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Trisha Torrey

What Can We Learn from Lady Sybil's Death (Downton Abbey)?

By January 29, 2013

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Spoiler Alert!

OK - I've waited 36 hours since Downton Abbey aired Sunday night. I didn't want to be a "spoiler" for those who hadn't seen the episode. Those of us who are fans are still in mourning. )

Downton Abbey is a marvelous TV drama which comes from the UK, airs on PBS in the States, and is in its third runaway season.
It takes place in the early part of the 20th century and focuses on British aristocracy and the people who work for them. In last night's episode, the character Sybil, age 24, gave birth to her first child and then died shortly after the birth.

Even if you know nothing about Downton Abbey, and never plan on bearing children, there is a lesson to be learned from Lady Sybil's death. That lesson has everything to do with the healthcare system, and little to do with the actual facts of her death.

Sybil, who everyone agreed was the sweetest, most endearing of characters, was part of the aristocratic family, the Granthems. Because they are aristocracy, appearances were far more important than reality. The fact that the family needed to keep up the appearance of being monied meant they called in a doctor, Sir Philip, who was far more expensive, far better known among their aristocratic circles to assist with the birth. Later they would be able to brag that they had hired Sir Philip to help Sybil give birth instead of relying on the country doctor, Dr. Clarkson, who had been her GP since she was born.

So, I'm guessing you aren't aristocracy, and you aren't worried about appearances - so what can we learn from this?

In the final days and hours of her pregnancy, Sybil began showing multiple signs of distress, ranging from her raised blood pressure, to her swollen ankles. Dr. Clarkson, the country doctor, right away suggested that she may be experiencing preclampsia and suggested she go to the hospital.

Sybil's mother and husband wanted Sybil to be dispatched to the hospital immediately....

But NOOOO. Sybil's father, Lord Granthem, who rules the castle and family (even when he makes stupid decisions) insisted that his expensive doctor, Sir Philip, could manage. Sir Philip insisted there was nothing wrong, that Sybil's experience was normal.

And they all kowtowed to Lord Granthem. Instead of trusting their gut, both Sybil's mother and her husband just gave in.

And THAT's what empowered patients can learn from Lady Sybil's death.... that trusting one's gut, especially when there is money involved, is vital. In this case, the money-hurdle was appearances. In most of our cases, the money hurdle is that recommendations are either being made so that someone will make money from us (that was my experience), or that money will be lost because of us (think of ERs and people with no insurance.)

If you trust your gut but you just aren't sure, then err on the side of caution - meaning, seek the help you think you need. Better to seek help and not need it than the other way round.

Don't let someone else talk you out of what you feel in your heart and head are right - or even when you just think something isn't right.

Finally, understand that if you have great insurance, then recommendations may be made for you simply because someone can make money from testing or treating you. And if you have no money or insurance, then recommendations may be made for you because someone CAN'T make money from you.

Follow the money.

Lady Sybil, as sweet and sincere as she was, has left behind a lesson for us all.

Now where's my box of tissues?

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Agree? Disagree?
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Comments
January 29, 2013 at 9:28 am
(1) Carolyn Thomas says:

Thanks so much for this wise advice, Trisha. I suspect that Lord Grantham will be sleeping in the guest room for quite some time from now on.

Although most of us don’t live in the elitist fairytale world of Downton Abbey, we still maintain the same reluctance to make a fuss in front of The Doctor – even when The Doctor is quite wrong. An interesting study published in the journal Health Affairs last year on our pervasive reluctance to be considered “difficult” patients reported:

“Even relatively affluent and well-educated patients feel compelled to conform to socially sanctioned roles and defer to physicians during clinical consultations”.

“Deferring to physicians” is why I went meekly home from the E.R. after being misdiagnosed with indigestion in mid-heart attack (despite presenting with textbook MI symptoms) Before I left hospital that day, feeling supremely embarrassed for having “made a fuss” over nothing, I was also reprimanded by the E.R. nurse who told me: “You’ll have to stop questioning the doctor. He is a very good doctor and he does not like to be questioned.” My question? After he had pronounced: “You’re in the right demographic for acid reflux. It is NOT your heart!” – I’d had the temerity to hesitantly ask: “But Doctor, what about this pain radiating down my left arm?!”

Even though I knew in my gut that his misdiagnosis just didn’t feel right, I was far too intimidated to demand further care.

My favourite bit of your advice: “Don’t let someone else talk you out of what you feel in your heart and head are right – or even when you just think something isn’t right.”

Regards,
C.

January 31, 2013 at 3:42 pm
(2) Alan H says:

Trish, you broke a rule when it comes to books, movies, TV series, televised sports which is never, never, never give away a plot or score.
I am an avid fan of Downtown Abbey (from 1st season on) & have recorded all 4 episodes from this 3rd season. Haven’t watched them yet, so I am going to try and make believe I did not hear about the latest event :(

February 7, 2013 at 11:54 am
(3) Dr. Pullen says:

I too waited a while. The episode led to intense discuissions at this family physicians home, more about physician ethics but also about eclampsia. See this post to read more about this. http://drpullen.com/sybildowntonabbyeclampsiadeath

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