Guerra On Healthcare: Clinicians Work In Flawed System
A recent hospital stay by family members generates equal parts admiration and frustration.
While we admire those who've blazed trails we someday hope to follow, we truly revere those whose accomplishments lay forever outside our scope of talent or inclination. This is why I revere people who administer to the sick. I am uncomfortable around hospitals, illness, and the related indignities. In short, I don't want to be there if I don't have to. So choosing a career that requires "being there" wouldn't make much sense. I'd never be as effective as someone who didn't mind, or actually liked, being there.
My wife likes being there, having spent 10 years as a hospital nurse in an ICU step-down unit where the sickest of the sick often languish on ventilators. Rather than adopting my selfish stance, which first considers how being around illness makes me feel, she -- like the majority of healthcare workers -- thinks about how much better she can make them feel.
But for those who can handle the environment, the day-to-day work of healthcare is extremely rewarding because, by its very nature, the healthcare environment sits on the fringes of normal human experience. It is one in which workers can experience the highest of highs and the lowest of lows almost daily. To the rest of us, these highs and lows come once a year, if not less frequently. According to Johann Wolfgang von Goethe, it is only on these fringes where life can be lived to the fullest. "A man can stand anything except a succession of ordinary days," he wrote.
I saw those fringes firsthand last week when, within the span of 48 hours, my second son was born and my father suffered a minor stroke. In fact, it was at the end of his visit to meet his new grandson at the hospital that my father mentioned "feeling a little strange earlier in the day." A few questions from me, followed by a brief interview with my wife (still recovering in her hospital bed), saw my father and me walking from the women's and children's hospital, across the parking lot, to the main hospital emergency department. For the next 24 hours (until my wife and son were discharged), I split my time between the two hospitals.
While all are now doing great, my father sat in the hospital far longer than was necessary, largely because of information-flow problems endemic to our healthcare system. His neurologist would not consider discharge until an MRI was performed, but that could not be done until his stent from a bypass operation and his sheath from an abdominal aortic aneurysm repair were both cleared. This took far, far longer than necessary. Part of the problem laid with my father not having, at the very least, accurate and easily accessible paper records of his past medical procedures or, at best, a personal health record (PHR) that can be toted around on a thumbnail drive or accessed from any computer.
But part of the problem also lies with a lack of electronic communication between physicians. Unfortunately, we're still largely stuck in a world where getting two physicians on the phone is the most expeditious way to facilitate the necessary information exchange. Of course, the frustration of trying to get a cardiologist and neurologist on the phone together could put someone in the hospital.
So the mini lesson here is that if you've got medical issues, have your papers handy and accessible, or enter all that information into a PHR. But the major message is to appreciate the healthcare workers who are exposed to both the wonders of birth and the sadness of prolonged and insurmountable illness every day.
At one point during the hospital stay, I was waiting for the elevator that would take me up to my wife and child. Coming up behind me was a family of five carrying "Get Well" balloons. They were all crying, but the tears were not of joy. I quietly backed away from the elevator so they could go up alone, save for each other and their grief. I felt terrible for them, while reflecting on how lucky I was.
It all happens in the hospital each and every day. How fortunate we are to work in, and with, such an industry.
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