Bertram: Bertram did not have an easy time during his recovery from liver transplant. But after one month, he was well enough to walk around the ward and look after his own medications. At least this was what the nursing and medical staff expected of him. Bertram still spent most of the day lying in bed. He said that he didn't have the energy to get up. Often, he didn't feel like eating or seeing visitors.

The transplant team could find nothing wrong with Bertram's physical health. But after another week with no improvement, it became clear that Bertram was severely depressed. A psychiatrist interviewed Bertram and his wife, then suggested an antidepressant medication. However, three weeks later, Bertram remained very depressed. This worried the team greatly. If he stayed in bed longer, he risked dangerous complications.

Finally, the psychiatrist contacted the family doctor that had referred the patient to the transplant team. This doctor confirmed that he had treated Bertram for serious depression before. Several members of his family also suffered with depression. He said that many treatments had failed to help Bertram. But he had responded well to one antidepressant drug. The doctor said that the family had instructed him not to release this information before. They assumed that the transplant team would decline Bertram for surgery if they knew of his problem with depression. Unfortunately, if the family had told the transplant team of Bertram's history, the team could have provided him with appropriate treatment earlier.

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