Then the thought, How could I possibly know it’s been a long time? I have no idea what time it is.
I look up and see a nurse. He is typing fast and diligently looking at a computer. His eyes are locked on the screen.
Please see me, I think, for I have not yet found words. I’m here. I’m alive. Can you see me? Please?
He types. He just hasn’t noticed yet, I think.
Then he speaks. “Are we feeling ok?” He is not looking at me; he is looking at the screen. And typing.
I have a name, I think. Please.
He asks me more questions, impersonal ones. He is professional. He is friendly. He doesn’t use my name.
My life has just been made better, by far, by nearly miraculous technology in the hands of a brilliant cardiologist. He is also a dear kind man with a loving soul, an unfortunately too-rare thing in modern US medicine.
In the hands of this man, I underwent a cardiac ablation for atrial fibrillation. Today, the day after that procedure, I am home with a heart that is beating steady and true. My throat feels as though it’s been stretched to the width of Tennessee, which I suppose is what happens when you shove a probe down it for a transesophageal echocardiogram, pull it out and then replace it with a breathing tube for the part that’s done under general anesthesia. My chest feels as though all 15 rounds of the Ali-Frazier Thrilla in Manilla were reenacted in there, which the good doctor said is basically what happens when they run 5 probes up femoral veins and arteries, puncture the atrial septum to get to the left side, and cook the errant cells that are causing all the ruckus.
I am better because of this. I will likely live longer, and healthier, provided of course that I do my part. It is a miracle, truly. Still, I cannot help but reflect that, with all that is right with this system we call healthcare, there is much, much that is wrong.
First, an apology. This is not about nurses. Not in general and most assuredly not about those who cared for me. They were unfailingly professional and friendly – well, all but one, but those are good odds. It’s also not about doctors, or techs, or any of the people in the American healthcare machine. As in every profession there are some great people in these professions, a few who should find a new job, and most who are simply and utterly competent and good-hearted.
But they work in a machine. The US healthcare system is the most expensive by far on the planet, and yet we lag behind almost every other industrial country in managing the risk factors that lead to chronic disease. We are 65th on the CIA’s ranking of infant mortality, behind such notables as Cuba, Serbia, and Slovakia, as well as most of Western Europe. We have dismal outcomes when it comes to preventable causes of death, according to the Centers for Disease Control.
We are great at the kinds of technological wonders that have just improved my life, and the medical machine made that possible.
But that machine, I have come to see from the perspective of a patient, is entirely about efficiency. The young man I woke up next to, diligently typing away, wasn’t ill-intentioned; he had too many people to watch over, and so many notes to type that he couldn’t afford to look away from his screen and look me in the eyes to see the disoriented, frightened man next to him.
The machine is about efficiency that cuts staff to the point that, instead of letting patients sleep and taking vitals across the unit in one short period, the few that remain have to go in and out of rooms all night in order to get to everyone. The result is no sleep for the patients. It is about efficiency that means no windows in patient rooms so you can make better use of space, but that also means no light and more disorientation to time. In this efficient machine things get done, but hospitals are no place for a sick person.
My experience in the machine was far superior to those who have no advocates, because of the blessing of my two loves Maddie and Flaun – the other two thirds of our triad family – taking turns so that I was never alone. It didn’t hurt either that I had a cardiologist who is both brilliant and my friend, and he is a powerful advocate for his patients.
Every nurse that I know recommends that you never leave a loved one alone in the hospital. Why? Wouldn’t you think that hospitals would be perfectly safe for everyone?
They probably are, but in an efficient machine, mistakes get made and human needs go unmet.
Pro tip for healthcare workers: never complain about the doctor who cared for your patient, while they lie there and listen to your side conversation.
Pro tip #2: come to think of it, don’t have side conversations at all, when you could be expressing interest in your patient instead. Especially when you are referring to me in the 3rd person.
Pro tip #3: if you want to know how your patient really feels, don’t ask “Are we feeling ok?” The natural response to this is “Yes,” which means you’ll spend less time, but it might not be true and you might miss some really important information. Not to mention that I don’t know how “we” feel because I have no idea how you feel.
Pro tip #4: for the love of all that’s holy, call your patient by the name they prefer. They’ll respond faster and feel more like a person.
I am home and happy and surrounded by the love of my family and the well-wishes of many, many friends, online and otherwise. I have benefitted from miraculous technology, a true physician-healer, and staff that carried out their duties in spite of the pressure put on cogs in a machine.
I am grateful beyond words. What better way to ring in the new year than with a new heart?
It’s just that, when it comes to caring for people, we can do better.
Dr. Les Kertay, Awakened Moments