So I am going to have to look into this—this business of St. Joseph’s Hospital not reporting to nurse practitioner Desta Anthony that I took drugs as prescribed and as tolerated. I tell Ms Anthony that I took insulin four times and the antibiotic twice and that if St. Joe’s didn’t report that then they are liars.
I try to explain to Anthony that the catheter is so I can get some sleep—sleep being a fundamental necessity of good health. I look at her and ask, “Do you remember the weeks after your babies were born when you didn’t get any sleep?” And for one moment, one brief moment, her eyes look inward and then look at me, shining, and I know I’ve made contact. Desta Anthony and I are connected on a human level of shared experience—she gets me!—then she goes blank again and goes back to talking about “noncompliance—or whatever you want to call it.”
In her world, words have no specific meaning. A couple other times she makes it clear that words are slippery things to her. Anybody can call anything anything they want to. We are not talking about any concrete realities here. What Desta means is, “I know what I mean, and you can call it anything you want to. It won’t change my mind.”
The Big Guy signs off, and I ask Desta about the injuries to my face. The good folks at the agency are counting on her to evaluate how bad the damage is and whether I need to go for x-rays. Desta, who has not touched me or gotten within six feet of my face, says it looks like it’s healing all right. Really, I think? It’s so painful that if you blow on it then it hurts but you’re not even going to get close enough to look at it? Desta Anthony tells me that she has not taken my case. I’m picturing her standing beside the road looking at a car crash victim who is bleeding out and refusing to help because he is not her patient.
One of her last comments to me is regarding my statement that I took meds in the hospital and her statement that the hospital record did not reflect. Anthony says, “I don’t know whether to call Dr. Gendelewski and the hospitalists liars, or to think you’re a liar.” She is fraught with a terrible dilemma and we all know which way she’s going to fall on this one. The doctor is always right; it’s just easier for her that way.
After she leaves, the Big Guy tells me that Desta Anthony is the sum total of contemporary American medical education. She cannot empathize with the patient. She is close-minded. Her thinking is rigid and inflexible. She is solely focused on the prescription of drugs and cannot function at any other level. “And she is,” he adds, “average.”
A psychologist told me that physicians’ I.Q.s average out at 120. New York City policemen don’t go above 100-110. (According to him, the reason for this limit is that policemen who are smarter turn to corrupt activities.) The boss doesn’t want anybody smarter than him working under him, so we can guess that Desta weighs in around 100-110. She is the average that your mother warned you about. It used to be the wise men and gifted children who went into the practice of medicine; now it is the totally average person who is given the power to heal you or harm you—or, simply, to deny you all service because she is not smart enough to understand the complexities of a situation. All she knows is that she is to do what she was taught and she was not taught to think, only to obey.
The next morning, at 9:00 a.m., the OT guy shows up at my apartment carrying a new shower chair. He tells me that they actually got three orders for the chair—my two, and one from the original hospitalist who should have done it in the first place. At 9:30, my aide comes and gives me a shower. It turns into a pretty good day. And my black eye is now brown and my cheek is turning green.
This brings us to this morning. Around 5:30 a.m. I realize that my nightgown has a wet spot. The catheter tube is leaking. There’s this little plastic port near the top of the wide tubing and it’s leaking. So I call the agency and get the answering service. The answering service calls the on-call nurse who calls me, then calls another nurse and has her knocking on my door at 8:40 a.m. Despite my previous experience with home health care agencies, I am really starting to trust this agency and think they are the good guys. Nobody can figure out what this little port is supposed to be used for but we all agree that it must be an equipment malfunction, and I wonder how in heck I’m having so much fun and being the one chosen for these disasters. First the tubing separates, then I run over the bag, and now the port’s leaking. Oh well. Tomorrow the regular nurse is coming at 8:00 a.m. to change the catheter.
At 4:12 p.m., the phone rings. Caller ID says it’s the agency. The regular nurse’s boss tells me that Desta Anthony has refused to take my case, therefore there is no one writing orders for me, therefore they are closing my case, therefore the nurse will not come in the morning to change the catheter.
Okay, let me get this straight: every physician, physician assistant, nurse practitioner and registered nurse who has seen me in the past month has declared emphatically that a Foley catheter will lead to an infection—an infection that cannot be treated because of my reaction to antibiotics. It is supposed to be changed every thirty days. It was inserted July 27 and it is now August 29. And at 4:12 p.m. they call to tell me that it will not be changed as scheduled at 8:00 a.m. tomorrow. What’s wrong with this picture? (To be continued)