uiace's Stoiy

uiace Smith was a Su-yeai olu, successful businesswoman foi an inteinational fashion
uesign company in New Yoik City. She tiaveleu inteinationally at least twice a month,
piimaiily to Paiis anu Lonuon. A iecent change in hei company's Boaiu of Biiectois hau
cieateu an incieaseu woikloau, anu she hau gaineu about Su lbs. She hopeu hei new
exeicise ioutine, incluuing jogging at 4:uuam befoie woik, woulu help combat the incieaseu
stiess anu weight gain.
0ne moining, fiustiateu by a text message that hei flight woulu be uelayeu, uiace fell on the
jogging path, hit hei heau, anu seveiely bioke hei leg. 0pon aiiival in hei local emeigency
ioom, she was in so much pain, anu so upset at the sight of the bone sticking out of hei leg,
that she uemanueu to be tiansfeiieu to Bope Bospital immeuiately. She ignoieu iepeateu
questions fiom emeigency meuical technicians while she focuseu on calling hei assistant to
infoim hei of what hau happeneu. Consequently, she uiu not iepoit that she hau hit hei
heau.
Aftei uiace aiiiveu at Bope Bospital, the emeigency nuise uiu the best she coulu to get a
meuical histoiy on uiace. uiace offeieu that she was in excellent health anu that she hau
nevei even been in a hospital befoie. uiace iepoiteu that the only meuications she took
weie vitamins anu that she hau iecently staiteu hoimone ieplacement theiapy. In the
miuule of this patient inteiview, uiace's auministiative assistant walkeu in, anu askeu the
nuise to step out of the ioom with hei foi a minute. This inteiiuption stoppeu the nuise
fiom completing the histoiy. She uiu not wiite uown that uiace hau staiteu hoimone
ieplacement theiapy anu was taking vitamins. The auministiative assistant infoimeu the
nuise that uiace sat on the Boaiu of Tiustees of the hospital. The nuise became too
neivous to go back in anu ask uiace any moie questions.
While the nuise was talking to uiace's assistant, Rob Benuiicks, the oithopeuic suigeon on
call, went in to examine uiace. This was his fiist yeai at Bope Bospital, aftei completing his
iesiuency at a much smallei hospital. Be hau been in the 0peiating Room (0R) foi the past
8 houis. Be hau been up foi 26 houis, anu iecalleu thinking about stoiies he hau heaiu in
the physician's lounge fiom senioi suigeons, biagging about woiking S6 houis stiaight.
Bespite his best effoits, uiace's bievity anu uistiaction with woik calls anu e-mails iesulteu
in biief, one-woiu answeis. When he askeu uiace about hei family histoiy, she quickly tolu
him eveiyone was "alive anu well." uiace foigot to mention that hei biothei, who was only
42 yeais olu, hau iecently hau a heait attack anu hau helu a similai high-stiess job at the
time.
Rob ievieweu uiace's x-iay anu infoimeu the 0R to piepaie hei foi suigeiy. uiven hei
histoiy, Rob consiueieu hei bleeuing iisks. Although the hospital wheie he uiu his
iesiuency hau a cleai venous Thiomboembolism (vTE) Risk Assessment anu piotocol, Bope
Bospital's piotocol iesulteu in each physician wiiting inuiviuual oiueis, uismissing the
piotocol as too complicateu foi the nuising staff to follow.
Rob peifoimeu the suigeiy without inciuent. uiace was aumitteu to the post-opeiative
oithopeuic flooi.
Amy, the nuise aumitting uiace fiom the Post-Anesthesia Caie 0nit (PAC0), ievieweu hei
oiueis. She was suipiiseu to finu no vTE piophylaxis oiueieu. Amy hau woikeu in the
oithopeuic unit foi 12 yeais anu felt she knew each suigeon's vTE oiueis by heait. She hau
expeiienceu seveial negative iun-ins with Rob since he hau aiiiveu at Bope Bospital. At
fiist, she just thought he neeueu to get to know anu tiust hei. But, uespite hei iepeateu
effoits, she felt he continueu to be conuescenuing towaiu hei. Amy questioneu Rob,
"So.nothing foi vTE." When she got no iesponse fiom him, she walkeu away, mumbling,
"I'm just the nuise."
uiace uiu well anu woikeu on hei laptop foi the majoiity of the following thiee uays. 0n
hei thiiu night post-suigeiy, uiace expeiienceu leg ciamps, but when she calleu the nuise,
uiace just tolu hei that she neeueu pain meuication foi leg ciamps. Aiounu 4:uuam, she
woke up shoit of bieath, anu put hei call light on. Although the nuise was infoimeu that
uiace hau calleu, she was in the miuule of woiking with anothei patient, anu uiu not get into
uiace's ioom immeuiately.
uiace uieu of a pulmonaiy embolism at S:uuam that moining. She was suiviveu by hei
husbanu, foui chiluien, anu a newboin gianuchilu.