Lessons under anesthesia
Nothing ever makes me feel more empathy for those we care for than my own occasional reluctant forays into our American healthcare pseudo-system. Adapting the old moccasin adage, until I've walked a mile in someone else's backless gown, I can't possibly understand how they feel.
Well, I walked a mile today — and then some.
I'm not going to divulge exactly what my procedure was, because that seems inappropriate and unnecessary, but let me just say that the same technique might have worked for a triumphant cave rescue.*
My adventure occurred at a hospital-lite, one of those newfangled outpatient surgery centers that try to combine the efficiencies of car manufacturing with the warmth of a TSA strip search and the peacefulness of a telemarketing call center.
I won't bore you with unpleasant and irrelevant details — unless they're funny and personally humiliating. But through this experience, I was reminded of three things we should always keep front-of-mind in our long-term care settings.
HIPAA was dead in this place, or at least on life support. My fellow patients and I were lined up in beds like jets waiting for takeoff, separated only by curtains, and I could clearly hear every conversation on every side, with nurses, doctors, anesthesiologists, and what might have been a mortician. There was a troubling complacency about privacy, both in room design and behavior. Lesson for LTC: It's difficult and inconvenient to be continually discreet, but we should never stop trying.
Bring on the noise
On a visit to a remote area of New Guinea years ago, I had the opportunity to wander through a teeming village market, where it was frequently suggested to me, by many voices, loudly and in a language I do not speak, that I should pause to purchase a wide range of local products. I mention this because it was quieter there than in the surgery center today. Lesson for LTC: Our facilities are homes, not flea markets. Whenever possible, let's use our inside voices.
We can hear you!
A male healthcare professional of uncertain specialty said loudly to a nurse, “I don't know who's next, but we're taking a break.” Since I was next, and I'd already been waiting two hours, this unscheduled respite was disappointing to hear. Then he walked away shouting, “What? Croatia scored!” Also, it's unnerving to lie in a hospital bed pre-procedure and hear a physician in the next curtained cubicle explain that he'd taken a biopsy, but not to worry, it's probably nothing. Lesson for LTC: Our residents may be sick and/or old, but they're not necessarily deaf. Don't say something out loud that you wouldn't want to personally overhear.
With the post-procedure fog still dissipating, those are my primary takeaways. Initial eyewitness reports suggest that I did nothing particularly embarrassing as I emerged from unconsciousness, beyond asking to “see the castle,” and consuming saltine crackers in the manner of Sesame Street's Cookie Monster. When the first batch was gone, I'm told I begged for more, shouting after the obedient nurse, “All you can carry!” She probably walked away muttering, “Florence Nightingale never had to put up with this.”
Ultimately, the silver lining of any personal healthcare experience for those of us who also work in the profession is to be clearly reminded what our patients and residents feel, and how important it is to respond with all the empathy and compassion we can muster.
Whenever any of us requires medical care and support, whether mercifully briefly or for the rest of our lives, at some level we all experience the same basic fears and frustrations. A sense of powerlessness, loss of privacy and diminished personhood always seem to accompany these unplanned intrusions into life's best-laid plans, even in the best care settings.
Today was an unpleasant but extremely helpful opportunity for me to remember that.
*Which raises the question, should I really be writing a column while still basking in the afterglow of anesthesia? It wasn't specifically forbidden in the take-away instructions, and a MacBook Pro isn't technically a motor-vehicle, so I think I'm technically in compliance. There's a chance, however, that I won't even remember writing this — much like my audience, who won't remember reading it.
Things I Think is written by Gary Tetz, a national Silver Medalist and regional Gold and Silver Medal winner in the Association of Business Press Editors (ASBPE) awards program. He has amused, informed and sometimes befuddled long-term care readers worldwide since his debut with the former SNALF.com at the end of a previous century. He is a multimedia consultant for Consonus Healthcare Services in Portland, OR.