Monday, October 11, 2010
In the Belly of the Beast
In my eight days in the belly of the beast, I learned that the hospital consists of two sections, like halves of the same heart, only working at cross purposes. The medical services side, the human side, offers care generously and with compassion. The administrative half - breathing icons of big insurance -gives care miserly and begrudgingly. There is the edifice, and then those that work within. The caregivers are the most wonderful people on earth, but the Hospital stands as a monument to the fraud and greed of the Health Insurance industry and their gangland, bureaucratic tentacles. American health care is run sort of like New York's five Mafia families. They muscled their way into a field they had never traversed before and forced people to buy their protection or face the consequences, only they call it, "You bet your life." Their loyal foot soldiers enforce "policy" in every major hospital in the nation, and are in the business of business, skimming profits from Medicare and deciding who gets preferential treatment according to who paid the extortion. After all, this is the world of the five dollar band-aid and the twenty dollar aspirin and a corporation's got to make a buck. The first line of the physicians' Hippocratic Oath is, "First, do no harm." The insurance industry's motto is, "Do harm first." Fortunately, my mother has, and deserves, the coverage by Blue Cross and Medicare known as the "Cadillac Plan." I, in turn, have the "barefoot pedestrian plan," which means I have been unable to purchase health insurance in over a decade because of the notorious "pre-existing condition," perhaps, the very condition that landed me in the hospital. Thus, when I checked into the same emergency room 12 hours after my mother, began a tale of two health cares.
Mom came in at an odd time and when her insurance was verified, the tests began. Within an hour a doctor was called, a CT scan performed, and immediate surgery recommended. Mom went directly from the emergency room, to surgery, and then the ICU where within three hours, thank God, she was resting comfortably after a successful procedure. My ambulance arrived during afternoon drive time and I was placed in a line of stretchers waiting to be registered. I was assigned an alcove, despite my "self-pay" status, and later found I was lucky enough to have hit the "early-bird special," and had only just preceded a rash of car crashes. I alternately hyperventilated into an oxygen mask or winced in agony for an hour before receiving an inoculation for pain, but the dosage wasn't sufficient and I swore they had given me a placebo. After several more hours, a sympathetic nurse who expressed her disdain for their allowing me to lie there in such a state, finally injected me with enough morphine to manage the pain in my stomach, but also give me a blinding narcotic headache. I was denied the two Tylenol I requested. In my delirium, a Physician's Assistant saw me and recommended a scan which produced the results requiring me to be admitted. When I was finally delivered to a private room close to 2am, I had already been in the ER for nine hours, during which time, I never saw a doctor.
Once delivered from the cash-register side to the human side, I received the same excellent care as did my mother. By sheer fortune, the doctor on rounds was ordinarily an oncological surgeon, and in one of those "only in Memphis" moments, I found he was a fellow "Brothers' Boy," from CBHS. He informed me that nine out of ten people now have their gall bladders removed laparoscopically, through the navel, and the procedure is so non-intrusive, they go home and walk it off. I was to be that tenth person. But first, I was to receive a regimen of antibiotics, which allowed me to lie there for several days and observe health care in action. The main thing I learned was that the doctors get all the credit, while the nurses do all the work. They are the front line in the battle against infirmity, they do all the procedures, they offer comfort to the concerned, and personal attention to the afflicted. Doctors pass through on rounds, making pronouncements from on high while the staff strews rose petals in their path, but the nurses are the hands-on face of health care. At the same time, they are bound by hospital "policy" and are at the center of the crossfire between insurance companies, doctors, patients and administrators. They have so many regulations to follow and record, it's like going to work and wearing a wet, wool cloak during your daily labors.
After my blood pressure scaled higher than a Sherpa's yak, my doctor decided it could no longer wait and informed me that only after waking up in recovery would I know if I had surgery or laparoscopy. While I was greeting the same anaesthetist that knocked out Mom the day before, my pressure was putting up numbers like Barry Bonds. I woke up with the pain of a gored matador, but thanks to the wonderful people on post-op floor 5-N, from Bessie the singing housekeeper, to dedicated professionals like Kayola Brown, who is bright and passionate and listened to several "mini-rants" that didn't make the paper, my healing has begun. I am indebted to these people, especially the nurses who should be making some of that doctor money instead of being unable to afford health insurance from the very place they work. Mom's bill is covered; mine would make Warren Buffett gag, reminding me of something wise my father once told me; "It's better to be rich and healthy than poor and sick." We're working it out. They're used to it now. The human side of health care is the best in the world, but the commerce side, the health-for-profit racket, is worse than wasteful and corrupt; it's immoral. We live with a medical system locked within some nightmarish Dr. Jekyll and Mr. Hyde duality which severely limits the greatest good. If we could only do something to rid ourselves of that evil Mr. Hyde. Oh yeah, I voted for Barack Obama. Sock 'em, Rocky.