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I was at an art gallery on my first date with a girl named Angela. I was trying to make time with her in a low key way - exercising my 'cultured' senses. Then I saw an original Tenniel illustration from Alice's Adventures Underground and Angela was quickly forgotten. Apparently, I was so mesmerized by the piece that Angela was beginning to feel left out. She nudged me with her unnaturally pointed elbow, "You can't have it." Resigned, I make room for the other patrons to look at the engraving.
Before we had a chance to peruse the other illustrations my beeper went off. On its evilly green glowing display was Mom's phone number with '911' appended to it. I called her immediately, and what I had been fearing most had happened, my Grandma was having chest pains.
Mom and I knew this day would come because we both had noticed Grandma (at 94) was slowing down - her constant complaints were not as original, you usually could get out of the way before she tried to hit you with her cane, she didn't think Sam Donaldson was as sexy anymore, etc.
I told Angela I was having a family crisis and she dropped me off at my Mom's house. I think the whole thing totally unnerved her, for she never went out with me again. Or maybe it was my drooling in the art gallery?
At Mom's house I found Mom totally off the edge. She was pacing at such a furious rate I had to jog just to keep up with her and have a conversation. Had she called an ambulance? No. Why? Because the hospital will kill her. Did Mom think that Grandma was magically going to get better? No.
I went upstairs to look at Grandma. She was in bed and in pain, but I doubted that it was her heart. She was just old and her body wasn't functioning reliably. She had just recently not been able to walk anymore. Mom and Grandma both had living wills which detailed no resuscitation efforts. But Grandma wasn't at that point yet.
I cornered Mom and gave her the facts. Yes, she may be dying, but is it ethical to let her be in pain until that moment arrives? No. We had no idea how much medical coverage Grandma had or what getting her to the hospital would cost, but if she went to the hospital then we would have to hope that Medicare takes care of those things.
Mom picked up the phone and called 911.
The ambulance arrived quickly and two sterling, manly, and competent paramedics attended Grandma. My tax dollars at work and worth every penny. The paramedics examined Grandma but couldn't conclude what was wrong with her.
I guided Mom through the various forms. Apparently, just to get to ride in an ambulance you had to sign in 4 different places.
The ambulance whisked Grandma away. Mom and I collected some of Grandma's favorite things; the sweater and scarf she always liked to wear and we followed.
At the hospital the world had obviously become unhinged. Vehicle accident victims, burnt children, and frozen winos littered the waiting room. After an hour we were able to flag down a member of the hospital staff. She took our name and said she would get back to us.
Another half hour passed when she returned. It seems that they had misplaced Grandma. They knew she was supposed to be admitted, but they had no record of her actually arriving. Mom, who hadn't smoked in 15 years, bummed a cigarette off me.
Finally, after an interminable wait, we saw one of the paramedics who had come to the house. He showed us to the room were Grandma was.
Grandma was stretched out on a table with only a sheet to cover her. The room was about 60 degrees and she was freezing. Mom helped her into her sweater and tied the scarf over her head. Grandma didn't say much except to moan a few times. The shocks of the day had made her insensible.
After 15 minutes watching Grandma feebly stir on the table, Mom started crying and left the room. I hung on to a developing sense of disassociation. It was like a warm blanket that would shield me from reality.
Occasionally I would poke through the drawers in the examination room. On one counter was a dumb terminal connected to the hospital's medical information database. I spent some time hacking on it. After a few minutes I was able to get into the patient information records. I search for Grandma's records but she wasn't even in the system yet. I was amazed; she had been at the hospital for over three hours!
Meanwhile Mom had found a knowledgeable nurse who guided her to the admissions desk. Mom had a few thousand forms to fill out. The same nurse eventually made it to Grandma's room. I started asking questions. Had they given Grandma any medications? No, medication was contraindicated until they knew what was wrong with her. Could we turn up the heat in the room? Of course, she'd take care of that.
The nurse started snapping on rubber gloves and suggested that I leave the room. I went to look for Mom.
I wandered white antiseptic halls lined with curtained partitions. The smell of death and corruption tickled at the back of my mind. The screams of the dying and maimed echoed against the shuffle of feet and the murmurs of the doctors.
I found Mom between two impressive stacks of paper. I helped her untangle the maze of Grandma's medical coverage. Grandma had bought a number of terribly cheap insurance policies over the years. None of them would cover the threatening tide of medical expenses, but, perhaps, taken en masse, there might be enough to cover the costs and not break Mom.
After an hour of filling out forms, Mom and I returned to Grandma's rooms. Thankfully, Grandma was asleep. We each retired to a corner of the room and waited listlessly for word from on high.
Occasionally a nurse would pop in and measure Grandma's temperature of blood pressure. They had been given permission to put Grandma on oxygen, which was helping Grandma immensely. Each of the nurses were exactly the same; terribly efficient, terribly earnest, and terribly caring. Unfortunately, they didn't know anything.
Here I got my first glimpse of the incredible dichotomy between nurses and doctors which was to so frustrate me over the next few months. While nurses care for patients, administer medications, and become intimately familiar with their charges, they are forbidden to make diagnoses. I can see where this kind of policy makes sense to the AMA, but it is painfully inefficient. I cannot count the number of times that there was something wrong with Grandma - the nurse knew what was wrong - hell, sometimes even I could figure it out - but we had to wait hours for the doctor to make the diagnosis and get back to the nurse.
Finally, after six hours at the emergency room the doctor told us that they didn't know what was wrong with Grandma, except that she was very old. They would keep her overnight and run some tests the next day. They sent us home. >>>
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