Affective Error

Abstract

Paul was a 58-year-old man who presented to a neurosurgeon’s office with difficulty walking for 6 months. He had been sent there by a neurologist who had diagnosed him with spinal cord compression from multiple herniated discs. The neurologist also warned the neurosurgeon that Paul had been verbally abusive and inappropriate with staff members. Paul arrived 30 min late to his first appointment and swore at the receptionist when she told him he could not be seen that day. During his second visit, he demanded that his spine be operated on the following week. He refused to provide anything other than a basic history saying, “it’s in the record.” On exam, he was weak in his legs and needed a cane to walk. An MRI showed narrowing of his cervical spine with compression of his spinal cord. Despite this, the neurosurgeon refused to operate, saying that he would be a “poor operative candidate.” Paul found another neurosurgeon who was willing to operate on him, with excellent results.