While attending a lecture on ethics at Bentley University, Dr. Iris Jaffe had an ethical dilemma of her own. In the end, she made a decision that might have saved the life of Jill Brown, the professor who was giving the talk.
Brown had opened her lecture by explaining that she was on crutches because of minor foot surgery six weeks earlier. And as Brown spoke, Jaffe noticed that even though Brown was sitting, she was short of breath and having trouble finishing her sentences. That, she knew, was not normal.
Jaffe’s concern grew when she looked down at Brown’s leg and noticed it was swollen up to the knee. Jaffe became increasingly alarmed when she saw, from her seat three rows back, that the veins in Brown’s neck were bulging.
Jaffe, a cardiologist at Tufts Medical Center, realized that Brown, a Bentley professor, was showing the classic signs of a pulmonary embolism, a potentially fatal blood clot in the lung.
“Now I’m sitting in the class and thinking, ‘What am I going to do?’ ” Jaffe said. “I’m not her physician. I just noticed these things. Maybe she has some reasons for all of this. Who am I? I’m somebody in her class. Should I say something? Maybe it’s none of my business.”
When the class — part of a women’s leadership conference — broke for lunch, Jaffe told the woman sitting next to her, an insurance executive, what she had seen. The executive said she, too, had noticed Brown’s veins bulging.
Jaffe made a decision. She would risk embarrassment and tell Brown about her concerns. Jaffe gingerly approached Brown, as the professor sat alone, waiting for her lunch.
“I have an ethical dilemma,” Jaffe told Brown, a management professor who studies business ethics and strategic leadership. “Can I run it by you?”
“Great! Dish! Tell me about it!” Brown said, assuming that Jaffe was coming to her for advice on a juicy problem from the corporate world.
“I’m a physician, but I’m not your physician, and I know nothing about your medical history,” Jaffe said. “But I’m concerned you have a blood clot in your lungs and you need to be seen right away.”
Brown was shocked. “What are you talking about?” she said.
The professor had assumed she was short of breath because she was walking on crutches and that a swollen leg was normal after foot surgery. She had not noticed that her neck veins were distended.
Jaffe told Brown that a blood clot could be life-threatening and offered to drive her to the emergency room. But Brown had plans to head out of town that weekend. It was a Friday in June, the last day of the conference.
Over the weekend, Jaffe, who has seen patients die from blood clots, could not stop worrying about the professor. She decided she would wait until Monday to e-mail Brown and check in on her. But on Sunday, an e-mail from the professor landed in Jaffe’s inbox.
“Thank you for saving my life . . . really!” Brown wrote in the subject line.
Brown explained that after the conference, she had gone with her husband to the hospital, where she was diagnosed with multiple blood clots in her lungs and deep vein thrombosis — a blood clot — in her lower right leg. Doctors treated her with blood thinners and ordered her to take them for the next six months.
“In the emergency room, the doctors kept telling me, ‘That woman probably saved your life,’ because I would have just ignored my symptoms because I thought they were normal after surgery,” Brown said in an interview. “I probably would have just kept on chugging and doing my research and, fortunately, I didn’t.”’
Jaffe remembers feeling a flood of relief as she read Brown’s e-mail. Estimates suggest that 60,000 to 100,000 Americans die of pulmonary embolisms and deep vein thrombosis every year. About a quarter of those deaths befall people who are diagnosed only after they collapse and die. Common risk factors include advanced age, immobility, obesity, and surgery.
“Thank God she’s still alive,” Jaffe thought as she read the professor’s e-mail.
Brown signed the e-mail “I’ll be indebted to you forever” — but said she was not sure how to fully express her gratitude to the doctor whom she now calls “my guardian angel.”
“How do you thank someone for saving your life?” she said.