Echo, Echo
While getting my Zumba on a couple of weeks ago, a couple of texts pinged my watch from my brother. He was planning a surprise birthday party for our stepmom, and I figured he needed help that could wait, so I shook them off my wrist and went back to shaking my booty. My addled mom brain has more holes than substance these days, so by the end of class, I’d forgotten about the messages entirely, and it wasn’t until I was on a conference call 90 minutes later that I noticed the red dot reminding me that I had new texts.
His messages were not about the party. They said that he had been summoned to my dad’s house at 4 AM because he was having trouble breathing and refused to call an ambulance. He stayed with my dad at home for a while, but the situation got to the point where this was no longer safe, so he was taken to our local hospital. My brother is a firefighter and doesn’t scare easily, so his concern pushed me into full trauma response. Time to fight. I grabbed everything I needed for a day in the ER (my laptop and charger, my phone and charger, and most importantly, a warm sweatshirt) and hightailed it over there.
It was raining buckets, and the hospital parking lot was so full that the valet service had stations within the multilevel structure. Cars were triple parked to deal with the deluge, and I had foolishly brought my truck and quickly got myself stuck and then panicked. I abandoned the vehicle, found a valet driver, and pushed the keys into his hand explaining that I was in a rush and that I needed him to figure it out for me. He gave me a claim ticket, and off I ran. Imagine my humiliation when I got to the elevator and realized my phone was still in the car. I trudged back to explain what happened with my tail between my legs, cursing myself for my “I don’t carry cash” lifestyle.
When I finally got to his room, the level of commotion did nothing to alleviate my fears, and I ran to his bedside to hold his hand because he was visibly afraid. Then, I turned my focus back to the work that needed to be done: understanding what was wrong and what they planned to do about it. I rattled off a staccato of technical questions to the ER nurse who kindly noted that we were wearing the same sweatshirt before asking if I worked in health care. In response to my answer of “it’s complicated,” she nodded and calmly answered my questions.
Once the ER team decided it was safe to transport him, they brought him up to the ICU, transitioning us into the belly of inpatient madness. Hospitals are extremely dangerous places. If you don’t have an advocate to speak up for you, they may kill you by accident. While ranting about this to my optometrist later in the week, she shared that her grandmother had recently died due to hospital error. After her grandma was admitted, an assessment concluded she was at a very high risk for a stroke. They then forgot about her, and she died alone before they remembered to check on her.
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Why is this happening? Institutional negligence due to low staffing, lack of funding, and more. These problems are a result of rot in our medical policy that permeates everything. This hospital is now the only one for miles in all directions. Patients are rolling in 24 hours a day with a litany of maladies including drug overdose, cardiac crises, broken bones, psychiatric emergencies, and everything in between.
It is also the sole provider of health care to many of the homeless population who present with complex cases as do the underinsured. Add to this the purchase of the facility by a healthcare conglomerate that sucked it dry instead of providing the cash infusion that was promised. The community saw this coming but shutdown was probably the only other option and that would have made everything exponentially worse.
Even with the understanding I have of the systemic failures, I was appalled by the shop that they are running over there. To respect my father’s dignity, I will leave the rest of the details with one exception. As they were getting ready to move my dad, one of the doctors made it very clear that he needed an echocardiogram. I was shocked! How could a patient with a known heart defect and respiratory distress be in the ER for about 8 hours with no echo? This is not a complicated procedure, but in all, it took about 24 hours to get this essential imaging done.
Echo indeed! During the following week, I felt like I was screaming into a void with nothing but the echo of my own voice playing backup vocals to the overworked staff whose responses to my questions were mostly snarky, sometimes angry, and other times intentionally technical in hopes I would get overwhelmed by the “big words” and shut up. Ha!
Despite the magnitude of these shortcomings, my own actions and emotions as well as those of my family members were the hardest to work through. They included rifling through my dad’s house like a bloodhound in order to find his Advanced Directive then trying to figure out what to do when the words on the paper didn’t seem to apply to our situation. Then my brother and I calling the number on the back of my dad’s insurance card to ask what hospice actually means. And though it all on day two, my father, frustrated about being poked, prodded, and offered only hospital gruel crying out that all he wanted was an “extra large, boiling hot fucking latte!”
I also struggled to accept the vastly different approaches to medicine that I, my brother, and my aunt (his medical power of attorney) use due to different kinds of training and areas of practice. As mentioned above, my brother is a firefighter and although technically he is not a paramedic, the situations he works on in the field lead that to be a bit of a distinction without a difference. My aunt practiced dentistry and then worked her way up to Deputy Director of the dental department of La Clinica, a game-changing public health care agency providing high-quality medical care to underserved people in the Bay Area. And then me; no formal training in medicine but bringing to the table over a decade of clinical experience across multiple specialties and while spending more nights in a hospital than most people ever will by an order of magnitude.
I felt I did not have a voice in the mechanics of my father’s hospitalization, the area in which I am most expert, and I could have lessened his suffering in a meaningful way. Anyone who was with me can attest to the fact that I had trouble managing my outrage. And yet, I imagine my brother was frustrated with my obsession with minutiae. And, I imagine my aunt was frustrated that I showed up, seemingly out of nowhere (more on that at a later date), very vocal in my opinions of what needed to be done.
My dad was discharged a week after his admission with no clear explanation of exactly what happened. The best way that I can frame this experience is as a critical dress rehearsal for the inevitable time when we are playing for keeps. What I can say is that during that time, my father will know that he is loved, each of us expressing this in the language that we know best. You will be able to find me easily, I’ll be the one with the extra-large latte, a squeaky wheel of high expectations, refusing to leave the room.”
