By Howard Dyckoff
First, there is Sam, the handy man. The “Eat at Mel’s, go for a 6 pack in the park” kind of guy. Having no medical insurance, ignoring health needs, eating the cheaper, high-calorie, low-nutrient food found in mini-marts and the scattered fast-food outlets of Deep East he slowly gets sick.
So he has diabetes and high blood pressure and parts of his hands and feet are becoming hard and insensitive. These parts of Sam are dying. They are leaving him. He listens to the doctors list his problems and tries to bargain about lifestyle changes. He doesn’t have stable lodging, no regular income, no regular place to cook. He promises to try to eat a little better, but his voice lacks commitment.
Also up there, on Highland Hospital’s 7th floor, was Roberto. He works as a security guard at malls and warehouses. Also diabetic, his feet have developed blisters that did not heal. He ignored the problem for too long. He is hoping to go on disability since he will not be able to walk for weeks as he recovers.
Roberto was very friendly and made efforts to get to know everyone. He would tell his story and he often described his diabetes as bad luck or an unfortunate turn of events. But he never discussed how he got diabetes or what he failed to do to keep it in check. Instead, his diabetes was like a relative he owed money and had tried to avoid. Until one day, he got cornered.
A Korean man was briefly in the bed next to mine. He said little but later I found out his cancer had returned and he quietly endured significant pain. I did not get his name, but his thin and small wife often sat next to him on his bed, sometimes holding his hand as he slept.
When he was discharged, I didn’t know if he had gotten better or was going home for his final days. He was the very portrait of stoicism.
Then there was David, who had many medical problems and deep pain that lasted all night. He was reticent to discuss his case other than to complain the doctors weren’t helping, or a least not fast enough.
But part of the problem was his record as an IV drug user. Hospital policy forbade giving him opiates and meds intravenously. He did receive several visits from his team of doctors, including one that suggested many oral alternatives, some of which he finally accepted.He had to take pain killers by mouth and on a frequent schedule. After a while, his pain was managed, but not before he accused much of the staff of ignoring his suffering.
After 3 days of complaints, and frequent wailing in the night, a nurse came on duty that had worked with him before. She met his complaints by pointing out all that he had failed to do from that last hospital visit and, as an senior, she held the authority of an aunt or mother. He stopped complaining and began to follow her instructions. He got better and then he got released.
In an interesting turn of roles, David eventually rose up to help another Latino man who was alcoholic and was missing his shoes when it came time for discharge. David encouraged the man to complain about the missing shoes and to challenge the discharge. Together, they demanded to see a social worker and to ask for footwear from the lost and found, and they were successful. The found shoes were a little big, but at least the man had foot protection for his way home and to La Clinica de la Raza the next day. That was actually a selfless act. Go, David.
Everyone was in and out in a week or less. But not me. I had to undergo 3 separate procedures, so I was hospitalized over 2 weeks. I saw the patients come and go, I saw the beds turnover. I saw and smelled the nurses aides disinfect each mattress before a new patient arrived. I stayed.
I saw the staff, most of them anyway, rise to the challenge of each new patient. I saw other patients get better while my own health was more precarious.
I’m sure I seemed a bit demanding to the staff sometimes, I hope not too often. But I was in great pain the first 9 days of my stay. I could barely eat anything and lost close over 15 pounds. I really appreciated any help that could be given and much was.
Part of that long time was due to the black hole that weekends are in this hospital and many others. The ER and Trauma Center get most of the resources on weekends and the senior residents and many technicians are off Sundays and often Saturdays as well. The hospital runs in day-to-day mode, but getting procedures planned, signed-off, and even executed generally doesn’t happen on weekends. Sunday becomes just a visiting day.
My second gall bladder procedure had to wait all of the long Veteran’s Day weekend, because there were no techs to preform it. That was 72 more hours of pain and not eating. But that procedure was actually performed at a different hospital, which shows the weekend black hole also happens at other hospitals.
I am very happy the second procedure was completed without incident and I did quickly get better.