Thursday, May 6, 2010


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!


Lisa G. said...

Jack, I am so sorry to hear about your mother. You are correct, the first 'Hospitalist' misdiagnosed her and she suffered longer than she should have. You should sue him for at least not repeating the CAT scan as they had done before. Again, I'm very sorry about your mom.

JUDGE TRUTH 101 said...

NO doubt profit was the motivating factor in the first hospitalists recomendations. I wonder how many bonus dollars this joker got for discharging patients early.

I hope you Mom is comfortable Jack.

Max's Dad said...

Wow,Jack, I am so sorry and your tale is oh so familiar. My Mom was SENT HOME by one of those guys on a Tuesday AFTER being diagnosed with pneumonia. She was back in Thursday and damn near died. You are so right, these guys are not only interested in the bottom line first and foremost, but they're just plain nasty to patients who dare to speak up.
I will keep your mom and you in my thoughts. Hang in there.

Jack Jodell said...

Lisa G,
Thank you for your kind thoughts. I don't quite know what I'm going to do with that guy. I've filed a complaint with the hospital and have also rated him very poorly on an online rating service. GRRRR!!!
Judgr Truth 101,
I wonder about that bird brain's bonus program too. And thank you for the sensitivity expressed in that last sentence. I really appreciate it.
Max's Dad,
I am sorry your mother received such shoddy treatment too. Callousness like that has no place in medicine, and doesn't belong in the boardroom, either!

TomCat said...

Jack, I'm so sorry to hear about your mother's cancer. I'm also sorry that you are not pushing a malpractice suit against the hospitalist and the hospital for keeping such a craven doctor on staff. A lawsuit might be an incentive for the hospital to fire the bastard.

Jack Jodell said...

Thank you. I am exploring the situation further.

TomCat said...

Glad to hear that, Jack. I hope and pray that this is as least painful for all concerned as possible.

Give her a Mothers Day hug for me, please.

Suzan said...

So sorry to hear this about your Mom, Jack.

My sister also has terminal cancer - lung and breast and is getting radiation and chemo simultaneously in order to try anything to save this young woman.

She was told by her primary physician to go home and get some rest when she had difficulty breathing and scheduled a doctor visit to report it, resulting in her emergency room visit two weeks later when she could hardly breathe at all.

They did a simple CAT scan and found a large tumor around her pulmonary artery in her lung.

And we know that doctor was just going along with the prescribed treatment to avoid doing anything like making that first CAT scan due to insurance regulations to reduce costs.

Poor us (US).

You should be complaining loudly and longly about that joker masquerading as a doctor, asking what bonuses were paid for patients who were convinced to check out early. And then speak with a tough attorney. That'll get their attention pronto!

In many other countries . . . .

Love ya,


Jack Jodell said...

Thank you, Suzan, and I am so terribly sorry to hear about your sister's unfortunate occurrence. Happenstances like these are wholly unnecessary and far too common. This "anything but a timely CAT Scan" mentality by insurance companies and hospitals is infuriating, and proves that our medical system id far more preoccupied with money than with people's lives. I am heartsick over this, but owing to the far progression of my mother's cancer pinning a malpractice suit on this bozo doctor may be a futile attempt. I'm still pondering it all as my mom slips away.

Best of luck to your sister and I hope she will be comfortable. Love ya back, and I'm feelin' for ya, Suzan!

amadmike1 said...

I don't really like a lot of lawyers but in this case I think I would be finding one regardless. Jack, I am sorry to hear about your mom. Mine is 90 years old, and beyond the standard aches and pains of arthritis, seems to be fine, but I worry every day. Hang in there my friend and thanks for the most illuminating post.

mud_rake said...

I've never heard of a 'hospitalist' until this post, Jack. What a crock! It truly is all about the money and those programmed robots on the right are just mindless shills for the hospital corporations.

Thanks for sharing this truly eye-opening experience with us. May your mother and you find peace in these difficult days ahead.

Jack Jodell said...

Thank you for your kind words, and good luck to your mom, too. 90 with a bit of arthritis is quite a milestone! I am still weighing options, but, of course, have more pressing priorities at the moment.For example, once Medicare coverage for her post-hospital care runs out (very soon), her "care" at a nursing home/rehabilitation home will run an outrageous $285 per day! That is another racket which is in need of close investigation and regulation!
You're welcome for the info. As you can tell, I, too, am outraged by this apparent scam. Oh, for the Canadian health care system!

Beach Bum said...

Jack I am so sorry about your mom. It seems everything these day boils down to being what is cost effective. The damn bean counters and lawyers will send us all to Hell far faster than any terrorist or other bogeyman.

Jack Jodell said...

Thank you, Beach Bum, and there is a tremendous amount of truth in that last statement you made.

David Whittle said...

Senior home care facilities are perfect to take care of elders when they actually requires assistance to make sure that they meet their daily tasks and live comfortable life. Nice Post.

Anonymous said...

A "Hospitalist" was a new entity for me as well when I took my brother to the ER because he hadn't been able eat anything and only managed to take a few sips of water for five days. This hospitalist didn't want to admit him because he didn't have insurance and as a result of his pissy attitude and lack of care my brother spent 80 days in the hospital due to complications which arose because the hospitalist never listened to his complaints nor ever examined him. My brother, who was diagnosed with treatable cancer, is now dying because cancer treatment had to be put on hold in order for him to recover from complication after complication caused by a hospitalist. I hate that my current goal in life is to make sure this so-called physician is never allowed to practice medicine again -- that is not the kind of person I want to be. However, if patients and their families don't start standing up to the many mistakes that are continually allowed to happen within the healthcare system too many lives will be lost. I'm sorry for the pain you and your family have suffered. Health care is now more focused on physicians covering up for each others mistakes than focused on the patient.