The symptoms were flu-like, high temperature and
chills. My impulse was to ride it
out, but when the thermometer read 104, my wife drove me to the emergency room
late on a Friday afternoon. Thus I
entered the world of medicine, a landscape similar to that of some distant
planet.
My experience with emergency rooms was limited to visiting
my mother at a downtown Los Angeles hospital near the end of her life. That one was secured by a uniformed
policeman cum sidearm and a metal
detector. This one lacked any visible security, but this is Texas, and everyone
present may have carried a concealed weapon. Emergency rooms are all about triage. A clerk, phlebotomists, nurses, and,
finally, a physician gave interviews with annoyingly-repetitious questions
(what are your symptoms; when did they begin; are you taking any prescription
medications?), listened with stethoscopes (“take a deep breath”), poked and
drew blood. About an hour after we
walked in the door, my wife and I were ushered into an examination room where
the poking and questioning began anew. Isn’t this redundancy what sharing
digital information is supposed to make obsolete? Finally a nurse terminated the examination and inserted
an antibiotic drip. Then we waited, me on a gurney, my wife in a chair.
Sometime around 3AM, my wife crawled onto the gurney with
me. She had finally reached the
end of her heroic endurance, and she was cold. By this time the antibiotics and extra strength Tylenol were
reducing my symptoms. The fever
broke, and a nurse was on the point of releasing me when she witnessed my very
shaky walk to the rest room. I
toddled back to the gurney with her aid.
Soon the fever returned as did the antibiotic drip. Tests would reveal
that I had contracted something called streptococcus
maitis, from a bacterium that resides in the mouth. I had made myself sick brushing my
teeth.
Diagnosis in hand, I was admitted to the hospital. An orderly issued a hospital gown,
socks with nonslip soles, a bed pan, towels and washcloths. I felt like a GI starting boot
camp. Then a nurse assigned me a
room and hooked up an IV pump that administered antibiotics and a saline
solution. Over the course of my
stay eight nurses (Jo Jo, Michael, Florence (twice), Rachael, John, Michelle
and LaVell) attended me day and night, taking vital signs, refreshing
medications, asking for my name and date of birth. Their irritating care and
the medication quickly reduced my symptoms and raised my hopes for an early
dismissal. I received visitors and read novels for the rest of the weekend.
On Monday physicians began their rounds. First among them was the infectious
diseases specialist who had prepared my wife and me for our upcoming trip to
Africa. After going over my chart,
he asked if we had altered our plans.
What he really meant was that, despite my protests, he intended to do
whatever he could to convince us to postpone the trip. In the end, and after getting the same
advice from the resident overseeing my hospitalization, our primary care
physician, and my sister-in-law, the pediatrician, I gave in. Apparently, if not completely
eradicated, the maitis bacterium can
cluster on a heart valve and cause serious pumping problems.
The next evening, as I lay in bed, a technician installed a
PICC (peripherally inserted central catheter), a thin, flexible tube threaded
through a vein on my upper arm into a ventricle. This allowed direct delivery of medication to the heart from
syringes supplied by UPS. The next
day I was free to go, but not before signing a half ream of forms authorizing
release of medical records, acknowledging that I understood the nature of my
illness (a stretch) and promising to be good (what choice did I have?).
Once at home, I began a regimen of antibiotics administered
through the PICC. Every day at
11AM sharp my wife used syringes to push medicine and anticoagulants into my
chest cavity. This lasted a month
and, apparently, did the job. To
mark the end of treatment, a nurse removed the syringe connection and pulled
out the tube. Therapy ended;
billing began.
As a seventy-year-old and a retired academic, the cost of
treatment and hospitalization did not affect my financial health. But trying to deconstruct the billing
documents has been migraine-inducing.
There are lines detailing services and costs followed by lines for
Medicare, Medicare deductable, sequester adjustment, and finally “Amount You
May Owe Provider.” Some of the
numbers are enormous, but through an inscrutable arithmetic, the bottom line is
nearly always $0.00. It is this
system that Mr. Trump wants to disrupt; it gives me chills (and fever).
