A Patient’s Perspective on Modern Hospital Care

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I practiced the medical approach known as Alternative Complementary Medicine. I have tried to describe the reasons for the huge change in concept by referring to it as a “Paradigm Shift”. It is, in a sense, “back to the future” by noting the teachings of Hippocrates, the so-called Father of Modern Medicine.

The Grim Reaper eventually takes his toll. Many of us “fall apart” bit by bit as oxidative metabolism gradually becomes less efficient. Thus cardiovascular disease, cancer and other degenerative diseases become more common as we age. This is a little like the gradual rusting of automobiles with age. Rusting is oxidation of metal. The important point to make is that the preventive approach, through nutrition and other Alternative approaches, is better and safer than the present use of increasingly dangerous drugs. But no treatment ever invented is perfect, for perfection is an impossible attainment.

So how does a patient fare if a cardiovascular crisis event occurs in the senior years? What if a 911 call goes out and the patient is taken to the nearest emergency room and is admitted to a hospital? The orthodox modern therapy becomes a mandate. But the major problem is that the emergency room physician, the cardiologist and indeed all the modern specialists have not accepted that the preventive approach usually provides many years of total disease freedom. Because of the present public attitude towards taking medication, perhaps the art of taking nutrient pills might be encouraged, together with nutritional advice and education. It is not very sensible to say that prevention is a failure when a crisis disease occurs in an octogenarian. One might say that such a person has “beaten the game of life”. Could that person have succumbed to the same crisis disease 20 years previously? Of course she could. The evidence is that the date of death is written in the genome of each one of us. We cannot lengthen it but we can surely shorten it and that is the current method of lifestyle that does just that. The major point that I want to make is that the early years should be spent in obeying the rules of life that are set in the Great Design offered by Mother Nature. But the possibility of crisis disease looms in the declining years and modern medicine needs to do its best to stave that off as long as possible. That is why increasing recognition is being given to the idea of Complementary Alternative (or Integrated) Medicine, a concept that seeks to bring the high tech, life-saving procedure and the preventive approach together.

When Medicine Becomes Big Business

This was brought home to me when my 82-year old wife had a non-lethal heart attack. It involved a 911 call, transport to the nearest hospital emergency room and admission for angioplasty. There is no doubt that this intervention was a life-saving procedure. My comments from here relate to our personal experience. As most Canadians know, hospital stays in the U.S. are governed by directives known as Diagnosis Related Groups (DRGs), a method  of classifying disease in terms of expected hospital stay and reimbursement. The acceptable time limits for remaining in a hospital are proscribed by government rules. This results in premature discharge from the hospital in some situations. Because of complications that were avoidable under proper surveillance, the premature discharges for my wife resulted in two further admissions to hospital involving emergency surgery.

Aside from this, where one might argue that complications of this nature are part of any crisis illness, I really want to comment on the perspective of a patient and the family in a modern hospital. First, the nursing was appallingly deficient. To try to summon a nurse for help was a joke and it would seem mandatory in the present hospital setting for the patient to have a family member present as much as possible. Yes, nurses are in short supply.

Healing Requires Peace and Quiet

Perhaps the worst thing that must inevitably have a slowing effect on the healing process is the noise at night. Monitoring bells ring, crashes and bangs of obscure origin occur and the constant chatter of attendant personnel prevents sleep constantly throughout the night. For a group of nurses to stand outside a patient’s room and discuss their respective boy friends and husbands in loud voices, as though they are at a party, is unforgivable. The visit of the doctor in charge is brief, coldly business related and virtually non-communicative. The patient and family visitors are left almost completely in ignorance of what is being done and the reasons for the various studies and procedures.

There is little doubt that at least some of the behavior of physicians today is because they are all practicing defensively. The “least said the best mended” formula rides high on their agenda. The prospect of a lawsuit hangs over virtually any procedure.

It is worth commenting on the hospital night setting when I was a student and as a resident. Patients in an English hospital were placed in large rooms called wards that would contain as many as 20-30 beds. The only thing that could provide any privacy was a curtain that could be pulled completely around each bed. The night nurse sat at a desk just inside the entrance to the ward and even the light that she used was shaded. There was complete silence throughout the ward and absolutely no lights were allowed after “lights out” call. The nurse could be summoned easily by any patient under her watchful eye. There were no monitors or electronic gadgets to distract her and her authority was gentle, kind, but absolute.

Beyond Technology

The modern concept is that technology is the master mind of nursing care and it is unusual not to find personnel sitting in front of a computer monitor. The personal touch that is so important in providing communication to patients had simply disappeared. Disease has actually become dollar driven big business and patients (heaven knows, patience has to be infinite!) have become numbers almost like items on a conveyor belt that propels the patient through the technologically controlled system.

As a physician, I cannot imagine practicing medicine like this. As a husband, watching my wife suffer needlessly for no other reason than a failed business model that values technology and efficiency over an atmosphere to encourage healing, was repugnant.

Physicians, nurses and health workers in general need to apply themselves to learning about the plentiful science surrounding disease prevention. As long as Big Pharma rules the roost that provides their enormous financial profits, things will only get worse. I can only see change as it comes from the collective demands of the consumer, the potential patients. It will never come from the medical profession until the public demands it and this will take a long time to soak in. The public needs to speak out.

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