Makomed's Weblog

Time is a Crutch

Posted on: June 23, 2005

Oftentimes, spouses bear the brunt of the responsibility when caring for a bed-ridden patient. Today I had to wrestle with a husband’s apprehension about where his wife should be treated and how we were supposed to get her transferred to a different hospital.

A couple of nights ago, he realized that his wife’s heart had become tachycardic. Her pulse had skyrocketed to 240 beats/minute. He called 911 and she was escorted to Centinela Hospital’s ER, located in Inglewood. There, she was stabilized and her heart’s pulse turned a normal 90 bpm. The Centinela physicians decided to admit the wife into the hospital for further testing. Apparently, she suffers from Systemic Scleroderma which aggravates her Pulmonary Fibrosis, which increases her Hypertension and does nothing to help her deal with Rhuematoid Arthritis.

His apprehension began to unfold when they were visited by the Cardiologist on duty. “All he did was ‘chat’ with her! I mean, literally, schmooze with my wife about nothing!” He wanted more. This was his wife, after all, and he wanted nothing but concrete answers about what was wrong with his wife, what was being done to fix it, and how long it would take. Everything had to be hands down concrete.

Things began to heat up when he found out about plans to do some invasive procedures on his wife. The Centinela doctors had begun considering an installment of a pacemaker even though they didn’t possess a thorough history of his wife’s maladies. “I know I’m not a doctor, but this is really something I’m not comfortable with, Howard. I don’t think they know her well enough and a doctor’s time is golden. Why would they spend their precious minutes deciding on whether my wife is capable of handling such traumatic procedures? I must get her back to UCLA.”

This is where I come in. After hearing his side of the story, I began to question what exactly could UCLA do that would overwhelmingly transcend the care that his wife was already receiving from Centinela? This irked him somewhat. He was adamant that UCLA’s staff would have a better perspective on his wife’s treatment. I decided not to pursue this issue further after seeing that he didn’t budge even after reminding him that Doc was on vacation for a week.

Instead, I collected the numbers for both hospitals’ transfer centers to see what needed to be done. It seems that all the papers have been filed and even an ambulance had been arranged. I spoke to all the people he spoke to and I only received irate replies. I told the husband that I would try to give him another update at 1:30 in the afternoon.

The bed manager for UCLA was enraged. “He wants a monitored female bed. That is something we don’t have right now. I just finished his wife’s nursing assessment and she is on my mind right after I finish transferring another woman from the ER and that is all I can do right now! You shouldn’t have given him a time. When you give a patient’s family members a time on the clock, all they hear is that they will get what they want at exactly the time you mentioned. No exceptions. You shouldn’t have done that. We just don’t have a bed for his wife. Period.”

All I could do was confirm that everything had been done and his wife was all ready to transfer as soon as a bed was available. I didn’t do much, but at least I was able to calm the patient down and act as his agent when dealing with both hospital personnel.

Through this, I learned that a husband (or family member) cannot suffer the mental anguish of watching his loved one suffer and is, therefore, unable to cope with hospital politics. He also cannot make sound decisions based on what is given to him because he is scared and not used to having little control over his wife’s health. He needs an agent, similiar to how a lawyer represents a client. He needs reassurance.

I had a whole big speech I was ready to give him, lecturing him on how doctors are much more competent than one might assume, how patients are getting savvy about medical procedures and that it fools them to think that they can treat the patients better than real doctors, that he should know that no medical procedures whatsoever will be performed on his wife without their consent, and that making more obscene phone calls would only burn bridges and cause more harm to his wife, etc. etc.

But I just told him that he did everything he could for his wife, everything was all in order, and all we had to do was wait.

I heard him sigh just before I hung up the phone.

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