care of an elderly patient who was suffering from decompensated alcoholic cirrhosis. His condition was complicated by hepatorenal syndrome, multiple electrolyte imbalances, and hepatic encephalopathy.
It was most complicated however by various ethical challenges and by the social and familial factors surrounding this patient’s course of treatment during his one-month stay on our service …