Freddie's Healthcare Events
Dr. Lawson Replies for WakeMed Leaders
Wednesday, August 13, 2014
Dr. Lawson Replies for WakeMed Leaders
August 13, 2014

Sent: Wednesday, August 13, 2014 9:58 AM
To: Fred Lempe
Subject: Re: Help Freddie Lempe

Mr. Lempe,

I appreciate your email and the obvious sincerity and earnestness of your hopes and desires for your son- who would want anything else? And as I indicated in my communications over the past couple of weeks, I believe it is critical for you and  Freddie's medical care team to sit down and discuss, and agree upon, a plan of care for him.

As you know Dr. Feinson's team put into place changes related to some of Freddie's medications. I believe they are willing to discuss a care plan including an attempt to wean Freddie from the ventilator.  However, as Dr. Udekwu and I have said  repeatedly, the medical care team will decide exactly what changes are made (including whether and how to begin vent weaning) based upon Freddie's clinical condition and what is clinically appropriate for Freddie. They will act in good faith to do those things they believe to be beneficial in Freddie's care, but cannot make decisions simply because you (or even I) believe they ought to take a certain treatment path.

Again, you will need to discuss with that team any and all details of Freddie’s care, but to my knowledge no physician involved in Freddie's care is advocating the use of bronch washes, chest tubes, or surgery.  That includes Dr. Udekwu in his recent  evaluation, which we facilitated at your request.  If the clinical team concludes that such efforts ought to be pursued, that would be fine by me- as I've said, I ask nothing from them other than that they practice good medicine- but I cannot in good faith attempt to persuade them to treat Freddie in a way that they do not believe constitutes good medicine. It is up to the physicians managing your son’s care to determine what the "needed medical treatments" are and, again, no medical experts  (including Dr. Udekwu and Dr. Hayes) are advocating for the invasive procedures you assert will help Freddie. 

It's important to be clear on that point- all of the physicians agree on the appropriate clinical treatment for Freddie, yet you remain unshakeable in your belief that they all are wrong. This creates a very difficult circumstance in which the medical care team cannot please you unless they agree to do what you request, which they sincerely do not believe is the right thing to do.  And to repeat, both Dr. Udekwu and Dr. Hayes have agreed with them that there is no indication to pursue the invasive procedures  you believe will help. It is not that Dr. Feinson’s team is just being obstinate in refusing to provide certain treatments or that anyone else (like “administration”) is telling them what they can or cannot do, but rather that they simply do not agree with your well-meaning (but not professional) opinion about what will “work” for Freddie.

So there are very few choices. The first is what I have already requested, that you discuss with Dr. Feinson’s team the plans for Freddie’s care going forward, recognizing that they are the licensed professionals with the experience and expertise in caring for patients like Freddie and that their responsibility is to craft a plan of care they believe is most appropriate. The goal would be to ensure that your views are heard and considered, but to allow the physicians to determine, according to their  professional responsibility, the elements of Freddie’s treatment plan.  The other option would be for you to work to find another physician or care team who would be willing to assume care for Freddie in a way you find compatible with your desires.  This would require Freddie to move to another location for his care, whether that is another hospital or a long-term care facility equipped to handle ventilator-dependent patients.

Let us pledge to keep the door of communication open. Again, I am happy to arrange a meeting between you and Freddie's medical care team at your convenience. This is important regardless of where other steps might lead. 


West Lawson, MD

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