My brother died on July 25, 2022. Jimmy had experienced multiple health issues over several months. He was dealing with diabetes, a dysfunctional bladder, and gastro-intestinal issues that led to an ileostomy. Then came the heart attack.
Jimmy had lost about 30 pounds before being hospitalized. On June 13th I drove him from a urology office in Warner Robins to Atrium’s Emergency Room in Macon due to severe nausea. He spent 12 days in the hospital before being transferred to their rehab facility on June 25th. On July 8th he was transported from rehab back to the hospital due to chest pains.
Problems would improve then reappear or something new would develop. A bout with COVID added to the complications but earned him some privacy. Sick folks separated by a curtain and having to share a bathroom seems an odd approach to rehabilitation. Maybe it’s meant to inspire escape.
The people were excellent. Doctors and others tried diligently to resolve Jimmy’s health issues. Nurses and support staff were compassionate and efficient. I was on a first name basis with the friendly ladies at the check-in desk. And a nice young man in scrubs showed me how to buy a bottle of water with a credit card. My card wouldn’t fit into the cash slot.
The process, however, is often frustrating. In my opinion today’s medicine needs a major overhaul. If I’m wrong, I’d love to hear an explanation. Here are some thoughts.
I completed a survey about Jimmy’s first stay but many of the questions weren’t relevant. A better method would be a short discussion before discharge. What could we improve on? What did we do well? What else do you need from us?
Some issues probably stem from insurance restrictions. Jimmy was sent to rehab before his bladder function was restored so left the hospital with a catheter. A scope said he was okay but his bladder wouldn’t listen. It’s hard to pay attention when you’re under pressure.
As he headed to rehab, my understanding was they would try to retrain his bladder. Once there, however, they said his urologist could address that later. He was miserable, so I called the urology office which made arrangements for intermittent catheterizations.
That’s too much information, but it points to a flawed system. If a patient leaves a hospital with a catheter, a follow up plan should be in place. I’ve learned not to take anything for granted and that every patient needs an advocate, which brings me to my next concern.
Specialization is beneficial, but it lends itself toward focusing on narrow areas rather than the big picture. Computers are filled with more information than anyone has time to review. Everyone is looking at something but I’m not sure anyone is looking at everything. Standard procedure seems to be oriented toward a quick assessment then working out a plan for someone else to implement the next day.
Dr. Joe Christmas spoiled me. He was a family practitioner who knew my history and sometimes what I was having for dinner. There’s a lot to be said for the country doctors of yesterday. Today’s medicine is a revolving door of hurried professionals juggling a plethora of patients they only know from a chart.
On a related note, I don’t know what all Jimmy was screened for. I asked more than once if he’d been tested for celiac disease, salmonella, diverticulitis, and C diff. The standard answer was, “We’ll need to check on that.” When no one writes your question down the answer is predictable.
And when a patient has procedures like endoscopies and colonoscopies, it would be nice to get a report that same day. Otherwise you’re left to guess what time someone is coming and hoping you don’t miss them. Even a text would suffice.
I have three suggestions for now and a fourth for next week. One improvement would be to provide a brief written summary each day in layman’s terms. Tell what’s been done and what’s planned. The second idea is to designate someone to answer questions. Patients need a liaison with access to information and ten minutes of time. My third recommendation is to stop wasting the weekends. Jimmy spent two days with a badly distended abdomen taking morphine to mask the pain. The search for solutions shouldn’t be paused on Friday afternoons.
That’s my two cents worth on today’s medicine, an opinion guaranteed to be worth every penny. If people in charge of corporate healthcare are reluctant to take my advice, I can’t blame them. It would be hard to put confidence in a man who needs help using a vending machine.