Happy Anniversary to my wife Lisa! 16 years.  We met exactly 21 years ago to the day in Montreal.  That was good day.

Status: 9.0/10.   A good night’s sleep will mend almost anything.

Events:  A group of 7 Dads is vacuuming, washing, and detailing our cars.  They’ve been part of a fathers and sons group since Ethan was in 2nd grade.  Our driveway looks like part of the stimulus package.  What a wonderful gift.

Comments:  So I promised you a recapitulation of Thursday at Hopkins.  We had been scheduled for an early 7:30 AM blood drawing for labs, but we’re now catching on to the rules.  Seems like everyone is given a 7:30 AM appt, so we walked in and saw several dozen people already checked in.  We guess we’ll try to get there earlier next time.

The real issue was the LP.  The actual procedure was done well (by the fellow in radiology), but delayed because they had to find the attending radiology physician to be present.  Now part of this is so that procedures are supervised, but there’s a subtlety to it as well.  In academic medical centers, almost all of the procedures are done by interns, residents, fellows, and even medical students.  There is an attending physician listed as “your” doctor (and in community hospitals he/she would be your private doctor who admitted you).  But all the procedures done by the students, residents, etc., are reimbursed to the attending physician as if he had done them him(her)self.

A number of years ago, the system was changed so that if your physician was going to bill for services, he/she would either have to actually do them or at least be physically present at the time supervising whoever was.  So now, not only is it important to have a senior doctor there to make sure it’s done right, he/she doesn’t get paid unless he/she is physically present.  So we waited a good half-hour as they tried to find the billing doctor. 

When he finally entered the room, the radiology technician (who had been most gracious and apologetic throughout this) tried vainly to make an introduction.  Let me set the scene: I’m lying face down on an uncomfortably cold, hard, lead table, with my lower back having been painted with antiseptic for more than a half-hour.  The radiology fellow is standing, gloved, hair-netted, and gowned in a lead apron, awaiting the arrival of the attending physician.  As he walks in the room, the technician says, “Dr. Whatever, this is Doctor Dan who’s having the LP this morning.”  Now, not a “Hello,” not a “How are you,” not a “Sorry, I’m late,” not even a head nod acknowledging there’s someone in the room he doesn’t know.  It’s as if no one had said anything.  Now, I’m going to get a bill from him, but I’m not his patient (even for those few minutes) I’m just another task on the “to do” list.  Do patients see modern medicine as uncaring and impersonal?  Wonder why.

After the radiology fellow found the right spot under fluoroscopy to place the needle for the spinal tap, she withdrew some spinal fluid for testing, and the oncology physician’s assistant injected chemotherapy (she had previously introduced herself and used comforting words throughout the procedure).   I was then wheeled outside in preparation for transport to the oncology outpatient rooms where I would lie quietly on my back for 2 hours (to prevent post-spinal headache) and rest.

As you might guess, no one shows up for more than an hour as I lay on a gurney in the hallway.  At least, Lisa is there standing beside me.  Transport finally shows up, and I’m hoping for a quiet ride back to where I can rest and recover.  But that’s not to be.  In what has become a repeating scenario, not a word from my gurney pushers to me, not an “Are you all right?” not “Are you cold?” or even a “We’ll take right to recovery.”  But plenty of words for everyone he passes in the hall – in fact, he’s yelling at nearly every passersby – some simple shoutouts across the hallway, some hits on women – it’s an ongoing and loud conversation I’m subjected to for the entire trip.  I just want to some quiet and rest, and I’m treated to a verbal circus.  Lisa is walking beside, and the guy doesn’t have a clue how inappropriate he is.  It seems that I’m not a patient that he’s been trained to take care of, I’m just a piece of meat (a hardly noticeable one at that) that he’s required to move from one place to another.

When he was hired, was he trained?  Did someone say to him, “You are one of the most important people patients will meet during their stay.  Remember, they’re uncomfortable and perhaps in pain.  They’re lying on their backs, looking up at a moving ceiling, disoriented, and maybe frightened.  How would you feel if you were in their position?  What would you want the person moving them to do?  Your job is to make them feel comfortable and calm, and give them a quiet and easy ride back to their next location.”

Please believe me when I say that this problem isn’t relegated to Hopkins – it’s universal.  Who’s in charge of this group?  Do they know what their employees are doing?  Do they have any idea of the effect it has on patient care and comfort?  Do I know they’re probably the lowest paid people in the hospital?  Yes.  Do I think they need to be part of the health care team?  Yes.  Am I going to try to fix it?  Yes.

Lisa brought home dinner from our favorite Chinese restaurant, and we ate by candlelight.  We exchanged anniversary cards, and thought about all the wonderful years together.  A good day.

Love,

 -Bruce

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14 Responses to “”

  1. Art Ulene Says:

    Happy Anniversary, you two! I am really sorry to read about how you are being treated. I just returned from MCing my 20th “Festival of Life” at USC/Norris Comprehensive Cancer Center…. and I can tell you for sure…. it doesn’t have to be that way. Patient after patient talked about the way they are treated by the parking attendants… the greeters…. the clinic staff…. the orderlies…. the technicians…. and finally, by their doctors. In each case, they were talking as if these people were friends and teammates… not “providers” and “service people”. So I really do think you should do something about this….. but not now. My blood was boiling as I red today’s blog….. and your blood must have been boiling as you wrote. There will be time enough to deal with “the Hopkins Way” of treating people. For now, it’s time to concentrate on family…. friends…. food….. and rest. Priscilla and I send our love. ART

  2. wendy Says:

    At Sharp Memorial Hospital here in San Diego- it’s been a bit different. They have this huge advertisment/ marketing TV campaign about patient care…and while I haven’t had any of your procedures…I have had colonoscopy x’s 2 under anesthia – and they bring a warm blanket and introduce themselves, explain procedures, ask about comfort, offer refreshements, water, and to call anyone to come get you post procedure. They even send cards to your home thanking you for letting them serve you. Which I think is a bit much but part of their commitment to a good reputation. It does make a difference.

    They’ve actually won some hospital service award.

    AND I walked through the emergency room the other day to find where all the san diego dialysis and tranplant social workers were having a meeting. I asked the volunteer standing in the ER if she knew where this specific conference room was….”Yes,” she said,” Come with me and I’ll take you there.” Now they’ve got the system down to a tee.

    Happy Anniversary to a worthy couple.

  3. Susan Says:

    HAPPY ANNIVERSARY! I AM SORRY OF WHAT TRANSPIRED DURING YOUR LP. IT SHOULDN’T BE LIKE THAT – AND I DON’T THINK IT IS UNIVERSAL… I AM SORRY YOU HAD THIS EXPERIENCE….. JUST BE HOME AND ENJOY. MUCH LOVE TO YOU BOTH

  4. Judy and Ken Freedman Says:

    Happy Anniversary 🙂 We vividly and very fondly remember your beautiful wedding. A Chinese carryout dinner by candlelight sounds perfect.

    We can talk about teaching empathy another time.

    Love and best wishes,
    Judy and Ken

  5. Hopie Says:

    I remember laughting so hard we cried at your rehearsal dinner, at a Chinese restaurant, your brothers antics! Glad you had a pleasant day today, see you very soon.

  6. Donna Hill Howes Says:

    Happy, Happy Anniversary you two spring chickens…..BIG smiles.
    Sending you love, and plenty of it!
    XOXO
    Donna
    Smiling at the thought of your candlelight dinner…..sigh….

  7. Carly Says:

    One of my favorite pictures ever is of me, passed out in my dad’s arms at your wedding. Though I don’t remember it; I was three. It’s still a favorite!

  8. Margot Says:

    Happy Anniversary Lisa and Bruce! Glad you were home to enjoy a quiet eveing together – sounds perfect! Hugs, Margot and David

  9. joel steinberg Says:

    One can see why people get so angry and frustrated by the hospital experience. Even having worked at my hospital for 18 years before retiring, I still sometimes get short shrift when I have to go in for visits, tests, etc. But I must say that Margaret has gotten “Rolls-Royce” treatment ever since she first felt the lump in her breast. Every test, procedure and treatment has been pretty much right on schedule; and all the personnel–nurses, aides, MDs, pharmacists, techs–have been exceptionally kind and solicitous. Maybe because M. is kind and likable herself. Happy Anniversary to you both. Love, Joel and Margaret S.

  10. Wendy Yaross Says:

    HAPPY ANNIVERSARY, LISA AND BRUCE! We are so glad you are home. What could be better than Chinese by candlelight? Love and hugs,
    Wendy and Daniel

  11. Judi Golding-Baker Says:

    Dear Bruce and Lisa

    Happy, Happy, Happy Anniversary! What a truly sweet 16! Lots of big hugs to to both of you.

    Judi

  12. courtney Says:

    HAPPY ANNIVERSARY Bruce and Lisa! 16 years is wonderful! wishing you many, many more years of love, laughter, hugs, and kisses w/ each other. =)

  13. mike magee Says:

    Bruce-

    Have to agree with Art on this. In my years in Hospital Administration, I saw the worst turned into the best because somebody at the top insisted on nothing less and made it happen. Somehow, some of the big centers got it in their heads that they are too big ( and too important in their own eyes) to worry about common human decency and caring. Truth is – breakdown in empathy like this is often associated with breakdown in systems and safety as well. Unacceptable – plain and simple!

    Sorry for talking shop, Lisa! Happy Anniversary and many blessings!

    Mike

  14. Tom Linden Says:

    First of all, happy anniversary to both of you. Bruce must be thanking his lucky stars every day that he has Lisa to accompany him on this sometimes painful journey. I know Bruce would do the same if the roles were reversed.

    On the treatment of you, Bruce, I’ll weigh in with my friends Art and Mike that the impersonal (and, at times, nearly abusive) treatment you’ve received is totally unacceptable. I can’t speak for any institution, but I was with a family member when she had a recent diagnostic procedure done by a fellow in radiology. He spent at least 15 minutes with us before he did the procedure and then talked his way through it. Fortunately, the biopsy was negative… I can’t imagine how I’d feel if I or a loved one had your experience. I hope you can effect changes at Johns Hopkins and elsewhere. It was my experience in medical school that one of the most prestigious institutions displayed terrible practices when it came to anything involving human interactions. And I have to ask doctors, nurses, orderlies, and administrators working in medical institutions, if you can’t treat people well, what are you doing in the practice of medicine?

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