Inside the gut of the healthcare system

First of all, a sincere thanks to everyone who sent well wishes to my son on his encounter with abdominal surgery. He’s doing very well on his first full day of recovery, and doctors are optimistic about a rapid improvement in his condition. We hope that he’ll be out of the hospital and back on his feet – or, more accurately, his favorite sofa — by Friday.

Surgeons spent about two hours yesterday morning exploring his interior laparascopically before locating a diseased section of the small intestine and removing a segment described improbably as the length of a foot-long hotdog, or about ten inches. While in the gastrointestinal neighborhood, they also yanked his appendix because, like the mountain to the mountain-climber, it was “there” and thus demanded surgical attention. The doctor later explained that future physicians would see the scar and believe the appendix had been removed and, if it wasn’t and they thought it was, they might misdiagnose a future malady, which made marginally more sense.

We’re staying at a splendid complex in Charlotte called the Levine Children’s Hospital, which is part of the Carolinas Medical Center. Levine is less than a year old, and sports all the bells and whistles you might expect from a medical construction project finished right before the recession hit. In fact, for our tastes, it sports a few too many bells and whistles, some of which are attached to a remote-control toy train that toots down the hall hourly to the delight of four-year-olds and the annoyance of 17-year-olds.

The entire hospital complex here is an intriguing mix of the latest in high-tech medical care and more down-to-earth systems with chronic problems. When my son was wheeled off to the operating room, my wife and I were taken to a special waiting room where we’d receive hourly updates on the details of the procedure. In addition, there was a big-screen video display that tracked the progress of each patient in each OR. It reminded me of an arrivals and departures board at the airport, with a color coding system indicating who was in pre-op, who was in “stage 3” (something to do with rocketry, I assume) and who was in post-operative recovery. The coding tactfully did not include a color for who had expired on the table or who got one of those cool stab-the-syringe-into-the-chest moves you see on TV. I think they personally inform you of those.

Contrast the elaborate video display with an ID tagging system that seems archaic at best. When we first arrived in admitting, my wife and I each received a printout bearing our crude photographic likeness, our status as “parents” (disturbingly set to expire at the end of the day) and a bar code that we would scan at various access points throughout the hospital. The printout is extremely poor, looking something like the rendering you get when you swipe a pencil on a piece of paper covering a penny and end up with a smeared imprint. There’s spare toner all over the place, making the bar code completely unreadable. So every time we go downstairs to visit the cafeteria, we’re not sure we’ll be back; there’s this one door where we’re halted until a hospital staff member comes along to let us through. I’ve waved the ID in as many different motions as I can imagine, which only leaves me looking foolish, not to mention hungry.

On the elaborate TV remote control in my son’s room, there’s a poorly placed red button between the “movie” and “TV” selection, summoning the emergency nurse when all you wanted to do was get that damn Hannah Montana movie off the screen. The IV pump keeping my son hydrated starts a different series of warning beeps every half hour or so, the different tones meaning the battery is low, the fluid bag is half-empty, or the med-evac helicopter is about to crash through our window. We’re never certain, so we call the nurse (or perhaps change the channel) just to be reassured. The relaxation screen-saver on one channel, showing a teeming tank of tropical fish, is actually a repetitive loop, not the live feed from Sea World I had imagined.

Of course, it’s really the human side of the business that’s far more important, and I have to give very high marks to all the staff and doctors working on our case. Our surgeon is a calm, cool customer by the name of Dr. Bambini, and he was ably assisted by anesthesiologist Brian May. Despite the fact the first sounds more like a vaudeville acrobat than a pediatric surgeon, and the second, I believe, was lead guitarist for the rock group Queen before drugs apparently lured him into his current field, both were consummate professionals in the treatment of my son. The rest of the staff, while well-intentioned, is sometimes a little less stellar.

There’s an unending rotation of individuals parading in and out of our room at all hours of the day and night, performing the various support services every bit as necessary as what the doctors do. (Not really). We met a new nurse yesterday afternoon who entered the room with a breezy “Hi, Cameron, how ya doin’?” We were immediately impressed by both her professionalism and manner until we realized neither of us was named Cameron. The receptionist in the OR waiting room came to tell us our son was out of surgery with the pronouncement “he’s done,” sparking some panicked nanoseconds before her broad smile told us she probably didn’t mean it quite like it sounded.

This cavalcade of health-care workers gets a bit overwhelming, especially when you’re awakened in the middle of the night by the latest visitors. Is this the vital-signs checker or the child-life services volunteer? Is this the nutrition person taking meal orders or a nurse’s assistant? Even if they do identify themselves fully, it still can be hard to keep them all straight, and you fall back on conventional stereotyping to determine what kind of person looks like what kind of worker. If you don’t, you may end up asking the two well-groomed guys in white coats for an unsoiled set of linens, or the tattooed woman with a tongue piercing and a blue smock for another dose of morphine. Though that might actually work out too.
When the woman from the admitting office stopped by to graciously welcome us and ask how we wanted to pay the $300 deductible, there was no mistaking her role. She offered to take a check, a credit card or a debit card, then walked away to inform us a few minutes later that the computer was down so she’d be back to try again later.
Which got me to thinking about what all of this exquisite technology and highly-trained care was going to cost us. Whatever it was, it would definitely be worth it to have our beloved son converted into a healthier teenager than when he arrived, but I won’t mind at all if Admitting Lady gets eternally stuck behind that door with the bad scanner.
In my next post, I’ll write more about costs and other interesting features of our visit into the heart (or should I say gut) of the American medical system.

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6 Responses to “Inside the gut of the healthcare system”

  1. starlaschat Says:

    I’m so glad to hear your son and family are doing well. I have so many mixed feeling about our medical system it will be interesting to read your take on it. I hope all will continue to be well, and that the family is home soon. Keep us posted.

  2. Rocky Humbert Says:

    Best wishes for a speedy recovery to to your son.

    As for you, DavisW, I’m extremely disappointed. You PROMISED something funny every day, and you let me down. What kind of lame excuse is skipping the day because your kid is undergoing surgery? Next time be creative — like the cat ate your computer mouse.

  3. © JM (aka Brain) Says:

    I have been following your blog. Good stufff, and I appreciate how family comes first with you. Glad to see your son is ok.

  4. Robert Says:

    Glad to see “Cameron” is doing well. Fluff up the pillows on the sofa for him.

  5. ahrcanum Says:

    It is nice when things go as they are supposed to. No place better than American Medicine! Glad your son is going to be a okay.

  6. planetross Says:

    I thought I had an “in” with the Brian May reference, but … you closed that one down. So … all I have is … good to hear your son is doing well and by the tone of the post (not pone of the toast) he is doing just that.

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