I bring you greetings from St. Joseph’s Hospital where my roommate and I are watching the Syracuse University football team play Stony Brook. I have been asked numerous times by numerous people “What brought you to the hospital?” I always have to fight the urge to reply, “TLC ambulance.” Nobody likes a smart ass.
Tuesday I wheeled to the Downtown Farmers Market for two reasons: (1) to buy flowers. What is life without flowers? And (2) because I was lonely and bored. If someone had knocked on my door and said, “You want to play cards?” then I never would have gone to the market. But I was dying of aloneness so I went and paid for it the next day, and the next.
Got dizzy if I rolled over in bed. Couldn’t breathe if I sat up unsupported. Kept expecting to pull out of it. Kept not. Friday morning I woke up in a fog. Couldn’t get on the computer. Couldn’t think. Reading the bible was very laborious. Couldn’t remember the words to “How Great Thou Art,” which I’ve only sung every morning for about twenty-four of the last thirty-six months. And I kept thinking that the agency was sending me a new aide for the weekend and I was too far out in la-la land to tell her how to make coffee.
If you’re too sick to get coffee then you darn well are sick enough to be in the hospital, so Friday afternoon Amelia and I got me ready and then called TLC ambulance (“Everything Rural Metro does, but without sucking”), which trucked me off to St. Joe’s. How to tell if the patient’s really sick: if she doesn’t open her eyes to watch the world go by then she’s really sick.
St. Joe’s has a new Emergency Room. It’s big and wide open—has lots of space—and is a whole lot quieter than the old ER. The “cubbies” no longer are narrow, dark slots wrapped in curtains. Now they are big rooms, hyper-lit, with television and sliding glass doors that shut out a lot of the noise of monitors beeping and whining. So Amelia and I take up occupancy and lots of nurses come in to process me.
I decline to have my blood pressure taken. I also decline all the other interventions modern medicine has to offer, and mostly stick to repeating “palliative care” and “Dr. Tucker.” Dr. Tucker is big shit at St. Joe’s—head of some stuff, professor of other stuff, general all-around good guy who people like to work with.
After while a nurse comes in and hands me her official cell phone—all the new ER’s nurses are now connected by cell phones—and asks me to talk to Dr. Tucker. He very nicely points out to me that he needs numbers to work with. He will take care of me but I’ve got to give him some numbers.
Oh, okay. I forgot all about that part of how the system works. I’ve forgotten a lot of things lately, like the fact that the stuff on the kitchen floor is called linoleum, not aluminum. So I tell the nurses to bring it on and I get a major blood draw, urinalysis, chest x-ray and EKG. We got there around 4:30 p.m. I now am generating numbers like mad. I’m explaining to anybody who asks that we’ve spent the last six weeks trying to get me into a skilled nursing facility. I say that and then they look puzzled and ask what the problem is.
I look at Amelia, searching for a short, usable answer. There is none. How to explain that the Neighborhood Advisor says nursing homes are prima donnas that accept or deny patients at will, or that two of them have just told us “we only take patients from hospitals” not from tiny apartments in HUD-subsidized housing, which I strongly suspect is a perversion of the rules and I would like to do some research on this but anybody who’s too messed up to give coffee-making instructions is not a good bet for researching federal regulations on anything more complicated than kitty litter.
So then a physician’s assistant comes in and tells me that except for kidney function, my numbers are pretty normal. I don’t believe her for one second. I ask her what my glucose level was and she says she doesn’t know. I invite her to take her sorry butt back to the nurses’ station and bring me the numbers. She does. My glucose level is 387 and she missed it. You want a discharge with that diabetic coma? She then does a little dance about how I can’t get admitted just because I have a ton of chronic shit going on—I have to be acute, she says.
And I say something designed to induce in her the awareness that her job does not include making decisions. Her job is to gather numbers for Dr. Tucker so he can make a decision. And I have every confidence that Dr. Tucker’s journey from medical student to Head of Stuff included a self-taught session in How to Bundle Numbers so the Patient Gets Righteous Treatment.
Amelia leaves around 8:30 p.m. and a respiratory therapist comes in to set up my auto BiPAP. Amelia and I, individually and jointly, know how to do it as does the nurse, I am sure, but this is a hospital, which is to say an enormous gathering of human beings whose primary directive is: Cover Your Ass. So the respiratory therapist is called, arrives promptly, and informs me that I’m being admitted.
Next week the guy who pushes the linen cart will be giving out diagnoses.
The respiratory therapist, who is—I think—Bosnian, says I’ll be transferred to an inpatient bed in about an hour, which is nonsense. If I’ve learned one thing from my journey through the hospital system it is that there is absolutely no correlation between an ER nurse saying, “You’re being admitted,” and a floor nurse saying, “You’ve got a bed.” (To be continued)