By Cecil Hoge
A day after returning from a recent trip to Asia, I fainted in the bathroom and managed to smash my right leg in a couple of places. My wife, who was concerned to see me fall and lose consciousness for a minute or so, insisted that she call the doctor. It was my guess that my fainting was a simple case exhaustion after a 9 day trip to Asia and a cold that I had caught, but my wife thought it was best to be prudent.
From there things went downhill fast. She called my doctor who was not available and ended up speaking to his assistant. The assistant said I should go straight to the Emergency Room and get checked for a stroke or a heart attack. Well, I didn’t think I had either, but my wife is a determined woman who believes in the edict Doctor Knows Best. I don’t, but I also know arguing with my wife over such things is a losing game. Hence, in a very short time, I found myself on the way to the emergency room.
On arriving at the ER , the admitting nurse, a sandy-haired and somewhat balding young man, asked about 3 questions and then called a “code orange” situation. That means that I may have had a stroke. I did not think this was necessary, but it certainly made me feel well-attended.
Immediately, I was whisked into the ER holding room to have blood tests, blood pressure, X-rays and, shortly thereafter, a Cat Scan taken. The attention, though not requested, was quite impressive. Nurses rushed around bringing water, taking vials of blood, hooking me up to an IV and presenting me with a turkey sandwich and a nice plastic receptacle to pee in. Multiple doctors and nurses came in to ask my name and birth. I proudly recited both with lightning speed. I knew their intentions were good and it was their job to ask the same questions time after time. And, true to their profession, they asked my name and birth date about 25 times.
It was only after about an hour of various tests and 10 vials of blood being taken that they announced that I would be admitted to the hospital for observation. I tried to argue that this was unjustified. My arguments were listened to respectfully and then denied. They said a Dr. Roth had determined that I should stay the night for observation. According to a nice young doctor lady named, Dr. Cooper, Dr. Roth was an excellent neurologist and also a very nice lady.
The fun did not stop there. They went on to say that I also needed an MRI of my brain and an Echo Cardiogram of my heart. I could see this was going to be a very exciting day. Personally, I would have preferred to stand up, walk out and leave, but several new doctors arrived to tell me what an imprudent thing that would be. At this point, I was comfortably enscounced on a hospital bed and my wife, who had back and knee issues plaguing her, decided to go home for a short break. After about an hour of munching on my turkey sandwich and drinking some water, some guy showed up and rolled my hospital bed to the MRI room.
There I got onto the MRI Table, put on earplugs and a MRI helmet to cover my brain. Soon I found myself inside the glorious machine which made an incredible racket. I tried to imagine that I was listening to some new, atonal guitarist like Slash or Motörhead, although if it was Slash or Motörhead, I am pretty sure they also wore earplugs. Anyway, after 28 minutes of banging, knocking, screeching, grinding, beeps, bells, dongs at the highest possible decibels, I emerged from the tin can, had the earplugs and helmet removed and was told by a trim Korean lady that the agony was over.
Almost immediately, I was whisked out of the MRI room on my roller bed and told the next stop was the Echo Cardiogram room. A young lady came and then rolled me off. It turned out to be a busy day in the Echo Cardiogram Room, so I was rolled off something called the Nuclear Room. There, in a corner behind a curtain, the nice young lady smeared some goo on my chest and took something that looked like a pestle for pummeling garlic, but was not, since it was metal and had an electric wire sticking out of it. Then she pushed the metal pestle against my chest and began to pummel me for the next 20 minutes while looking at a computer screen. She was kind enough after the procedure was finished to say that she saw nothing bad that she could tell. Of course, she said dutifully, the pictures from the Echo Cardiogram would have to be reviewed by a cardiologist.
After that the real excitement began. I was wheeled to my new home…room 314. There I found a gentleman named Orlando in the next bed with his daughter sitting by his side. A curtain separated out two beds and my bed was next to the window while Orlando’s bed was nearest to the door. For a while things went pretty well. I didn’t hear or see Orlando even though he was in the room with me only a few feet away. His daughter seemed to be pretty jovial, asking her father to think of the medicine a nurse was trying to administer as vodka. That seemed work well as long as his daughter was around. However, things went south once she left.
The first thing I noticed was that Orlando had some kind of bowel problem. This became evident as a succession of nurses came to change his clothes and wash him up two or three times. From the smell of it, I judged the bowel problem to be of the solid variety. And I could tell by the offhand comments of the nurses that they were, as is perfectly understandable, getting fed up with the mess up and clean up routine of Orlando.
Pretty soon a special ringer nurse was brought in. At first I thought he might be a relative, but I finally realized he was a late night nurse brought to help out with the more difficult cases. Pretty soon Benny (that was his name) was doing his very best to take care of Orlando. In doing so, Benny noticed I was watching Fox News about the election. While Fox News is not my favored media, I, being just back from Asia, was eager to catch up on all opinions of each station, so I was moving back and forth between Fox and CNN, soaking up their diametrically opposed opinions. I have to say, horrifying or not, the Presidential Election of 2016 is really interesting.
Anyway, Benny, in between trying to calm down Orlando, started to ask me questions about the election. Who did I think would get elected, Benny asked. I said I was afraid that Trump was going to win. How could he win, asked Benny, Trump hates everybody.
Well, I agreed that Trump did seem to hate everybody, but I still said that I felt that he might really win. For a while Benny and I had a nice conversation on the state of the world and for while, things the room were pretty quiet.
Around 7 pm and while Orlando was still relatively well-behaved, the good Dr. Roth, the lady neurologist, showed up to say that she had looked at my Cat Scan and my brain MRI and had found nothing out of the ordinary. She went on to say that she really no idea why the nurse called it a code orange situation because she could see no evidence from the tests results she had seen of a stroke or of brain damage. That was good news to me and we had nice little conversation about what happened, how I fell, what parts of my knee that I bruised and how it is good to check if you have had a stroke. After about 20 minutes of this nice conversation, she drifted out the room on her to other patients, who no doubt had more pressing needs.
A little after the nice lady Dr. Roth left, Orlando decided to up his game, just as Benny and I the beginning to get into a further conversation on politics. Not only was Orlando asking Benny for more cleanings and more changes of clothing, he was beginning to tell Benny that he had not checked into the hospital and it was all a big mistake. I could see that Benny was having a tough time dealing with his new problem child.
But Orlando, who turned out to be very obstreperous 92 year old man, was not content to leave it at that. You would not think that a 92 year old man could be that difficult, but Orlando was not to be underestimated. Pretty soon Orlando was trying bribe Benny to take him to a hotel and claiming he had been kidnapped. Benny bravely tried to reason with Orlando that it was his own family who had put him in the hospital.
But Orlando was not buying that for a minute and pretty soon he calling out loud for the police to come and rescue him. This went on for a good two hours with other nurses coming in and frantically and Benny and the other nurses trying to reason with Orlando. All efforts failed and Orlando kept up cries of “Help” and “Police”. Again, you would be surprised at the strength and persistence of Orlando.
Now, since Orlando was a 92 year old guy, his voice and physical strength was not as great as a 40 year old man. That said it was enough to keep 3 females nurses and Benny frantic with trying to reason with him and trying to restrain him and trying to keep up with his mess ups and clean ups. Finally, in consideration of the fact that I was an innocent victim who just happened to be in the same room, the nurses had a little pow wow and decided to move me to the only empty room on the floor, room 304. I was very grateful because the cries and antics of Orlando were beginning to wear me down.
As I was being wheeled out, I wished Benny good luck.
Benny was not optimistic.
“Oh, no, I am going to die tonight,” he said as I was being I wheeled out of the room.
I found out, just as I was leaving, that Benny was working overtime, so it was probable that Benny had not much sleep.
I left Orlando and Benny to their pain and was rolled off to the relative quiet of room #304. Here, I kind of struck gold because I was the only human in the room. Considering the fact that this was a very busy night in Mather Hospital, another fact that I learned as I was being wheeled away, I was really lucky to have a room of my own.
Shortly after getting to room #304, the nice nurse who had rolled me over, came to check in on me. I am guessing she was in her late 50s and, after asking her a few questions, I found out she had been working in Mather Hospital for about 20 years. She was concerned to see if I was now comfortable and she checked on how the various hookups to the portable monitor I was wearing, took my blood pressure, pulse and temperature, all of which were normal. She was concerned to see if the TV in my room was working – it was not – and she promised to call the TV company to make sure they got it working.
I complained about the IV that was still in my arm, even if it was no longer connected to anything. My nice nurse said they could take that out because you never if they might have to administer some medication. I didn’t like the idea of having a catheter sticking in my arm, but there seemed to be no way around having it.
The nice nurse went out of her way to apologize for the behavior of Orlando, saying that it must have been stressful listening to Orlando protest his situation. I said that I thought it was probably far more stressful for the nurses, her, Benny and the other two nurses, having to deal with cleaning and changing and restraining and trying to control Orlando.
Sometimes the patients get that way, especially, the elderly. she said. And then she said something exceedingly strange which made me have some sudden and genuine sympathy for Orlando.
“You know in Florida they don’t give colonoscopies to patients over 75. I don’t know why they give prescribe a colonoscopy for patients over 90. You know, he had a bowel prep. So his bowel problem was caused by the bowel prep that he was given. That’s why he had to be changed so many times.”
It was then that I realized that it was kind strange to order a colonoscopy for a 92 year old man. I mean, what was the point? If the test was negative, what would they say? You can go home. If the test was positive, what would they say? You got colon cancer and maybe you will die. If you are already 92, you probably know you do not have many years to live. So, again, I could not help but wonder why Orlando was having a colonoscopy. I can hope there is some logical reason for that.
Anyway, I was grateful to the nurse for being kind enough to come back and check in on me and give me this somewhat strange information on the plight of Orlando.
I mentioned before that my new room was relatively quiet and that is true. By that I mean, I did not have to listen to the croaking cries of Orlando as he endeavored to get released from the hospital. So in that sense, the room was much quieter. However, after a few minutes in my room, I began to really notice all the other sounds and the spectrum of different noises was truly impressive. There bells and beeps and humming sounds coming from both the various machines in my room and the machines just outside my room and just down the hall.
It seems that in a modern day U.S. Hospital all the patients are hooked up to some kind of machine. Now I was relatively free, being only hooked up to a monitor that kept track of my heartbeat, my CO2 content and my blood pressure. And my monitor was relatively quiet. It only beeped and binged a little bit. In my room, was another monitor that seemed to be a general monitor somehow connected to all the other patient rooms. And if a patient pushed the little button to call a nurse, it would start beeping. And if nurse didn’t come, it would start beeping louder and more frantically and if the nurse did not come for a longer time, the decibel level would increase with each minute.
It was then that I realized that my room was really not as a room meant for patients, but rather it was designed as a nurses station. However, on nights where all the rooms on the the hospital floor were fully occupied, this nurses station was occasionally used as a patient’s room. Hence, my good luck in having my own room.
All this probably meant that this particular room might have been somewhat noisier than the other rooms with patients in them. I say somewhat noisier because in truth all the rooms were inherently noisy, mostly because the many patient were all hooked up to different machines that beeped and whistled and hummed and droned and moaned and whined and made noises that the most brilliant digital musician could only dream about.
Now, by this time it was about one o’clock in the morning, and because evening had set in, there were very few sounds of nurses and doctors on the floor. This made the noises from the various medical machines and equipment really loud and really dominant. And while I was trying to go sleep, I tried think think of what that really like. I came up with the idea that trying to sleep in that hospital room was like trying sleep on the inside of a pinball machine while a pinball game was being played.
So imagine, if you can, a man on a hospital bed inside of a pinball machine with the pinball bouncing off of different parts of the pinball field and a very active and enthusiastic pinballer pushing buttons frantically trying to knock the pinball around my bed while the pinball bounced off of different stations, making maximum decibel bell sounds with bings, and dongs and sirens going off. In short, it was impossible to sleep.
This was not improved by the fact that a nurse showed up at 2am and 6am to take my vitals and several more vials of blood. I suppose this what a modern hospital in the U.S. is. I could not help but wonder to whose benefit all this was? Was it to the benefit of the electrical company powering all these beeping and binging and ringing and buzzing machines while happily charging for the needed electricity, or to the benefit of the makers of all these wonderful high tech monitoring machines keeping track of all the vitals of all the patients, or to the benefit of the nurses and doctors who occasionally looked at the data continuously streaming out these machines, or to the benefit the patients whose vitals were being monitored while they trying to get some sleep among all this clamor.
I did not go around floor and ask each patient if they were able to sleep, so I do not know for a fact who got sleep and who did not. I can only say that I think you would have to be in deep coma to get some rest on that hospital floor.
As you might understand, by the time the morning rolled around and sunlight began to flood into my beeping and binging room, I had long made up my mind to get the hell out of there at the earliest opportunity. So when the nurse brought in the tray with the long dead pears in little cup of goo juice, the Raisin Bran cereal with warm skim milk and the decaf tea which tasted like warm oak leaves, I announced to the nurse that I wanted to her to call my doctors and tell them I wanted to get released as soon as possible.
At first the nurse said it was up to the doctors to decide when I would be released and that they might decide they needed a few more days to observe my condition. But I was ready for nurse because I had used my sleepless night to good purpose. I had gone to the trouble of reading through the nice booklet they provided on patient rights and I immediately pointed out that points #11 and #13 permitted me to refuse all hospital services and to be advised by the doctors of all the reasons that was a bad idea and to then leave the hospital. So, I told the nurse, unless the doctors can give me some actual and valid reason not release me, I was determined to be released that very morning.
Now, this may make you think that I was just as much a trouble-maker as the 92 year old Orlando that I mentioned earlier, but no, I was far more diplomatic. I said I really would like my doctors to sign off on this, to say that it was perfectly all right to leave because after all, after taking a bunch of tests, they found nothing wrong.
Anyway, this approach got the attention of my nurse and while she was very much saying doctors know best, she was still sympathetic to my wish to get released. So she went off to consult one of the doctors who was now coming onto the floor to make her rounds. Soon, a nice young Indian or Pakistani lady Doctor (I preferred not guess which country since the two countries seem to hate each other) came in to try to persuade me that this was unwise. First, she tried to persuade me that I had stroke.
No, I said, I have already had a nice visit the night before with the good doctor Roth. She said my Cat Scan and my brain MRI were both normal and showed no evidence of a stroke.
“Hummh,” said the lady doctor, “Well, we are worried you might have had a heart attack.”
“Why?”, I asked, “Did my EKG or Echo Cardiogram show evidence of a heart attack?”
“Well, the EKG was normal, but I did not know you had an EchoCardiagram. I will have to check that out.”
I told the young lady doctor, who I am sure was trying to be a professional and as responsible as possible, that I was pretty sure my EchoCardiogram would be normal if my EKG was. After all, I had no history of heart problems, I get checked every year for heart or other problems, I don’t take medications, I exercise regularly, I have normal blood pressure, heartbeat and temperature. I then went on to say, if the doctors can tell me one good reason to stay in hospital longer or take other tests, I would listen to that, but if all the tests they had so far were normal, after a Cat Scan, a brain MRI, an EKG, EchoCardiogram and God knows how many tests on the 12 vials of blood I had already given, I am going call this fishing expedition at an end and insist upon leaving the hospital.
The good lady doctor was not happy by this, especially when I asked to get the doctor to review all this in the next two hours. She went off shaking her head in dismay. She had, by the way, beautiful black hair and I was only able to guess that she was either Indian or Pakistani and, as mentioned previously, one has to be careful about suggesting either these nationalities since they hate each other with a passion. And of course, she could be some other nationality. Whatever, she seemed to be a fine young doctor lady, who was a little too prudent for my taste, but no doubt well-intentioned.
As luck would have it, the needed doctors to approve my release did show up around 11am and they did come by. They were headed up by the good Dr. Ahktar. Now with a name like that you think he looked like a terrorist from the Middle East. Not this Dr. Ahktar, he looked more like Princeton graduate. Under his white cloak, he wore snappy collegiate sweater vest, spoke the most fluent American and seemed to have a sandy complexion and sandy hair to go along with his All-American look.
He seemed like a truly nice guy, although he did reiterate that they would love check me out a little more. In any case, he did admit it was true that all the tests they conducted were completely normal and there was no real reason to keep me in hospital any longer. In the end, he signed a release and extracted a promise from me to see my regular doctor within four days.
With great relief, I left the hospital, went home to recoup from the beeps and buzzing and ringing and dinging and binging that seemed to inhabit my head for several more days. How anybody can actually rest and recover in a hospital is beyond my understanding. I can only hope that there is good scientific reason for all the machines and all the noises in a hospital.
In the allotted four days, I did schedule an appointment with my regular doctor, Dr. James Kelly. He kindly saw me, asked what happened. When I told him it was his assistant who recommended me to go to the hospital.
“That’s the best thing you could,” he said, “If you come to our office and for some reason do have a stroke, it will probably be too late to help you. You did the right thing.”
Dr. Kelly then took my temperature, my pulse, my blood pressure, listened my heart, looked in my ears and in my mouth.
“Everything looks normal,” he said.
I asked Dr. Kelly to tell me what the blood tests the hospital conducted told him. I had brought along the hospital report that they gave me when I was released.
“Let’s go through that,” said Dr. Kelly, taking a look at the paperwork that I gave him.
He then went through the 25 or so test results listed on the paper. After stating each test, he ended with two words:
“All normal.” The only thing that was not quite normal was cholesterol level.
“This really isn’t pertinent to these these tests, but your cholesterol level is really good – 117 over 56.”
I was glad to hear all of this. I then told Dr. Kelly that I thought my passing out and hitting my knee on the bathroom floor was probably the result of being tired from my trip to Asia, having a cold and taking Contac.
No doubt, that was what it was, said Dr. Kelly. He then went on to volunteer this:
“You know, years ago, when I went to church as a kid, every Sunday, someone would faint in the church. And what did they do? The priest would give whoever fainted some water, tell them to sit down in a pew for 20 minutes and then send them home. That was it. It was a different time.”
That reminded me that I had fainted in church on two separate when I around 14.
“It’s all the lawyers.” Dr. Kelly volunteered, “That’s why the doctors give you all these tests. If there were no lawyers or they just put a cap on liability insurance, they would give you half the tests and you have been out of the hospital in less than two hours.”
This led to a different track. I had come to my own conclusion that giving me all these tests must be pretty expensive. I was thinking $10,000 or $15,000 for the day I was in the hospital and the various tests I was given.
I asked Dr. Kelly what he thought the cost for my visit might be. He did not hesitate to answer.
“$25,000 to $30,000,” he said, “And you know, it goes on all day long, every day, people coming to the ER, getting all sorts of tests done, most them just because the doctors know if they do not prescribe the tests, they will be sued by the lawyers. The system is broken and I don’t see it getting fixed.”
I left the good doctor Kelly on that note. I must say this experience, both the visit to the hospital and my talk with Doctor Kelly set me to thinking.
As far as I can tell Obamacare or whatever system we put in place of it, just does not have a chance to ever be reasonable in cost. Nor is it likely to ever offer patients the best possible service. Our system almost seems setup to subvert that from happening.
I can say without question that I think it was important to check out what happened to me. It is no stretch of imagination to think that I might have had stroke or even a heart attack, especially for a man of my present age (74). So clearly it is important to check out some health event and see if it is serious. And certainly doing this without questioning and as fast as possible, is also equally important.
That said, the system a patient is confronted with today is clearly vastly expensive and vastly over-protective. There must be, there should be, a better and less expensive way to quickly and quietly determine if someone is having a stroke or a heart attack without the fear of thousands of lawyers suing for and against what happens or what did not happen. It is truly a broken system.
One can only hope a better way is found forward in the future.