Part III
A Nation of Sheep
It has been a while since I wrote my last thoughts on this subject. However, I never forgot that I must fulfill what I consider to be my duty to people and the medical community. The delay is due to a lack of the required time: I have been primarily engaged in taking care of my wife, who is suffering from multiple medical problems.
An even superficial glance at the medical care provided today for our nation shows a very rapid degradation. And unfortunately, no one accepts the responsibility for this decline and no one cares or speaks about such despicable circumstances. So naturally, no one will attempt to improve it.
I have heard people expressing the opinion that in our country, pigs on a farm, horses in a stable, and dogs and cats in a house get better medical care than most citizens. Maybe this statement is stronger than the fact, but probably not by much.
The greed of businessmen in charge of healthcare, the lack of enthusiasm of the medical professionals in performing their duties, and the incompetency of our medical organizations at the city, state, and national levels, in conjunction with our national apathy, is taking its toll on the quality of healthcare provided by our system. Unfortunately, we as a nation fit well to be within the scope and parameters of “a nation of sheep.”
The patients’ physicians who are the best qualified to plan and pursue a proper medical plan for their patients have lost, in most cases, their hospital admitting privileges for treatment of an illness or a state of observation.
I discussed this specific problem with a cardio-electro-physiologist and asked him why doesn’t he HOSPITALIZE a patient with multiple episodes of atrial fibrillation for evaluation and to institute appropriate management. He responded, “Literally, nowadays, the privilege to admit our patients has been taken away from us and given to the emergency room physicians. We are not allowed to see or treat our patients unless asked by the hospital-assigned physicians, the HOSPITALISTS. In all cases, the hospitalists will be in charge of the patients.”
I followed a few of these cases in the Portland area hospitals. During one of these hospitalizations, the patient had three different hospitalists, two of whom were, frankly, quite incompetent.
The governing laws of our country make it legal for hospital officials to violate patients’ most important right: the right to select their own physicians. We, as patients, are considered incompetent in choosing our physicians. Instead, such privilege became a tool in the hands of hospital administrations. They became the recipients of the right to act as our legal guardians and appoint a physician for us, the same way that the courts of law may select a court-appointed lawyer for an accused or a claimant.
We cannot easily measure the outcome of the disaster created by these individuals; however, in studying the situation, I have come to believe that in most instances, the danger created by this group of appointed physicians outweighs any benefits they may be able to offer. To illustrate the scope of the problem, I shall recount a few cases in that I was a witness:
Case 1- An elderly lady suffering from high blood pressure, periodic irregular heart rhythm, and diverticulosis of the large bowel with bouts of the inflammatory process (diverticulitis) suffers from a sudden onset of rectal bleeding. The family called 911; the emergency crew, contrary to the patient and her family’s request to take her to a hospital closer to home, transported her to an OHSU branch hospital in the Portland suburb.
She was severely anemic, requiring a blood transfusion. CT scan of the abdomen showed the source of the bleeding to be an inflamed diverticulum. The ER physician felt she should be seen by a specialist and possibly undergo an invasive radiological procedure to stop the bleeding. Unfortunately, the hospital was ill-equipped to undertake such a task. The main OHSU hospital refused to admit the patient for lack of bed! In decades of my practice, I had never encountered nor remember an occasion when a medical facility abstained from giving lifesaving care to a patient. One can use their imagination to type of physicians graduating from such institutions.
Several hours later, the patient gets transferred to St. Vincent Hospital, where a bed becomes available. She undergoes another CT scanning in the presence of an interventional radiologist, ready to take care of the bleeding site. But, to his surprise, due to the delay she saw no bleeding, and the effort was futile, leaving the patient with danger of repeated hemorrhages.
The patient gets admitted to the floor under the care of a hospitalist. The doctor does not accept the responsibility to check the new patient and therefore, does not leave any order for her medications. Around 3:00 AM, the patient woke up with severe headaches, and her blood pressure was over 190 mm systolic. They promptly notified the physician and received the order, “Give her two Tylenol.” He ignored the extremely high blood pressure and again did not bother to visit the patient. The headaches got worse. In that chaos, the nurses did what they could, and the family took it upon themselves to give her antihypertensive medication that patient had in her purse. How many patients benefit from their family’s knowledge to compensate for a hospital-appointed physician’s ignorance and criminal action?
Case 2- A cardiac patient with a pacemaker, suffers from periodic episodes of irregular heartbeat, atrial fibrillation. She started having bouts of a new form of arrhythmia, appearing similar to ventricular tachycardia. The cardiologist feels the findings were compatible with a pacemaker-mediated action. He suggested resetting the pacemaker. A few days later, the situation worsened, and the arrhythmia episode intensified, requiring immediate attention. The family called 911 and transported the patient to St. Vincent Hospital emergency service.
A consultation between the ER physician and the cardiologist on call for her physician ends up with the same conclusion given to the patient earlier. She gets admitted for observation and evaluation.
The family tries to manage her the best they can. In the morning, a lady accompanied by a gentleman enters the patient’s room. She introduced herself as the medical resident in charge of the case. The resident, acted as the leading responsible individual of the case and completely ignored the EKG findings by the Apple Watch EKG System, as well as what the ER admission cardiac monitoring device showed. She insisted that the function of the Apple Watch is worthless and emphasized that patients can be discharged and followed as outpatients.
The patient’s condition deteriorated rapidly. On the family’s insistence, her personal physician’s office arranged for the patient to see another available cardiologist on the same day. The doctor spent over an hour and a half evaluating her condition and adjusting the pacemaker; something that should have been done in the hospital.
Case 3- An elderly patient with bilateral glaucoma, unresponsive to the standard treatment, was scheduled for a corrective surgical procedure. Because of her multiple medical problems, the ophthalmologist consulted with her treating physician to admit the patient post-surgery for observation.
On the assigned day, the surgery started two hours behind the schedule time because of the unavailability of an operating theater. Amid all these occurring, the patient’s blood pressure rose to an alarming level, 215/125. Family members requested that she receive antihypertensive treatment immediately. However, their request fell on deaf ears. Instead, the nurse notifies the anesthesiologist. After looking at the patient’s chart, the latter said to the family, “I have never seen a diastolic pressure so high.” Then, he addressed the patient with this comment, “You may develop a stroke at any time,” and walked away!
An ominous silence covered the room. Everyone was astonished by the doctor’s comment and his inhumane character. Why didn’t he re-check the blood pressure? Why did he not prescribe an acceptable form of treatment? What had transpired at that moment and in that room was mindboggling.
Can anyone possibly imagine what went through the patient and her family’s minds? Are these happening in the United States, or are we live in the middle of the African Sahara? The nurse refused to administer the medication already available and in the patient’s purse. It was against the hospital policy! It took over an hour for the pharmacy to send the same medicine. That was an emergency occasion. The only reason that came to mind was, “patient was to get all the risk for the hospital to be able to charge $15.00 for the 15 cents pill?
The surgery was successful, and the eye pressure fell within the mid-normal range. The patient was admitted to the surgical unit on the hospital’s seventh floor. However, the dressing over both eyes must remain untouched until she visits the ophthalmologist the following morning.
During the night, she wakes up with severe headaches and asks the nurse to check her blood pressure. The BP was 190 over 100. Again, there was no order for any medications, even with all information available in her chart. The nurse refused to administer the patient’s own available drug, “it was non-compliant with Hospital Rules.”
She begs the nurse to call her husband since she can’t see with her eyes patched. Her husband becomes furious and threatens legal action against the hospital if the patient does not receive the appropriate treatment immediately. The nurse in charge realized that the patient had no assigned physician and was not evaluated by any doctors, while transferred to the floor. The whole hospital system failed, and no one could explain why!
Family members decided to sign her out of the hospital early in the morning. They felt that keeping her in such an environment would be more dangerous than having her at home. At that time, the hospitalist showed up with a list of non-excusable excuses for the lack of care that she should have received but did not get.
These events are not only the problems facing any specific part of the country. By talking to our colleagues, around the nation, I found out that the situation is the same wherever you go.
HOW CAN ONE EXPLAIN THESE INCIDENTS? WE ARE PAYING MORE THAN ANY OTHER NATION FOR OUR HEALTHCARE AND RECEIVING FAR INFERIOR SERVICES. WHY?
THE REASONS ARE CLEAR TO EVERYONE EXCEPT TO US. WE ARE AN APATHETIC NATION THAT COLLECTIVELY MAKES WHAT IS KNOWN AS “A NATION OF SHEEP.” UNABLE AND UNWILLING TO STAND UP FOR OUR VERY BASIC RIGHTS AND ALLOW A GROUP OF SELF-INTERESTED INDIVIDUALS TO TAKE OVER OUR LIFE.
Life expectancy in the US is lower than that of comparable countries, and unlike the others, is not recovering from the hit due to COVID (from HealthSystemTracker). You may wish to visit my previous articles on this subject and in my blog.
EVEN THE PEOPLE OF THE THIRD WORLD COUNTRIES WILL NOT TOLERATE SUCH DISGRACE.
More on this subject later.
Guils of Guilan 