The American medical industry is insane. I know this because a psychiatrist just told me so.
One day in early August, when I was safely embedded in one
of St. Joseph’s Hospital’s brand new hospital beds, Liza Ebert, a very good
discharge planner, came to my bedside and said, “We have a doctor to follow you
after you get out of the hospital.” She
then explained that she was referring to Desta Anthony, a nurse practitioner,
who created something called MobileMed.
If you want to read some really good marketing, you can Google Desta and
read all about how she started this home-visit operation.
So I call her up from my hospital bed and she says, yes, she
will take me as a patient, but she won’t make an appointment with me until
after I’m discharged. That was on a Friday. On Monday, I get discharged and
the visiting nurse tells me that Desta’s on vacation. Wow, Desta.
Nice of you to let me know that you weren’t going to be around when I needed
you. I also hear from various sources—Desta, maybe—that the doctor under whom she served has left her. She has a covering doctor but he will only
see her; he will not see her patients. And she’s got a second nurse practitioner to work with her.
My problem is that I have an indwelling catheter. It’s supposed to be changed in thirty days. The dorkhead hospitalist at St. Joe’s discharged me without writing an order for the catheter. Okay, I am walking out of the hospital with
this thing hanging out of my crotch but there’s no paper work that says
so. The home health care agency’s nurse needs to know when the catheter was started and what size it is, but St. Joe’s doctor hasn’t included that in the paper work. Nice. At some point somebody goes
off on me about this and I get really upset and reply, “How am I supposed to
know what’s supposed to be in the paper work? It’s between the doctor and the nurse and I am neither. Don’t yell at me!”
So I am at home with a catheter and the nurse comes and
changes the catheter bag. Bright and
early the next morning the tubing on the bag separates and urine starts spewing
all over the place. In a panic I pull
the emergency cord and the building superintendent, two emergency medical technicians, and a fireman show up. The elder of the
two EMT’s fixes the problem and I’m back in business. Then I call Desta Anthony and leave a message requesting an appointment.
Meanwhile, I feel better than I have in a long time and
decide to try to pick up my usual routine, so I wheel to the downtown farmer’s
market. I am sitting there choosing a bunch of zinnias when I suddenly realize that the tote bag containing my catheter bag has fallen on the ground.
And I have wheeled over it. I try to reverse the wheelchair, stand up, and pick up the bag and, instead, I fall screaming on the ground. Lots of people
run and gather around me. I look at the
outstretched hands and pick the two that are attached to the most muscular
arms. Some nice men hoist me up and back
into the chair while a woman says, “I’ll get your purse.”
“No!” I say. “No, no, no!”
One of the men says quietly, “It’s okay; I understand.” He saw the catheter tubing coming from the bag to me and got it. Whew!
By now the agency has sent me an intake nurse, an
occupational therapist, and a regular nurse. They are doing their level best to get me stabilized, transitioned, educated and all set up safe and sound but there’s
no freaking doctor. The medical system works on the basis of doctors.
Without one, all the rest of the people can’t do their jobs. And I don’t have a doctor because I’m allergic to all medications. Doctors won’t work with me. I can’t take their drugs and they are one-trick ponies who don’t know how to do anything except prescribe drugs.
Among other things, the OT guy has realized that I seriously
need a new shower chair but he can’t get a doctor to write the order. The hospitalist who is supposed to do it isn’t returning phone calls. So now we
come down to the second Friday after my discharge and Desta Anthony calls and
tells me she’s not going to take my case. WTF!? I was discharged and an entire complex medical care system was built up based on one single thing: that Desta Anthony could be trusted to do what she said she would do. Now she’s saying she won’t.
Why not, I ask?
Because you’re not homebound enough, and noncompliant, she says.
So I ask her to please come and meet me. I’m not what the paper work says I am, I
say. Give me a chance. Come and meet me before you make your final
decision. She says she will, and we agree to meet on Monday. The next day
the shower chair collapses under me and I fall and get hurt. When I get up on Sunday morning my left eye is black and purple and my cheek is swollen and too painful to touch. Because no doctor would write an order for a shower chair.
On Monday, the agency’s OT guy returns my call at 8:00 a.m. He and the nurse are mega-worried about how badly injured I may be from the fall. He asks if my face is broken. Beats me, I say. He says he hopes
that Desta will write the shower chair order when she comes. I doubt that she will. Hope doesn’t float here, so I urge him to
continue to try to get another doctor’s order for a new chair. He is also hoping/expecting that when Desta comes in the afternoon she will do an assessment of my injuries and see if I need to go for x-rays. I say nothing to the
OT guy but after he hangs up I sit up in my hospital bed and start making phone
calls. I know how to do this crap and am
very effective at it. The problem is that I’m getting older and sicker and more tired, and I can’t do it. And there’s nobody to take over. What’s going to happen to me? (To be continued)