A 70-year-old woman walks into a small Nevada emergency department with what looks like a straightforward problem: a dislocated shoulder after becoming lightheaded and falling. Then she vomits blood. A lot of it. Within minutes, her blood pressure is dropping, she’s getting colder and weaker, and Dr. Noah Kaufman realizes his patient may be bleeding to death in front of him. There is no GI specialist in the hospital, the surgeon at home wants to wait for lab results, and Kaufman is the lone physician working the night shift. So he does something physicians are trained never to do: he lies. Kaufman tells the surgeon that he has informed the family there is nothing more they can do and that their mother is going to die. The response is immediate: “I’ll be right in.” What follows is one of Kaufman’s most memorable saves, and a story about clinical judgment, medical hierarchy, the art of getting a reluctant consultant to act, and those rare moments when doing right by a patient requires a physician to step outside the usual script.
“To have to lie to a colleague to save a patient’s life was a real powerful moment in my career.”
