Tuesday, May 01, 2007

Reflections on Heart Surgery

My Mom had unexpected heart surgery yesterday in Nearby State, so I made the drive there and back for moral support. (That's why my voice was absent from the comments yesterday.)

Having been relatively lucky in medical terms thus far, I came to the cardiac ward as a newbie.

It's a weird mix of futuristic and backwards.

The technology now, of course, is amazing. The entire surgery took just over an hour, and she was conscious and very much herself – if a bit tired – immediately after. The doctor's entire report to me consisted of “she did great!,” which is really all I wanted to hear anyway. Pacemaker technology has apparently improved tremendously. I remember the warnings about microwave ovens and suchlike; now, they pretty much say “don't arc weld” and send you home. Mom has made it this far without arc welding, so I like her chances.

They even have rolling x-ray carts, so they can do x-rays without moving patients. Pretty cool.

What they don't have, though, is a handle on the logistics of what they're doing.

For example: why would a hospital serve patients nothing but a steady diet of red meat in gravy? Didn't they get the memo? The only fruit Mom got was smuggled in. This strikes me as perverse. You'd think a hospital, of all places, would serve healthy food.

But that's trivial compared to the really basic information the doctors and nurses apparently didn't relay to each other.

With every new medical person in the room – and it was a cast of thousands over the course of the day – the same litany of questions was repeated. Mom got to repeat her weight to several different people, even though she was weighed in when she was admitted. You'd think someone would have written it down. Each new one would ask whether she was diabetic, whether she's right-handed or left-handed, whether she had arthritis, etc. I wouldn't expect any of those answers to change after the first time they're asked on any given day.

At one point, an aide came in to check Mom's blood sugar, until the nurse at the station bellowed that Mom isn't diabetic. The aide shrugged, smiled sheepishly, and left. This did not inspire confidence.

When they rolled in the x-ray cart, I actually had to volunteer to leave the room. Had I not volunteered, it looked like they would have just fired off a few anyway.

When the wheeled Mom's stretcher from the first waiting area to the next waiting area – and wow, do they have waiting areas – the little automatic door-opener didn't work. It was almost slapstick.

I was amazed at the amount of “hurry up and wait.” It sort of felt like sitting on the tarmac when your plane is 8th in line for takeoff. You're strapped in, you're committed, and you're not moving. They don't tell you much, and what they do tell you is weirdly cryptic. (True example: “take her stuff, because she won't be coming back here.” Okay, where will she be going?) It doesn't seem to be malicious so much as structural – they don't communicate with each other, either.

The contrast between incredibly sophisticated technology and a staff that seemed to have only the faintest grasp on what was going on was striking. What little information that was written down was written on paper, which was stacked hither and yon. Apparently, PDA technology hasn't quite hit there yet. Sure, they can implant a microchip that decides whether you live or die, but a PalmPilot is beyond them. I don't get it.

I'm all for the cool lifesaving gadgetry, but it's only as good as the system behind it. Surely they have access to cutting-edge communications technology. I know this isn't my usual topic, but does anybody out there know why they're still using paper files, and re-asking the same questions over and over again?