A Visit To The Hospital

My husband was recently a patient in one of New York City’s most prominent hospitals. You all know its name and you’ve probably heard lots of good things about it. And their ads on local TV and newspapers are inspirational. Why would anyone seek care anywhere else?  This hospital is a huge, formidable institution, serving the NYC community and, really, the entire world, for many many years. It is a very very busy place, impersonal for sure, but, one hopes, masking brilliance, competence and patient care in an academic setting where they train the elite to become doctors, if they are lucky enough to get accepted. My husband waited for quite a while in order to have his elective procedure done at this institution.

What we learned during his five-day stay is that the hospital is dirty, incompetent and filled with professional staff who truly are quite comfortable ignoring many of the patient’s critical needs. Some of the staff are merely ok. Some are nasty to the point of being cruel. Many are totally uncaring.

I can’t possibly describe every nightmarish moment. A synopsis will have to suffice.

His eight hour procedure, under general anesthesia, was cardiac in nature. We chose the physician carefully, with recommendations galore. He was, as we Jews like to say, “the best.” We did not expect him to disappear after a cameo visit with us following the procedure. We literally saw him for about five minutes and never again. Phone calls to his office were responded to, slowly, by nurses, fellows or physician assistants.  No phone call was ever returned by the man himself. He never once made rounds with his students or independently.  So much for a teaching hospital.

This might have been acceptable if my husband had a smooth recovery. He most certainly did not. The insertion of Foley catheters caused him endless and ongoing problems. One night, after midnight, for example, a nurse practitioner (my assumption since no one ever identified themselves), came into our room (it was a private room and I was there 24/7) to remove the Foley. She was alone and was confronted with an enormous surge of blood,  which she could not stop. She frantically pushed on the emergency call button and was ignored.  Finally, in a panic she asked me to run into the hall and get a nurse. The first nurse I came to was calmly chatting at the desk with a colleague. Seeing my distress she completely ignored me!  “Help,” I screamed. “My husband is going to bleed to death if you don’t go into his room immediately.” Her response will stay with me forever. “I’m talking,” she calmly pronounced.  Ultimately, my fury, fear, and anger prevailed and she slowly meandered into his room where she was finally able to stop the bleeding. If he had been alone that night he would not have survived.  Just another night at one of Manhattan’s premier hospitals.

His first room after recovery was a four person ward, supposedly akin to intensive care, minus the actual intensive care! Each patient was dutifully hooked up to monitors which beeped incessantly. These monitors were rarely actually checked by the staff. More commonly they were ignored by all except the suffering patients, unable to sleep with the constant noise level and the stress of knowing those monitors were designed to activate action on their behalf.  Instead the patients and the monitors were ignored. Inaction prevailed.

Sleep was a rare commodity. At 11 pm each patient had his temperature taken. An hour later each patient was removed from bed to be weighed. Anyone lucky enough to fall asleep with the cacophony of noise would certainly be awoken. This hospital was clearly  no place to begin a recovery.

I read a lot and I’ve read about hospital borne diseases. Cellulitis for example. A nurse trying to coax my husband’s vein into producing blood just kept on poking. I finally intervened and I do not know what took me so long!  I told her to go and get someone else to do it since I could not allow her to keep poking away at him. She was furious but she complied. The next person who came was more skilled and succeeded on her first try.

And I read about contagion in hospitals.  Cleanliness in this place is a virtual unknown.  Staff use gloves but virtually never wash their hands prior to donning their gloves.  I know how tedious this can be for them.  But, when lives are at stake a little tedium is surely not asking too much. And don’t ask me about the cleanliness of the rooms and bathrooms.  Secretions secretions secretions.  Just share all those secretions!

It’s imperative to keep track of the patient’s medications since the staff clearly do not.  Medicines were doled out without rhyme or reason, and with no attention to timeliness.  The standard response to a complaint was the orders were changed.  Never verifiably true.

Calling in a consultant proved to be beyond us. Urology sent us first year residents.  Consistently. Our willingness to pay for private doctors was met with a brick wall.

The word iatrogenic means medically caused. It’s an important word to know since I remain convinced that many of the aftershocks of hospitalization are iatrogenic. At least that’s true for this august institution. I hope it’s not the same at your health care provider.