Thursday, May 6, 2010
BROKEN HEALTH CARE HITS HOME!
Our broken health "care" system has hit home. I am sad to say that my elderly mother, who will turn 86 in less than 3 weeks, has been diagnosed with terminal cancer. We are all saddened by this news and I, in particular, am extremely disappointed in, and angry about, the way her case was initially handled.
No, I am not accusing anyone of malpractice or trying to build a malpractice suit. And no, she has not been booted off her insurance policy or had Medicare slam the door on her - at least not yet. But I clearly believe she has been victimized by the dybamics of economics in our current, very broken system, which is definitely placing cost-saving measures well in front of patient needs and comforts.
My mother had a full hysterectomy done at the time she was diagnosed with uterine cancer back in 1988. Because the cancer had broken through the wall of her uterus, her surgeon wisely decided to follow up with radiation therapy and a brief cesium implant to kill any stray cancer cells which may have escaped the immediate area. His decision kept her alive and cancer-free for more than 20 more years. But he also warned that this radiation treatment would result in radiation proctitis, which is a kind of burning damage to nearby tissues which results in scar tissue. He further mentioned that this form of proctitis also results in colon cancer.
Long story short, this may or may not have brought on her current cancer, which is called adenocarcinoma. Rather than appearing or originating in her colon (large intestine), it appears that this cancer originated in either her stomach or in the glandular bile ducts in her pancreas. From its origin, it has migrated throughout her abdomen and resulted in a partial blockage of her small intestine, the aftereffects of which led us to hospitalize her.
For more than six months, my mother had been suffering from irregular bowel function: nauseous, sometimes constipated, sometimes having diarrhea. Her appetite fell off markedly in the new year, and she was vomiting with steady diarrhea in mid-February. We were concerned she was becoming dehydrated, and she was incredibly weak, so we brought her to the hospital on February 17. They put her on an IV and a liquid-only diet, and she was given a CAT Scan. The determination of ulcerative colitis was made (inflammation of the colon) and she was discharged to a rehab center (nursing home) a few days later, after she was able to hold down solid food again. She was advised to rest and eat several small meals each day rather than 2 or 3 large ones. She was sent home after a week or so there, and seemed to be doing better for a time. Her stomach and bowels seemed to be functioning better. But by the end of March, she was again feeling queasy and weak, and her appetite dwindled. By mid-April, she was again vomiting, with regular diarrhea, so we brought her back to the hospital. Here they again put her on a liquid diet and took an inconclusive x-ray of her abdomen, which was now becoming distended and hard to the touch. It was obvious something was radically wrong. And it was here that I became aware of a relatively new entity in health care: the "Hospitalist."
In the good old days of not-that-long ago, your own family physician, the doctor who knew you and your personal case best, would spend part of his or her day prowling the halls of nearby hospitals to check in on his or her patients who may have been admitted there. He or she would consult with staff doctors and other on-site medical personnel and prescribe a treatment and medicine regimen. Nowadays, though, in many hospitals, your personal physician no longer pays a visit and has been replaced instead by a "Hospitalist."
A Hospitalist is a doctor of internal medicine who has been hired by and works for the hospital directly, ostensibly to relieve the burden of and free up time for your primary care physician (family doctor). But, given the experience my mother had with her Hospitalist, I would suggest that his main task was to be a company man and boot patients out of the hospital as quickly as possible. This, of course, makes both insurance companies AND hospitals happier, as it reduces both of their costs and indirectly creates more profitability for them.
From the second day after her readmittance, until we finally requested he no longer be her Hospitalist, this son of a bitch was obviously repeatedly trying to get my mother discharged! Here was a frail, elderly woman who could not keep food or liquid down, had chronic diarrhea, who had just been in the very same hospital for the very same symptoms two months prior, and this cold, uncaring moron was telling her she couldn't stay there indefinitely, and that she had better soon choose a rehab center to go to! When she told him she didn't feel she was well enough to go elsewhere yet, and that she thought doing so would inevitably bring her right back to the Emergency Room for a third admittance, he cooly told her, "You know, I think you're just getting attached to this place." He still pressured her to agree to a discharge, even though she was still weak and unable to keep down solid food. UNBELIEVABLE!!!
We filed an immediate appeal with Medicare against this decision to discharge and she was granted an automatic 48 hour reprieve pending review. That night she again vomited and the next day a different Hospitalist ordered a CAT Scan. It revealed what appeared to be a partial obstruction in her small intestine. A surgeon was called in and he examined her and then decided that exploratory surgery would be the advisable option. Upon opening her up, he discovered the scattered nodules of adenocarcinoma and a larger tumor which was responsible for her blockage and its resultant nausea, vomitingm and diarrhea. He proceede to clamp off the diseased portion of bowel and created a bypass so her undigested food could again flow for whatever time she has left. Then he sewed her up and gave us the bad news.
I remain furious with that first Hospitalist, whose priorities were obviously in herding patients along like anonymously numbered calves from one pen to another, just because it seemed the most cost-efficient thing to do. In the process, I believe he made an incomplete and inaccurate diagnosis of my mother's condition. He represents our broken health care system personnified. He was effectively acting as a one-man "death panel" and proves how far off base Sarah Palin's lying misrepresentation of government-run health care was. He was acting on behalf of a private system, overly concerned with money and profit and under-concerned with patients' needs. This complete and utter nonsense must change!