The Medical World Is Fighting A Major Battle: Who Wins Matters

Neurology Rounds With The Maverick:
Adventures with Patients from the Golden Age of Medicine

Author: Bernard M. Patten, MD

Publisher: Identity Publications, location unknown, 2019

The author’s credentials are “par excellence” – Undergraduate from Columbia College summa cum laude; MD from Columbia University; Fellow of the American College of Physicians, Royal Society of Medicine, Texas Neurological Society, and American Academy of Neurology; and certified by the American Board of Psychiatry and Neurology. Practical work experience too long to list, but Bernard Patten is not shy about telling it to you throughout his book.

In fact, he is anything but shy. This is one of many books he has authored, but the first one I’ve read. His style is bold, taking no prisoners when it comes to arguments, and pulling no punches when it comes to describing situations and events. We could hope he really did not talk like that to patients or colleagues or supervisors – but alas we would be disappointed.  This guy was born a “maverick” and it suited him well throughout his career and beyond as he now takes up writing.

His emphasis throughout the book is “facts” and where there are no facts, there should be no assumptions. He applies this to his field, but also the media, big companies, and medical institutions – with considerable success.

But here’s why Patten wrote the book. He wants this book’s shared knowledge to increase the reader’s intensity and range of experience – for the purpose of examining and clarifying one’s life and the lives of others.  He will have succeeded if after reading it, the reader will be able to decide for themselves, “if it is better for a doctor to function at the junction of art and science and practice medicine NOT as a STRANGER, or is it better for a doctor to enter the survival mode, knuckle under, and muddle through. . . to your detriment. . . Decide: is it better to let your insurance company make medical decisions for you or better to let your doctor?”

Patten’s career was based on getting complete histories of his patients and relating to them as friends, giving them the time, the attention, and the honesty, they need. He was a master at that. On the other hand, while modern medical advances have saved millions of lives, almost all of today’s doctors are more concerned about covering their butts from lawsuits and understandably so.

Time after time, Patten presents a case from his experience, really scores of them, gives you all the facts, medical and otherwise, and then says, “Attention reader: your diagnosis, please. How would you handle this situation and this patient? How would you handle her/his family?” Often, I felt I was part of a TV’s Dr. House episode.

The lesson about work and research and evidence and thinking are all outlined clearly in the text – you can’t miss them. And they’re great lessons that can be applied to anyone’s life.  Two examples (garnished with the author’s sense of humor) follow.

Lesson: Absence of evidence is not evidence of absence. If you see it, you may believe it.  If you don’t see it, you don’t know. If you don’t know, then suspend judgment.

Lesson: This is important: turning off the respirator makes the brain dead. It doesn’t prove the brain was dead before the respirator was turned off.

Patten is not a big fan of insurance companies and he explains with real cases, why not.

He has an approach-avoidance conflict with the existence of God, prayer, afterlife, heaven, or hell. For the most part, he appears to ridicule all believers in those things. But when they work in his favor, he seems to be thankful for them. As for miracles, he would tell you that he is the miracle-worker and he gets very ticked off when people give God the credit, although he does admit that is a weakness in his character. So, you understand where he’s coming from.  He worked in the age when people did see their doctors as at least a ‘god’ – I remember them well.  In his case, he actually believed it, or so he leads you to think. I must, however, admit he has a great response to a patient who thinks God is telling her to kill her clients.

Patten is also very opinionated on the issue of the media, to the point where I wonder what planet he’s from when he says Fox News in his opinion, “is almost all false witness and false information.” He also is no fan of the current President, yet in his own life, time and again, he acts like him and brags about it. He would have done well to leave politics out of his book, but alas, he has reached the point where he feels he has no need to impress anybody, considering he was freed from such troublesome conditions earlier in life. With that freedom, he proceeds to tell jokes throughout his stories (some not so funny) and some quite surprising coming from a doctor. While I’m at it, if you squirm at the talk of sex (even when it is related to medicine) this book may make you a little uncomfortable.

At the same time, Patten has some great lines. One example is, “There is free speech in America, but you have to pay a price for it.”

He is not a big fan of TV, often yelling out at live cameras, “If you are watching, you are damaging your brain. TV is junk food for the mind.” And on ‘reality’, he writes, “Oh well, reality is nice to visit, but most Americans can’t live there and wouldn’t want to live there even if they could. That’s one of the reasons people watch TV – to get away from the realities of life. In modern America, we have escapism on a planetary scale.”  The context is well worth the price of the book.

But then again, so is just about every one of the 32 chapters or tableaus as he calls them.

His biggest disappointment though is the reception his research in the area of breast implants received from his medical colleagues, many of whom thought he was just plain wrong in his findings. But when asked if they had read the published work, they responded they had not, but got all they needed from TV.  Bummer to say the least.

Before I tell you this book is a must read – for doctors, patients, families of patients, hospital administrators, government health officials – let me just mention a few of the topics he covers: Aristotle Onassis; a horse admitted to hospital for humans (yes, you read correctly); placebos; mistakes; patients predicting their own death accurately; malpractice suits; and breast implants (including what happened to famous celebrities like Pamela Anderson Lee, Mary Tyler Moore, Cher, and others.

Patten ends his book with some advice for any potential scientists who may pursue research into the consequences of implant materials and techniques. I’ll let you discover that on your own.

Here’s my advice on the book: First -- read it. We all need to better understand the worlds of hospital administrators, doctors (surgeons vs. medical team), labs (and what often goes wrong). This book provides that understanding and more.  Second – if you’re a God-believing person, don’t stop praying for your loved ones who are under the care of doctors for serious ailments or diseases. Regardless of what Patten himself thinks, his book clearly proves the need for divine intervention – certainly in term of discernment, diagnosis, and treatment – in this very business- and finance- driven world.

Most highly recommended.

n  Ken B. Godevenos, President, Accord Resolutions Services Inc., Toronto, Ontario, October 2, 2019, www.accordconsulting.com

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I Hope You Can Sit This Dance Out

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My Tango With Cancer: My Perilous Dance With Healthcare & Healing

Author: Apryl Allen

Publisher: Oray Publishing, 2016

                                                                     

                            

                     

My Hope Is That You Sit This Dance Out

I was attracted to this book for two reasons: First, I am a cancer survivor and second, I always wished I could dance, but never really mastered it. I hoped Apryl Allen’s book would help me to better understand how much more so many others suffer when they first hear the dreaded “you have cancer” diagnosis. I’m also glad that my own dancing skills were so poor that the Cancer dude decided not to spend a lot of time with me. Sometimes it pays to be a wallflower.

This author was anything but.

She believes in ‘fate’ playing a role in everyone’s life, but unfortunately she never gives us a good handle on exactly what ‘fate’ is or how it works. For her, it just seems to be what happens.

The book is full of what I call “gems” partly because they are so true and partly because they are so obvious. One example is “Happiness is the best medicine when you’re sick.” Another is “No doctor calls with good news.” With each one, a reader can relate to some of his/her own experience. For me, this latter one reminded me of the day I had met my son for lunch and we were sitting in the patio of a Greek restaurant on Avenue Road in Toronto when my doctor “called” with the news that I had cancer.

There is much to learn from a book like this as well. For example, I learned MRI’s are sometimes undertaken when they can’t find the problematic nodule through a mammogram.  Or, that some doctors say having had breast implants is not a cause of breast cancer based on the fact that those are the very things they insert after a woman has had a mastectomy and wants reconstruction surgery. [Whether you buy that argument or not is up to you, but it reminds me of what much of the medical community says about abortions, i.e., “It’s a very simple and safe procedure.” Just ask many of the women that will tell you otherwise.] She provides us with solid information on specific tests that study the genes and behavior of a cancerous tumor to predict the risk factor of its return by uncovering its hidden biology. And much more.

We identify with Apryl’s search for a way to ask a doctor which option of treatment he/she would pursue if the patient were his wife or his daughter, without making them liable for any choice they give you.  Good luck on that.  We realize with the author (partly because she keeps reminding us) that cancer is indeed “as individual as the person themselves”.  We also have to content ourselves with the fact that even practitioners tell us, “there’s no such thing as ‘the best doctor in a field’” but rather it’s all about who you feel more comfortable with. Add to that the fact that so many good doctors in the same field can disagree so readily with each other on not only the diagnosis but also the treatment even when the diagnosis is the same. How alarming.

Allen communicates her story as a narrative in the present tense giving us sometimes moment by moment, other times day by day or month by month accounts of what she experienced and how she felt. With that, she is able to convey the high demands that are imposed on a cancer patient (or their advocate) if they are to beat the disease. There’s an excellent ‘sidebar’ on how difficult it is to tell various people about what you’re going through as a cancer patient. She has a wonderful handle of the different type of listeners (or non-listeners) that one encounters when embarking on such communication.

Throughout the book, the author praises her husband for his commitment to her and his willingness to be there for her whenever and wherever. There is no doubt that one’s chance of victory here is greatly enhanced by the presence of such a partner and/or close friend.  Her accounts of what irritates her (and sometimes her husband) when under this kind of stress is most honest and serves to point out how we change under such circumstances.

She saves a good deal of her disgust with the medical system as a whole, for incompetent administrative staff, inconsiderate professionals, uncaring insurance companies, and processes that are designed with anything but the patient in mind. She wonders, as I have for years, how on earth those who don’t speak the language, or have no one to advocate for them, ever have a chance of navigating the troublesome waters of our medical system. The very thought of what can go wrong and often does is enough to give one cancer!

Time and time again she comes to grip with the fact that although we have taken all the measures we possibly can to snatch victory from the jaws of defeat, we ultimately can only resort to praying for the impossible. Perhaps because she is a Native American (Comanche) she resorts to more than prayer as we normally think of it and involves herself somewhat with the occult, where she attempts to be, and actually believes she is, in contact with her deceased mother.

In conclusion, she wrote the book because nothing she had read when she was a cancer patient, ever came close to describing how one actually feels and what one actually thinks throughout the whole process. This book accomplished that with great success. 

--- Ken B. Godevenos, President, Accord Resolutions Services Inc., Toronto, Ontario, December 6, 2016. www.accordconsulting.com

--- you can order the book right here:  http://astore.amazon.com/accorconsu-20 

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Remember the 2004-12 TV Series Called “House”? Well, here we go again – only reality makes room for miracles

Miracles We Have Seen:

America’s Leading Physicians Share Stories They Can’t Forget

Editor: Harley A. Rotbart, MD

Published by: Health Communications, Inc., Deerfield Beach, Florida, 2016

                                          

I could not help but think of the TV show starring Hugh Laurie as Dr. Gregory House as I read this book. But this time, these real doctors share stories of miraculous events that can’t be explained by medical science.  And they admit it. Some of them even attribute the outcomes to faith and God – often when nothing else can be credited with the interventions.

Seventy-five different medical professionals share their unforgettable stories. The editor almost always provides the reader the information and sources needed to follow up on these real cases. This is not only helpful but makes each story (most within our lifetime) even more real for the fact-checking, research-hungry, web-browsing enthusiast.

There is a big difference, as the book’s contributors point out, between declining proven medical treatments that are available and beneficial, choosing instead to wait for a miracle, and allowing doctors to do all they can to help save a loved one. The former approach often ends up in disappointment, while the latter allows room for miracles to occur when the science alone cannot.  That’s a major lesson we can draw from this book.

A number of stories hinge on the coincidences of location, timing, and/or the availability of the expertise. To the purpose of faith, the probability of such occurring together in any given case is too much to leave to chance, but that’s a decision each reader will have to make for themselves. Based on how these doctors write about the ‘miracle’ they share, I often wonder how many of them are ‘hidden believers’ in the Creator, but just won’t or can’t say it openly here. In this book, we seem to be getting the message, both doctors and family members, “Do your job and God (or miracles) will take care of the rest.” These doctors have learned that “beyond the limits of (their) medical knowledge and skill, there is also always the power of hope.”

One story that sticks in my mind is that told by Debra Gussman, MD, entitled “An Impossible Pregnancy”. That one alone will challenge your ‘unbeliefs’.

Miracles We Have Seen is also invaluable for teaching the non-medical reader so much about medicine and how our bodies work. What makes it particularly good in this way is that the editor(s) have made sure that the stories these professionals share are explained in ways that the average man and woman can understand.  I learned a lot. Here are but a few examples:

·      In one story entitled, It’s Alive! By Robert J. Buys, MD, we learn about an “embolus” (the term for any kind of substance that shouldn’t be there traveling through the bloodstream) and how doctors attempt to deal with one that is in the eye. Fascinating insight (no pun intended).

·      White blood cells being a sign of inflammation, the body’s response to infection and other foreign substances.

·      What doctors mean by the term “failure to thrive” when referring to children, that is, a condition in which growth and body weight are far below normal.

·      Transplanted hearts (or any organ for that matter) come with great challenges – nothing is better than the organs we were born with if we can keep them working well.

·      An ‘obtunded’ patient is one who is losing consciousness or difficult to arose.

·      As a general rule, “people who fall three stories. . . have about a fifty-fifty chance of survival.”

·      And many more things and terms and practices and discouragements. For example, the realization by doctors working in Africa that healing cannot be just “medical”, it is often economic, as one patient stares them in the eye and says, “Cure my poverty, and you will cure me.”

The stories in this book are divided into major chapters entitled: Spectacular Serendipity; Impossible Cures; Breathtaking Resuscitations (my favorite); Extraordinary Awakenings (my second favorite); Unimaginable Disasters; Mysterious Presence; Global Miracles (dealing with epidemics); Miracles In Their Own Time (a modern historical perspective); Paying It Forward; Difficult Decisions (my third favorite); Silver Linings; and Back To The Beginning (transforming doctors into professionals – a great piece of writing).

We learn how doctors, pediatricians in particular, have a hard time as they often project their own children onto their patients, sometimes “identifying so strongly that it’s difficult to stay objective”. Then there are the times when doctors feel, “Yes, we have saved a life, but to what end?” That’s the often haunting question when one knows the patient will live but not as one would have preferred.

And if that’s not enough, in the Epilogue we are told that 100% of the author proceeds are divided among 75 different charities designated by the contributors and listed in that section.

I had occasion to be in the hospital right after I read this book. It greatly enhanced my appreciation of the wonderful doctor that took care of me.  Very highly recommended by anyone who is a doctor or ever needs to see one.

·      Ken B. Godevenos, President, Accord Resolutions Services Inc., Toronto, Ontario, November 13, 2016. www.accordconsulting.com

 Get the book here: http://astore.amazon.com/accorconsu-20

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I Wish I Hadn’t Read It; But I Want My Children To and Fast

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Being Mortal: Medicine and What Matters in the End

Atul Gawande, Metropolitan Books, Henry Hold and Company

New York, N.Y., 2014

I picked up this book when it first came out. It was highly recommended by one of the magazines I read. With the exception of books that I read to help me with my spiritual journey, this book has had more impact on me than anything I’ve read lately.  Here’s why.

Atul Gawande is a skilled writer.  His sentence structures flow easily.  Here is a medical doctor that is also very much skilled in the craft of communication. You will enjoy his honesty, his humor, and his ability to share difficult news with you in a way that has you saying, “Thank you, although I wish I had not known”.

Gawande admits that doctors today are wired to keep us alive and really have very little knowledge of how to let us die, seeing death in their patients as a failure. And this sets up the main foundational premise of his book as he writes, “Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things.” It is then up to us, our family, our medical team, to determine just how much and for how long we will fight this enemy.

Early in the book, Gawande introduces us to the concept that while they have the physical ability and the financial means, “the elderly have. . . chosen what social scientists have called ‘intimacy at a distance’.” This then provides the setting for most of us when we do get beyond being elderly and actually arrive at being old, no longer having our full physical capabilities to serve us well, and in many cases, not having the financial resources to buy that care.

Regardless of our personal circumstances, sooner or later, “ . . . independence will become impossible. Serious illness or infirmity will strike . . .And then a new question arises: If independence is what we live for, what do we do when it can no longer be sustained?” The author spends considerable time showing us how things fall apart with some real-life examples from his family and his patients.  You’ll see someone you know in one or more of them and you may even imagine, down the road, your parents, or worse still, as I did, yourself in one of them. Gawande says the problem is that more than half of the very old live without a spouse; have fewer children than ever before; and have given no thought to how we will really spend our last years.  Unfortunately, or fortunately, the latter will never be the case after you read this book.

As the author steers us to our second “dependence” stage of our life (the first one being our infant years), he also reminds us that we cannot rely on the typical nursing home to make it all bliss.  He writes, “They [nursing homes] were never created to help people facing dependency in old age. They were created to clear out hospital beds – which is why they were called ‘nursing’ homes.” He then goes on to explain the likeness between prisons and nursing homes and how while they serve one or more societal needs, they do not address “the goal that matters to the people who reside in them: how to make life worth living when we’re weak and frail and can’t fend for ourselves anymore.” Much of the book is spent in answering that question and he does so competently. That alone makes the book valuable reading.

He also points out that an adult child, when trying to find a residence for their aged parent, who asks, “Is this a place I would be comfortable leaving Mom?” is asking the wrong question.  What should be probed is, “Is this place what Mom would want or like or need?”

The book covers our search for autonomy and a better life in our old age, as well as when it’s time to let go and the serious and very difficult conversations and decisions that must take place at some point between and by parent and child, and between and by patient (and family) and doctor.  These are very insightful chapters. In the chapter on letting go he tells us, reminding us of his earlier premise that, “. . . the enemy has superior forces. Eventually, it wins. And in a war that you cannot win, you don’t want a general who fights to the point of total annihilation.  You don’t want Custer.  You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can’t, someone who understands that the damage is greatest if all you do is battle to the bitter end.” And then he shows us how we can do that.

What I also found fascinating and very helpful was his description of three types of doctors a person can have – not so much in what they do for us, but rather how they arrive at what is done to us.  In a day when doctors seem to have a choice who to take on as patients, maybe it’s time we considered seriously who we want taking care of us or our aged parents.

The last chapter in the book is entitled Courage and it includes a line I found most memorable, “Assisted living is far harder than assisted death, but its possibilities are far greater, as well.”

In the Epilogue, using the death of his own father, also a doctor, as was his mom, and the ritual of sending him off, Dr. Atul Gawande shows us exactly what he means by “Being Mortal”.

This is a book very highly recommended for all who have reached the age where they get a senior’s discount, for all who have parents of that age, for all doctors who deal with aging patients, for all politicians, and all ministers or counselors. If I left anyone out, please forgive me. It was an oversight on my part and you can blame it on my age. 

-- Ken B. Godevenos, Accord Resolution Services Inc., Toronto, Ontario. 15/12/27  

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MEDICAL ERRORS: ONE MAN'S RECENT EXPERIENCE

MEDICAL ERRORS: ONE MAN’S RECENT EXPERIENCE

-- by Ken Godevenos, Toronto, 15/01/22

On December 29, 2014 my wife’s doctor advised us to take her to emergency because of how she was describing the pains in her chest.  She had suffered a heart attack.  The next day, she was transported to another hospital where she underwent an angiogram and angioplasty. Two stents were inserted into her arteries.  Then back to the admitting hospital for overnight observance and home by New Year’s Eve.  So far, so good.

Between then and Thursday, January 15, she had felt some chest discomfort three times and used her nitro spray to counteract it.  It seemed to go away, but not totally. That morning, she had a previously scheduled appointment at her cardiologist’s office to be equipped with a 24-hour monitoring device for her heart, a routine post-heart-attack procedure.  Thinking she would here cardiologist that day, she had made some notes of what she wanted to tell him.  When she found out he was still doing his rounds, she left the typed notes with the staff.  Upon his return to his office, her doctor immediately called and wanted to see her.  He had read the information she had left.  That action alone made a very positive impression on us. 

He sent her right back to the admitting hospital and arranged for a second angiogram at the other hospital the next day.  In the meantime, he had an echocardiogram done on her.  Thankfully, her cardiologist wanted to take no chances.  After all, this woman is still a young sixty-seven years of age and she is very spry, exercising regularly, eating well, and weighing around 113 pounds soaking wet.  The bottom line (after the second angiogram) for my wife at least was: her heart was as strong as a twenty-year’s old; her arteries were all clear; and the two stents were operating perfectly.  We brought her home later on that day.

So what caused the pains she was still feeling after her first angioplasty?  The excellent doctor who performed the second angiogram, although extremely busy that day with both emergencies due to procedures as well as in the recovery room, took the necessary time without being rushed, to explain two potential reasons for the pain.  The first was what he called “heightened awareness”.  A patient who undergoes such a procedure is often super-sensitive of any pain he/she experiences afterwards, often worrying if it could be a heart attack again.  Under normal circumstances, the same individual could well simply exercise right through the pain (and that in fact is what the doctor suggested in my wife’s case; all in due time, of course).  The second reason given was equally plausible.  Because the stents are stiff (made of stainless steel mesh), the arteries they are attached to are not accustomed to them yet.  So when the patient exerts some effort which causes more blood to rush through the flexible arteries, the irritation becomes more noticeable and thus the pains.  Again, these would decrease over time.  And sure enough, to the point of writing, a few days after coming home again, no pain at all.  We expect her to be her old self, showing the rest of us all up, very soon.

But in the five whole days she was in the hospital and I was with her for the majority of that time, in emergency, in recovery, and in a regular room (that wasn’t so regular as you’ll soon read), we observed and learned a lot about hospitals and the medical profession and how they work.  It was no surprise then when I read the leading article of the National Post on Saturday, January 17, 2015 written by Tom Blackwell entitled, “How Much Do We Know About Medical Errors?”

First let me assure you that in the process, we met some very wonderful and very professional people – the doctors that took care of us, almost all the nurses, the ambulance teams, and even the cleaning staff.  These people work hard and they do a lot of good for a lot of people.

I remember once kidding a friend’s young teenage daughter about her dad not making it to what I considered was an important board meeting one night, to which she replied, “Yes, sorry, he was up all night saving lives.”  Her father, my friend, was a senior cancer surgeon at one of our well-known hospitals.  I learned my lesson as to what really matters that night and then again recently as I watched so many others doing the same thing – saving lives.

But I also learned some other things – things that if addressed would make these wonderful men and women even better and more valuable to all of us.  Here are just but some of my experiences.

Over the years, I have had my share of experiences with hospitals.  Some of them were great ones, and some a little worrisome.  Besides being born in one, I suffered peritonitis (a potentially fatal inflammation of the abdomen's lining) at eleven months of age.  My father hid under my bed (they weren’t allowed to stay overnight at that time) in the hospital in Athens so he could be with me.  I lost my mother in a hospital after she had gone into a coma on her 64^th birthday.  My daughter was incorrectly diagnosed with a blood clot in her lungs, when all she had was pneumonia, because of failure to correctly interpret the x-rays.  In my own case, after they all thought I had three heart attacks, it was eventually concluded that I had pericarditis (an inflammation of the pericardium [the fibrous sac surrounding the heart]).  I lost my father in a hospital of advanced cancer when the doctors told me they could help him live for a few more hours, maybe a day or so, but then it would be over. Together, we decided to let him go earlier rather than later and I was thankful for their guidance and honesty.  More recently I lost my loving grandson after having him for six hours – just long enough to hold, hug, kiss, and pray with, and then return him to his Creator, even though everything went perfectly right through the delivery.  And that’s just the family; I’ve also watched others, friends and associates, die in hospitals.

In our most recent experience, we observed numerous problems that were more often than not clearly a result of process glitches and/or fatigue rather than inexcusable human error.

When my wife returned to her admitting hospital right after her first angiogram and accompanying angioplasty, she was returned to her previously assigned regular two-bed room on the appropriate ward in the hospital.  There was only one problem – when she had left it she was the only patient in the room but on her return that night, there was someone in the second bed with a bad cough.  By morning, that patient was put in isolation due to suspected MRSA (and actually had it as we found out later).  The Mayo Clinic says this about MRSA: “Methicillin-resistant Staphylococcus aureus infection is caused by a strain of staph bacteria that's become resistant to the antibiotics commonly used to treat ordinary staph infections. Most MRSA infections occur in people who've been in hospitals or other health care settings, such as nursing homes and dialysis centers. When it occurs in these settings, it's known as health care-associated MRSA (HA-MRSA). HA-MRSA infections typically are associated with invasive procedures or devices, such as surgeries, intravenous tubing or artificial joints.” And while this patient’s visitors had to wear masks, all we could do to protect ourselves was make sure the curtains surrounding her bed, that only went so far down, were drawn.  We were not even asked to wear a mask.  Fortunately, so far, neither of us has caught the infection, but its existence created another problem down the road.

When we returned to emergency in the admitting hospital on the second occasion, a number of things didn’t seem right.  Again the doctors involved were wonderful.  No problems there.  But other things happened that shouldn’t have.

At one point, the medication my wife was being given by a nurse was wrong.  We asked the nurse to check the records and we had to show her the problem.  She apologized.
At another point, while the doctor and one nurse had told her not to eat anything after midnight because of the procedure due early the next morning, the next nurse on shift in the morning offered her breakfast.  We had to remind her that my wife was not allowed to eat and this nurse also apologized.

One staff person came into the prep and recovery room for the procedures that my wife was getting and informed a patient that they were not going to do her procedure as scheduled.  Needless to say the lady was very distraught.  It turned out that the staff individual didn’t even know which patient she was talking to and had her mixed up with someone else.  That mistake not only upset the patient, but also embarrassed the rest of the nursing team who had been doing their best to keep things under control with a very busy caseload that day.  But that didn’t stop the ‘team’ being human, from talking about it in an obvious manner and volume, when the staff person had left.  The impression that resulted for those that could hear them was not good.

And then there was what I considered the biggest problem.  It happened on her second visit in this whole experience while waiting in the emergency room overnight before going by ambulance to the hospital where her repeat procedure would be done the next morning.   When we arrived the second time at the admitting hospital, I was told I had to wear a mask because, and I quote, “The whole emergency department is under isolation.”  I put one on, as uncomfortable as those things are, trying to be obliging.  But then I noticed that my wife didn’t need to have one on.  As a matter of fact, most of the staff walking around and other visitors and patients didn’t have one on.  That seemed odd.
A short while later my wife started to get up to use the bathroom.  A nurse rushed over and said, “I’m sorry but you have to stay in bed and we’ll bring you a commode.”  I hit the roof.  My wife was quite capable of using the bathroom as she had the last time she was in the same emergency ward two weeks previously.  We exchanged some words and finally they let her go to the bathroom.  They then explained that “she” was the one in isolation and that she would continue to be for her future visits until she was found to test “negative three times in a row” from having the MRSA virus.  So, that was it.  They unnecessarily exposed her to a patient with MRSA on her last visit and told her there was nothing to worry about.   Then they admit her again and lie to us about why I had to wear a mask.  And things got worse.  The doctor on duty clearly supported us and said there was absolutely no reason for her to be in isolation – there was nothing on ‘his’ files to that affect (which begs the question of whether all files are synced properly) and her blood results were negative.  She was perfectly capable of getting up and around.  The nurses argued that they had no choice; it was beyond their control because of the IPAC (Infection Prevention And Control, Canada) rules.  The doctor tried to change their mind unsuccessfully.  A hospital higher up was brought into the picture as well and he prevailed.  But, in the meantime, my wife had gone to the bathroom.  And again the impression we, and anyone who was watching, were left with was not good and unfortunately due to my frustration, I had a part in that.

My anger, especially with the charge nurse who seemed to wander in from nowhere and started telling me off because I got somewhat excited, had to do with the fact that they had lied to me in the first place, and secondly that they weren’t agreeing among themselves over what they claimed to be a “common practice”.  Thirdly, I felt we had a right to know that we had been exposed to on the last visit at that time (not just now) and that IPAC would require my wife to be in isolation each time she came to the hospital until she tested negative in her blood tests for MRSA (apparently even if that took five years or more).  We should have been told that before we left the hospital the first time.  And we certainly should have been told it when we returned the second time rather than the lie to us and tell us the whole ward was in isolation.  They must have thought we were blind or that we’d never stick our head out beyond the curtains around her bed.  Holding her defensive position, the charge nurse would admit to no fault on her part or that of her nurses and failed to recognize any of my points.  All she was concerned about was my raising my voice.  That “holier than thou” attitude ticked me off even more and unfortunately often reminds me of how some other positions of authority defend themselves (but we’ll save that for another story).

And remember that nitro spray?  It was originally prescribed by one doctor and concurred with by another, for when she felt pains.   But the truth is it does not work for all pains accompanying heart or coronary problems.  As it turns out, we find out later that nitro spray works well when the pains are caused by narrowed arteries (so wisely prescribed in my wife’s case), but not when the pains are due to the two potential causes described above, one or both of which were possible in my wife’s case.  Now we know.  Perhaps that would not have been as big a surprise had we been told about other possible causes of pain, albeit it would still appropriately require the “checking out through a second angiogram” to be certain.  And good knowledge of possibilities also helps minimize fear or worry.

My heart goes out to all those who are not fluent in English; to the very aged; to all those who have been taught that doctors and hospital staff are gods (like lawyers) and one is never to question them; and to all those who do not have an advocate who looks out for them constantly while they are in the hospital.  (There must be a business opportunity there somewhere.)  I say this because mistakes do happen.  And while taking the wrong medication, being fed when she should not have, or putting her unnecessarily under isolation may not have physically harmed or killed my wife, the data indicates, according to the National Post’s investigation, that “the true number of preventable deaths is likely in the realm of 35,000 annually.  That’s four (deaths from medical or in-hospital errors) every hour.”
I don’t want anyone’s head.  These are all good people working hard and doing their best.  Some of them are phenomenal and go out of their way to do all they can to help their patients. But the system has weaknesses.  No one is learning from the mistakes.  No one reports, let alone records, the errors as the National Post piece pointed out.  Many patients just can’t wait to get out of hospital and get on with their lives.  Mum’s the word.  If they get out, like my wife, they are among the many fortunate ones.  But what about those that don’t get to go home – not because they died from their wounds or illnesses, but because the system failed them?

A newspaper exposé series like the one that got me thinking about our recent experiences with hospitals is a very valuable tool for the public.  But clearly, it also can have a negative impact on how the public feels about the medical profession.  It is with some justification.  But it is not something we want.  I remember the days when my own parents would never think of asking for a “second opinion” and I remember many a doctor back then actually getting angry if one of their patients did insist on one.  Hopefully, those days are gone – at least for good doctors.  They welcome a second opinion.

But there’s more work to be done in minimizing the errors that do take place.  Let’s hope that the good doctors (and there are many more of them than the other kind) will take it upon themselves to demand their hospitals start keeping records, without blaming those that make them once (we all make mistakes), so that improvements can be built into the processes we all so very critically depend on.

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