My Hospital Experience

English novelist, playwright, and short story writer, W. Somerset Maugham, wrote something that appealed to me often during my career as a Quality Manager: “It's a funny thing about life; if you refuse to accept anything but the best, you very often get it.” One corollary of that statement would be, “If you accept less-than-the-best, you will quite often get it.”

Thus starts the tale of my recent hospital experience.

Now, it’s hard to keep a timeline straight so don’t hold me to anything. I told you about Amy, my daughter, being home for Christmas, the finding of the swollen bumps near my implanted port, and the subsequent return of Amy and her “monsters” (the dogs) to her home in Tampa. So let’s start again on Wednesday, January 2.

BTW, here’s a photo essay of a port being accessed. The guy looks a lot like me only he has hair! Go with me to a chemotherapy session and that's what you will see them do to me.

I called the VLCC on Wednesday to explain the symptoms I had found, namely the soft “bumps.” Other than the lousy cough, which I attributed to a cold, I experienced no other symptoms. They invited me over for a look and I accepted.

While there, Nurse Practitioner Nancy ordered a sonogram, which revealed a blood clot in an artery leading to my right arm. They started me on Warfarin /Coumadin and Lovenox to thin my blood.

I returned the following Monday for a follow up and blood tests to determine my INR number, which would tell them how well my blood is coagulating, or not. My doctor-of-the-day, Dr. C., asked me why I was wearing a mask. I informed him that I had what I thought was a cold and that I was stingy and didn’t want to give it to anyone else, especially cancer patients with intentionally compromised immune systems. At the same time, I didn’t want to pick up anything else! He made me take the mask off.

I left the clinic that day continuing the Warfarin but not knowing what I would be doing about the Lovenox. Nothing was said about my cough. And I still felt like crap.

A Fatigue Factor (FF) of 10 would mean that I couldn’t get out of bed. An FF of 9 would mean that I could get out of bed long enough to get to the bathroom, the recliner, or the kitchen, but couldn’t stand for very long. I call it “Riding the Recliner” time.

I was somewhere around an FF of 6 or 7. I could get up and around a bit, do the dishes if there weren’t too many, but had to sit down soon. I could go to the store if I used a cart to lean on and didn’t get too many items. A quick in and out!

Tuesday, still feeling fatigued and with the cough, I decided on a reality check. I called my insurance company’s 24-hour healthcare hot line that featured real nurses. It took quite a while to bring Nurse Sheila up to speed with my conditions and how I got there. I informed her about my upcoming appointment with my Personal Care Physician (PCP) in the morning concerning my blood pressure.

She gave me some tips to ease my suffering, but made me promise “cross-my-heart-and-hope-to-live” that I would keep that doctor’s appointment.

I sometimes feel like a victim of Procrustes, who was a Greek robber with a famous bed. If you were too long for the bed, he amputated something so that you fit. If you were too short, you were put on the rack and stretched until you fit. For him, everyone had to be the same height, or else!

One of my favorite Jefferson quotes goes like this, “There is nothing more unequal, than the equal treatment of unequal people.” It would seem to fit with the Procrustes bed situation, and later, you will see, will be appropriate for my situation. And, if you get me drunk enough sometime and ask me, I might tell you how and why that quote appeals to me so much.

I went in early, before 8:00, to the VLCC to have blood drawn to test my blood clotting rate to see if the Warfarin was working. Even though I told them that I had an appointment with my PCP at 8:30 and had to leave by 8:15. they didn't get to me until 8:20!

While waiting, I found out that I had a 9:00 appointment there with the doctor-of-the-day, Dr. C. I told them that they had to tell me about such appointments and that they hadn't told me because if they had, I would have told them that I would be in my own PCP's treatment room at that time.

I walked out of the building at 8:25 at ABCMC. Six minutes later I was one quarteer of the way around Green Bay, slowing down to exit at GV only to find that the exit ramp was glazed over with ice, had been recently salted because two cars were in the ditch with two police vehicles warning other exiting drivers! It took me another 9 minutes to get the rest of the way to my doctor's office. Did I mention that I wasn't feeling well at all???

BTW, I finally got to meet the "Diane" who had cancer and was undergoing treatment as well whom I thought was so young because she kept calling me "Sir." She's not as young as I thought. Her teenage son had just returned from a trip to France with the exchange student they had had living with them! I told her if she ever wanted to talk and compare notes
that she should give me a call.

My PCP took x-rays and found nothing. His exam found nothing; my blood O2 was 100 (they look for 90-100) even though my breathing was rapid and shallow. Except for the fact that I had a nasty cough, and I felt really fatigued, NOTHING! He wanted to put me in the hospital but he had nothing to hang his hat on.

He admitted me anyway.

I drove home, got my son up early, and had him take me to the hospital before he had to head off to work. My fun started while checking in, right in the room.

I’ve told you here about my name issues. I use my first initial and middle name. It’s on my driver’s license, my social security card, and most of my documents. Has been for decades. But it drives Procrustes wanna-bes NUTS! They want a first name and middle initial. And will do anything to get it.

So, when they gave me an armband that said, “Benjamin B” and asked if that was me, I flipped out. I said, “No, that’s my father.” Actually, my father died in 1961, but that was his name, not mine.

So started what seemed like a half hour discussion/argument that didn’t end when I showed my driver’s license and insurance card. I tried to explain that I had been trying for months to get my records and my name changed in their computers to little avail, as evidenced by the conversation I was having. We finally compromised; I put the armband on until they could get another one, while they made copies of my driver’s license and insurance cards.

They still had a problem with what to call me. We must have talked for 15 minutes on that subject alone. It reminded me of that comedy routine, “You can call me Ray, or you can call me Jay…” Did I want my first name to be “H.” or “H. Benjamin” with no middle initial? I finally explained that I had had the same problem with my insurance company and they finally resolved it by calling me H. B. Since that was whom my insurance company felt they were insuring, and subsequently paying the bills for, the hospital could just use the same name. The insurance company would be less confused by H. B. than by anything else. I think the hospital bought it. My bracelet right now says H B.

I’m just barely in the door, feeling really whipped —I’m up to an FF of 7-8 by now—and having to go through all this!

I got dressed for the hospital, my new-from-Christmas pj bottoms and their gown, climbed into bed, and had the bed explained to me. It had all sorts of bells and whistles.

Did I mention that it was a private room? They felt that private rooms were more conducive to recovery for patients. LOL!

While explaining the bed and all the switches on the bed, they mentioned that the electricians had screwed up. The wiring for the reading lights on the wall behind the bed had been run to the overhead florescent light. So the room light switch and the reading light switch both ran to the overhead light. A light so bright I never used it because I hadn’t brought sun block! I’m sure it works well enough for lighting the room during a Code Blue, but not something you want to turn on in the middle of the night just to go to the bathroom.

As a Quality Manager, I kept a quote by the founder of IBM, Tom Watson, close at hand. “If you want to achieve excellence...as of this second, quit doing less-than-excellent stuff.” I knew at that moment why I’ve been having so many problems. Aurora expects less-than-the-best from their people. When mistakes are made, little effort is taken to change them.

My oncologist, Dr. P had told me that he was head of the Quality Committee when I brought up some issues. His point was that they were more interested in “important” things.

Frédéric Bastiat—another person who didn’t use their first name—was a classic liberal (libertarian) theorist, economist, and member of the French Assembly. He proposed a theory called “The Parable of the Broken Window.” I can explain it like this; have you ever noticed an abandoned building with only one broken window? Probably not. As soon as one window is broken and not fixed, people feel free to break the rest of the windows. Fix the first broken window as soon as it’s broken and you keep the rest of the windows intact. Simple!

Another way to put it is exemplified by that old canard, “Take care of the pennies and the dollars will take care of themselves.” In other words, pay attention to the details and there won’t be any big “important” issues to worry about. Apparently Aurora hadn’t heard about it.

Dr. C showed up asking why I was in the hospital! He wanted to know all about my symptoms. My PCP had asked when was the last time I had seen an oncologist and I had told him it was Monday, two days ago. He asked if I had mentioned the cough and I said "Yes, indeedy!"

So, the hospital did a CT Pulmonary Angiogram (CTPA) on me and found that I had ANOTHER blood clot, a pulmonary embolism (PE), in an artery to my lungs! The VLCC had missed a clot. But, they already had me on the proper course of treatment for blood clots, but the cough still had my PCP concerned.

The only symptoms I exhibited for the first blood clot found were the swellings in the area of my port. The only classic symptoms I exhibited for a PE was rapid breathing and a cough. Obviously, those can come from a variety of sources. I've had the rapid shallow breathing during almost every chemotherapy treatment. It was what was causing that cough that still had them concerned.

That was pretty much my first day, unless I remember something later. My first night, though, was something to remember.

They take down a list of meds and OTC supplements that you use when you fist get to the hospital. I usually keep a list in my HP iPAQ, which has amused quite a few nurses and gets me remembered the next time I go in. They wish everyone was as organized as I!

So, they knew I took a sleeping pill before bed. I’ve blogged about it here as well.

WELL! They made NO provisions for me to get sleeping meds of any kind. If I need sleeping pills, due to my chemotherapy-induced insomnia, in the serenity and familiarity of my own home, how much more might I need them in a strange and unfamiliar NOISY hospital?

Attention to detail? I think not.

I’m going to leave you here tonight and get ready for bed. I’ll pick up this tale tomorrow.

Do I still have to remind you "As a juror, I will exercise my 1000-year-old duty to arrive at a verdict, not just on the basis of the facts of a particular case, or instructions I am given, but through my power to reason, my knowledge of the Bill of Rights, and my individual conscience. When needful, I will judge the law itself." -L. Neil Smith