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NB: this is a diary written by my brother Michael who is not as web savvy yet as he would like to be. My brother is a husband, father, teacher and writer in NYC. He contracted H1N1 as a result of his profession....

The virus infected my ear canal, which caused the nerve in my ear to get inflamed. I couldn't hear at all out of my left ear, but I just figured the thing would clear up once the flu went away. Then I contracted pneumonia. The hearing loss on my left side is permanent.

.... then he took a Gilliam-esque sojourn through the health-care system.

I just got out of prison.  Actually, it was the hospital.  But it’s a lot like prison.  Your movements are limited. You eat whatever they serve you. And you’re often surrounded by screaming people.

The big difference – the medical and nursing personnel are a lot nicer than prison guards; caring, very skilled and professional, in fact.  But they can’t stop the patients from yelling, shouting or threatening themselves or others.

"You hurt my hand," the patient in the next bed said to the nurse trying to change his IV tube. "I’ll shoot you.  I’ll shoot you with a gun!" When he wasn’t threatening nurses, the man moaned loudly.

A lady across the hall shouted at her nurse, "I’ll kill you!" The nurse had tried to get the lady to sit in a chair instead of lying in bed all day.  The lady also yelled at various people in her room at other times, "I don’t like you!" and "Jesus, take me now!"

Another patient had cancer, but he wasn’t being treated for the cancer.  He got medication to relieve his pain. He moaned in his bed, "Aye, aye, aye."  When his very large family visited, they loudly discussed the man’s options – either get chemotherapy or go to a hospice.  At one point in the conversation, the man yelled, "Give me a gun and I’ll blow my brains out right here!"  This didn’t sound very reasonable to anybody.

My own contribution to the noise of our loud room was a cough.  It wasn’t a little cough. It wasn’t a clearing your throat kind of cough. It was a sloppy, wet, ragged cough which built to an intensity of multiple explosions that doubled me over, made me dance like a puppet on a string, or brought me to my knees.  My brain clashed with my skull and lost the point every time. I was left gasping for air, exhausted by the hacking. I could clear a room with this cough.

I had pneumonia. I didn’t want to go to the hospital.  The doctor put me on antibiotics, but I was getting worse at home.

At my house, after work and picking up my three-year old daughter from day care, I would feed her and collapse on the couch while she watched Sesame Street or Dora DVDs.

My daughter had gotten a doctor’s outfit, a white lab coat, from her mother, to wear for Halloween.  It also came with a toy plastic syringe with a plunger and a blue plastic reflex hammer.

As I slept on the couch, a hammer would tap on my eyelid, or a syringe would be plunged into my head.  I opened one eye to see my child, in her doctor’s outfit and Dora haircut, examining me.  "I’m trying to make you better, Daddoo" she said.

"Thanks, honey," I croaked out. Then I would go back to sleep.

After several days, I realized this routine wasn’t working out too well.   So, on my doctor’s advice, I went to the emergency room at the local hospital.

When I got there, I was put on an antibiotic IV drip and hours later transferred upstairs to meet my roommates.

The patient in the next bed, the guy who threatened to shoot the nurse, pulled out his oxygen tube one time.  When a patient care associate (PCA) tried to change a wet dressing of his, he fought with her.  

She said, "Your dressing is wet.  It needs to be changed."  The patient, who I called Bob, because I didn’t know his real name, shouted, "It’s not wet!"

The PCA said, "Please don’t fight me."

"I’m not fighting you.  You’re fighting me!"  Bob yelled.

The dressing was wet.  A nurse told me later that Bob has dementia.  "He doesn’t know what he’s saying."

Bob didn’t seem to have an obvious injury or illness. I asked her why Bob was in the hospital.  She said that if a patient is difficult, the nursing home will send the person to the hospital so they can get a break.  The hospital keeps the guy for awhile, then sends him back to the nursing home.  The nursing home holds Bob for awhile, then rebounds him back to the hospital.

Another patient, whom I called Nelson, chokes a lot on his food.  One of the hospital staff told me that Nelson can’t really swallow anymore.  He needs a feeding tube in his stomach, the staff person said. Nelson is in a nursing home too. They try to feed him and he chokes.  So the nursing home sends him to the hospital.  When Nelson wasn’t choking, he wore an oxygen mask continuously. He moaned continuously too. At 88 years old, he struggled to breathe.  His skin was patchy and white and he looked older than the Constitution. He was in my room for a few days, then discharged back to the nursing home.

Three days into my stay, between coughing fits, receiving antibiotics through an IV and observing my roommates, I was visited in the room around bed time by an administrator for the hospital.  She was very nice, and courteous too, as she placed a bill for $300 on my bed. She patiently explained that my insurance company has a deductible.  So I owed the hospital the money for what the insurance company didn’t cover.  I could pay with a check or credit or debit card.

I was stunned.  The administrator explained that this would be my only bill.  She said the insurance company would cover everything else. I wanted to believe her. There was a part of me that wanted to scramble out of bed, get my debit card from my money clip and pay the bill to the polite lady, to get rid of the debt.  And there was another part of me that had trouble understanding this visit at this time. A little voice inside me said, "You want me to pay the bill with these people shouting and threatening all around me?"

I asked the administrator if I could think about paying the bill another time.  She said OK and that she would come back the next night so I could pay my bill.

I had never seen the relationship of hospital services connected so openly and plainly with money.  I know that $300 isn’t even a lot of money compared to the astronomical care costs for cancer and heart patients that we read about in the newspapers. But something about the presentation of the bill didn’t feel right.

Here I was sitting in my hospital bed, with a nasty case of pneumonia, getting ready to go to sleep for the night and I’m being told I owe the hospital money. And I realized that I was not just a patient. I was a customer. One who hadn’t paid his bill.

I was in the hospital for 10 days.  To supplement the antibiotic hitting my veins, I would talk to the infection in my lung.  My brain shouted at it on a regular basis, "Die, bacteria, die!"

If the other patients threatened to hurt the staff, I could learn from them, but yell at something that was actually hurting me. I wasn’t really shouting out loud of course, but talking inside myself. While I doubted the effectiveness of this tactic, it was good for my morale, and even more important, it didn’t cost me anything.

The administrative lady never came back.  Now that I’m back home with my wife and little doctor, her reflex hammer and plastic syringe at the ready, I’m going to pay the bill.

When I went through all the mail I missed while in the hospital, I got a letter from a company I had never heard of. The letter stated that this company "is a health care management organization that reviews health care services for your employer...After a review of the information submitted, we have determined that the requested services are medically necessary."

I wondered what would have happened if this corporate faceless bureaucrat had determined that my hospitalization was not necessary. Would I have to pay the as yet unstated bills for 10 days in the hospital?  I could not imagine the costs involved. I didn’t want to think about it.

If the insurance company refuses to cover other services I received, and the hospital sends me a letter saying I owe them more money than the $300 deductible, I’m going back to the hospital – psychiatric this time.

* * * * * * *

Michael G. lives, works and goes to the hospital in Queens, New York

Originally posted to taodog on Fri Dec 11, 2009 at 08:14 AM PST.

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Comment Preferences

    •  "Deductibles reduce overutilization of services" (9+ / 0-)

      is the mantra that "health care economists" employed directly or indirectly by insurance companies repeat ad nauseam. With health care "reform" and mandates we will see more and more high deductible policies.

      High deductible policies are an invitation to bankruptcy for patients, doctors and hospitals. Many of those nursing home patients are getting cared for at a loss to the hospital. Many patients never pay their deductibles.

      And guess who ends up paying for all of this? Not the insurance companies who take their profits off the top. The middle class patients, the doctors and the hospitals who serve low income people pay for this.

      Wonderful diary showing how the system works.

      look for my DK Greenroots diary series Wednesday evening. "It's the planet, stupid."

      by FishOutofWater on Fri Dec 11, 2009 at 08:29:05 AM PST

      [ Parent ]

  •  People who claim we have the best healthcare (7+ / 0-)

    obviously never had to use it.  I too had a room mate who moaned all night.  She had back surgery and needed something for the pain.   They told her they had given her all the medication they were legally allowed to give her.  So she (and I) suffered in pain.  Then they moved her or released her.  I was supposed to be in the hospital for four days but I begged my doctor to release me earlier.  He released me after three days.  I did not get a good nights sleep for three days.  Nurses would wake me up to take my temperture all hours of the day and night.  I was polite to the nurses and my doctor was really great.  That was almost ten yrs ago.  When I had to have surgery again, I insisted on having a private room.  Again it was noisey and I did not get a good nights sleep the whole time.  This must be normal that being in the hospital does not equate to getting rest.

    •  Erm, bull. (to them, not you) (0+ / 0-)

      There is no 'legal limit' to pain meds.  What there are, are situations in which prescribers worry too much about overdosing the patient and being sued.

      But I have to agree, I've never been able to rest well in hospitals either.  The beds are wonders for lifting and moving and changing shape and weighing you, and all sorts of things...apart from sleeping.  Even barring noise or lack thereof, or vital signs checks when you'd rather be asleep.

      Those who labour in the earth are the chosen people of God. - Thomas Jefferson

      by Ezekial 23 20 on Fri Dec 11, 2009 at 09:44:21 AM PST

      [ Parent ]

  •   Are you better now? (3+ / 0-)
    Recommended by:
    irishwitch, AnnCetera, whaddaya

    Ten days is a long time for the antibiotics not to work. Did they prove your pneumonia was bacterial and not viral? It can be amixed.

    Many years ago I had a CMV (cytomegalovirus) pneumonia and was bedridden for six months. I was not right for a year. I coughed my lungs out.  Antibiotics do nothing for viral illnesses. They go only away in their sweet time.  

    Public option or corporate option...pick one.

    by Jane Lew on Fri Dec 11, 2009 at 08:47:26 AM PST

    •  "mixed" n/t (1+ / 0-)
      Recommended by:
      irishwitch

      Public option or corporate option...pick one.

      by Jane Lew on Fri Dec 11, 2009 at 10:49:06 AM PST

      [ Parent ]

    •  rest and recovery -- reply to your post (0+ / 0-)

      Hi. Thank you for your comments. I had bacterial
      pneumonia.  The initial anti-biotics were unable
      to do much.  Maybe they weren't strong enough. But the second battery of anti-bios they gave me were
      effective and I have recovered, fully.

      I know about the coughing your lungs out thing.  You had it for a much longer time than I did.  And all I can say is, I'm sorry you had to go through that.

      Best Regards,

      Mike Gold

  •  I hope you are feeling better (2+ / 0-)
    Recommended by:
    irishwitch, whaddaya

    I have spent some time in the hospital and I have to say I have been very lucky.  I do not think that the hospital in my area has open wards so I have always had a private or semi private room.  Even when I was a charity case.  The time I had to share with more than one person is in the psych unit.  Now that is a place where you need your own room.  I woke up in the middle of the night to find a woman staring at me while I slept.  She then, along with another woman, tried to kill herself.  Too much stress in the psych unit my friend do not go there.

    That passed by; this can, too. - Deor

    by stevie avebury on Fri Dec 11, 2009 at 08:57:25 AM PST

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