Sunday, June 15, 2014

Not Anti-Medicine, Just Pro-Human

The hospital where I had my ankle surgery performed is known for its crowded emergency room, long wait times, and overall busyness. It is also known for its competence and success in medicine. I am lucky to have had access to it, and I know from growing up in a rural area where top-of-the-line care was often a long ways away that it isn't that way for everyone.

Still, that busyness brings out some less savory elements of medical care as well including a depersonalization and almost factory-like precision that leaves someone (me) feeling less like a human being and more like a piece of meat being inspected before preparation for dinner.

While (by my rough estimate made while trying to sleep after getting into the ER at 8pm and finally admitted to a room at 5am) there were 11,000 people in the room per hour (expertly timed to only enter when your eyes close), none of them seemed able or willing to give me any information about what was actually happening to me. For instance, someone came in to get my dinner order long after a different someone had told me I was being discharged by noon, and that second someone told me I could have lunch while a different someone told me that the doctors "forgot" to remove the order that I couldn't eat, so I missed it. The noon discharge time came and went. Another someone came and took my insurance information while a different someone brought me my prescriptions, charged to an insurance account that didn't exist, a problem I thought I had cleared up hours before with the first someone. Another someone came and checked my vitals followed by a different someone checking my vitals about 12.3 minutes later before she would give me any pain meds, which happened to be the pain meds I hate the most and begged for an alternative but wasn't given.

It all felt, to be honest, like when I worked at McDonald's in high school. The McDonald's business model consisted of breaking down even the simplest task into tiny, tiny pieces and letting each employee have only a minuscule number of tasks assigned to him/her. They turned us, basically, into machines. I could not, for instance, put the ketchup on the buns because I'd only be "trained" (hahahahaha) to put the meat patties on the buns and might therefore put the wrong amount of ketchup and doom the entire company.

That's what it felt like with all of these medical professionals. Each one had an area in which he or she was competent (I do believe they were each competent in their own tasks, and most of them were kind, which I appreciate immensely), but they weren't able to connect with one another, and so there was an endless assembly line of Rube Goldberg proportions, and I was the product in the middle, tinkered with endlessly and (too often) pointlessly.

I never met the surgeon who actually performed my surgery. He came in the room after I was knocked out and left before I awoke. I have no idea how many plates and screws are in my leg, and I have no idea where or how large the incisions are because I haven't seen them beneath the splint--a splint that will be removed a week later than my discharge papers say because they had no openings at the office. I don't even know if my tattoo is still legible because it almost certainly got sliced. 

It's not that I expect them to stop mid-surgery in what I know is a busy day of saving people's lives, ankles, and health and take pictures of my tattoo, but damn, I am still a person, right?  

In fact, the only time I felt like someone was really paying attention to me was when I was being upsold a nerve block the way they try to sell you gap insurance when you buy a car. Those people looked me in the eye, called me by name, and were generally personable. After listening to them do the same to everyone else in the prep ward around me, I figured out that it was because they were salespeople. (I said yes to the thing but then got wheeled out of the operating room before they did it and upon waking without any pain decided I didn't really need it anyway.)

The thing that aggravates me the most is the pain med situation. 

I can't take Percocet without turning into a ball of crying mush. I hate it. That's all they'd give me in the hospital, even though I had a bottle of Vicodin that I got from filling a prescription from the very same hospital staff while awaiting my surgery at home. So, twice, I had to take Percocet, and twice it made me cry in front of strangers, and twice I felt small and vulnerable and panicked. 

But even small, vulnerable, and panicked, I told everyone who would listen (including people I'm sure had nothing to do with prescribing medication) that I didn't want to go home with a bunch of narcotics. I'd take them as long as the pain was horrendous, but as soon as it fell down to say, merely terrible, I'd really like something non-narctoic please and thank you. I was always polite, but I was always clear: I do not want to be on narcotics. Please give me prescriptions that allow me to get off of them as fast as possible. 

I went home happy that they had listened, armed with two prescriptions, one for Vicodin, and one for a little green pill they assured me was a non-narcotic pain pill. I made it clear that I planned to switch to those alone as soon as I could. 

Then I looked at the bottles. The Vicodin came with two refills good for six months. The other pill came with no refills. Sigh. I began to feel like maybe they weren't really listening to me. 

I stopped taking the Vicodin two days after the surgery and just took the other pill. It didn't seem to be doing much, so I Googled it to figure out if I just needed more Vicodin or what.  

I was livid. 

It's not even for pain. Its primary use is as an anxiety med that is prescribed alongside narcotics to make them work better. In other words, it was only meant as a sidecar to Vicodin, a sidecar I was supposed to drop while I continued popping narcotics for several more months despite my very clear and incessantly repeated wishes that I not be on them. 

I bought some extra strength Tylenol. I manage. 

But I have some trust issues now. 

Much like this skeptical dog. 
Maybe my dislike of narcotics is a little silly. It is based from a two-fold set of concerns. First, I hate the way they make me feel. I don't like fuzzy thoughts, drowsiness, and slow reaction times. I feel out of control and not myself. I don't want to feel like that. Secondly, I have seen several people whose lives were very negatively impacted by an addiction to pain pills that started during a routine injury. I want no part of that.

But whether my fear is justified or not, it's my body. I should have the right to say what goes in it whether it is silly or not. I should not be, as I feel like I was, placated like a child and prescribed things without anyone actually listening to what I was saying. 

I have been lucky enough to have good health and therefore very little experiences with Big Medicine, but the limited experiences I have had have not been good. Fighting for the right to give birth without being medicated into immobility and set up for months of unwanted narcotic use don't make me feel like the medical industry is on my side as a human being. 

I'm so very, very grateful that the technology exists to put my ankle back together. I am so very, very grateful to have access to people who know how to use that technology and to have the insurance to pay for it. 

But I sure wish I could still feel like a person while it happened.
Photo: James Yu, JaconYarboroughPhotography


  1. I know exactly what you mean and it's one reason I got out of (working at) the hospital years ago. Now I do home health, which has it's own disorganization, but at least I feel like I can treat my patients as human beings. Hoping you recover quickly and without any complications!

  2. So many of my nurses were incredibly nice, caring people, so I can only imagine how frustrating it would be!