Making Hospital Sausage

 

Making Hospital Sausage

A hospital is a great place not to be in. That is, you don't have to be there. However, it's a great place if you do. Which is why I'm writing this Sunday from my hospital room at Largo Medical Center felled by the influenza virus and consequent pneumonia Wednesday night.

  Having been dosed quickly, by vein and mouth, with multiple antibiotics, steroids, Tamiflu, and plentiful oxygen and other respiratory applications, I will, as one doctor reassuringly informed me, "survive" or "live". I don't recall exactly his words, but accepted either quickly. So here I was and am, time on my hands, time to look and watch and listen.

  I've been in hospitals before. The first was at age 13 at the end of WWII and I vividly recall the large 10 bed ward of fellow appendicitis, surgical, and general illness victims in Alexandria Hospital, Va. I particularly remember the one large globe light in the center of the ceiling. That's where the little guys with the long red tongues hung on with one arm while taunting me with "nah, nah, nah,nah". They didn't say why, but the morphine probably had something to do with it and the morphine was the result of my incessant vomiting as the result of the ether. I survived that, too, but let's just say things were very primitive, even simple or black and white, not the red tongues of course) back then.

  Sixty-six years, particularly the last 25, has changed medical technology, doctors and hospitals and the change is accelerating even as we race to catch up by trying to fix everything in one place with one order with one delivery system today for a system that has already run out to tomorrow (a separate story or stories). At any rate, a hospital is a dynamic, sometimes dramatic, complex, confusing, yet orderly, happening place.

  And there I was in the middle of it. In the stomach of the beast. The sausage at a sausage factory. After the peaceful registration process at the Emergency Department reception room, the move to the ER is like being placed carefully and expertly on a New York City street corner where everyone knows where they're going except you. Friendly and intense people wrap, prod, probe, stick you with appropriate materials and you're room ready.

  You wake in the morning, after several more probes, pokes, and doses, to relative quiet staring at an acoustical tiled ceiling in a 12x12 room off an 8 foot corridor off the big corridor. A small lavatory and bathroom jut off the small corridor. The back wall is covered with computers, electrical cords, hoses and attachments some of which are attached to the adjustable bed and some to you. A large window overlooks a golf course, useless to you, but pleasant to view. I think all rooms here are single ones, but since essentially I'm an infectious bomb, I probably wouldn't have a roommate anyway. It's nicer. But, I'm not alone.

  Like a rising tide, the activity begins. You hear it from the halls, on the intercoms, in the footsteps, in voices, like an increasing wind rustling through the trees and then the parade begins. Nurses, food servers, technicians, housekeepers, phlebotomists, respiratory specialists, lab techies, in and out of the room, followed later by one, two, three doctors. Computers collect and record everything and report where, I don't know, nor to how many or how long. The sounds, the rhythm, the tempo, the pitch moves in overlapping waves and gradually subsides but doesn't give out as the day goes by.

  It's a ballet of people. Professionals, patients, visitors, vendors, cleaners, cooks and dishwashers, administrators, and clerks. Unknown voices on unknown devices operating extraordinarily expensive and delicate equipment, on delicate human beings with a preciseness and confidence that probably isn't always warranted. There are check lists, and check procedures, and regulations and protocols interplayed between and by human beings of various personalities, abilities, knowledge, and concern, nationalities and cultures. And, despite the inherent conflicts, the pressures, the demands the work gets done with an overall cheer, at least in the patient's view. 

  The sausage is made, stuffed and wrapped and out the door. Not very pretty, but well prepared. All in all it's a high cost environment delivering high cost, innovative (also high cost) and high quality care. For which I get a bill. That is, Medicare and my supplemental insurance company, and I will pay the bill. That bill will probably exceed the sum total of all my office visits, blood and other tests, as well as  drugs that I have received or used in the past ten years.

  Medical care isn't going to be less expensive. It may get cheaper by the unit, but there options and quality and overall cost will increase. We'll have to pay for it, because none of us wants less than there is out there. And, the care is good.

  That's the lesson for today. 

  I have one more item. My stay was as pleasant as it could be under the circumstances and the people friendly and helpful and effective.  But about that bathroom light bulb. It's still out. So, tomorrow my wife is bringing in a ladder, a screw driver and a squiggly fluorescent bulb. She will fix it. I expect to deduct the following from my bill:

  1. 8 ' ladder rental: $100

  2. Screwdriver use: $25

  3. Bulb: $225

  4. Patient supervision: $500

  5. Overhead, billing, etc.: $100 

  6. Rental, LED flashlight: $50

  7. Wife's labor:Priceless

 
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