Patient suicide (physician unassisted)

Abstract

The first time I met Hoke he was sitting in a bed in the cardiac care unit, bare from the waist up except for a diamond necklace. He was an obese man in his mid-60s. His wide bald head was surrounded by a fringe of long grey hair. Festooned with electrodes, wires, and intravenous lines, he sat dignified and stern and seemed to be in no mood for light banter. After introducing myself I asked him: “What were you doing when the chest pain started?” He fixed me with an intense gaze and replied: “I was giving a policeman a blow job.” I laughed, quite helpless to resist. His delivery was deadpan, professional, and hilariously funny. He looked quietly pleased. Many months later he told me that I had passed a crucial test at that moment. If I had not laughed he would have looked for another doctor. I learnt that this had been Hoke's third acute myocardial infarction. For many years he had been a successful florist in Washington, DC, but he had given up working since he was now virtually crippled by congestive heart …