The Hematologist

May-June 2019, Volume 16, Issue 3

An Unusual Thank-You Letter

Follow-up to "An Unusual Consult: Charlie the Lemur"

Stephan Moll, MD Professor of Medicine, Division of Hematology/Oncology
University of North Carolina School of Medicine, Chapel Hill, NC

Published on: April 30, 2019

Few things in my professional life are more heart-warming than the occasional letter, note, email, or comment from a patient or family member with a thank you for medical care that I have provided. I treasure such pieces of feedback. They help me deal with lackluster days. They energize me. They remind me why being a physician is such a remarkable profession.

Today I received a thank you note from the veterinary staff looking after Charlie the lemur at the Duke Lemur Center. I was involved in Charlie’s care and reported on this unusual consult in the March/April 2019 edition of The Hematologist. Charlie, an eight-pound lemur, had right leg lameness, initially thought to be due to a venous thrombosis.

Charlie has died. He had not gotten better. His right leg lameness developed into unexplained shifting arm and leg lameness, which severely impacted his ability to locomote. Despite all interventions for possible infectious and immune-mediated causes and various pain medication strategies, his lameness continued to progress, and the veterinary staff was unable to adequately control his pain. For these reasons, humane euthanasia was judged to be in his best interest.

It was a sad day.

On autopsy, a small focus of pneumonia was found — growing multidrug resistant Staphylococcus haemolyticus. The leg joint surfaces appeared inflamed; histology and cultures from the joints are pending. The possible final diagnosis was pneumonia with septic arthritis.

Below is the note I received from the Duke Lemur Center:

“It is with a heavy heart that I write to inform you that Charlie is no longer with us. He battled multiple medical problems over the last 12 months, many beyond the scope of what we could have diagnosed or treated without your support. You graciously answered the call for consultation, diagnostic and therapeutic support throughout the process. Your generous support was crucial in us being able to provide Charlie the highest quality care available. On behalf of all the Duke Lemur Center staff, we thank you for all you have done and for your continued support.”

The letter included a photograph of Charlie when he was still able to free range in one of the Center’s natural habitat enclosures, and a copy of his footprint, as a token of the staff’s appreciation. Thank you for the letter. I treasure such feedback.

Note: Please refer to the article by Dr. Stephan Moll in the March/April 2019 issue of The Hematologist covering Charlie's initial consult.

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