Notes of Concern…
….Jackson Blair
“CHARLES”
Like you, I have read all the horror stories about events that took place in hospitals. For instance, there was the surgeon who left his patient “open” on the table while he ran to the ATM to cash a check.
Then there was the fellow who was to have his right leg amputated only to awake and find his left leg gone.
Also, there were a number of stories of patients post surgery who found through x-rays that surgical instruments and sponges were left inside the wound when the surgeon “closed."
Recently, I had occasion to head to a hospital (not local) for some pre-op testing and preparation. Frankly, I really wasn’t thinking about these horror stories as I pulled into the parking lot.
I went right up to the check-in window, as instructed. “Hello Charles," said the lady. A very lovely young woman began to go over the pre-printed information they had on their form. I told her I used my middle name and would like to be called Jack. She said “Ok Charles."
Things were moving along smashingly until she got to “heritage” on her pre-completed form and read off the form that I was “Irish/Iraqi.”
Irish/Iraqi!
I didn’t even try to figure out where they got that.
Even if they actually have someone employed to just look at a patient and guess, they never would have come up with Irish/Iraqi. I have the fair complexion of my ancestors and I am built like the Scots.
She was nice enough to correct it for me.
While she was writing I was thinking of what it would have been like to have been visited by an Imam or Mullah carrying a bouquet of green clovers in my hospital room and wanting to share prayers on the rug with me five times a day.
She asked if I had a Healthcare Proxy on file. When you are contemplating surgery you are always so relieved to be asked who gets to decide to pull the plug if things don’t go as planned. I responded that I indeed had one but not at that hospital.
“No problem Charles," said the lass. I said, “please call me Jack. My first name is Charles but I use my middle name."
She gave me a form and asked me to fill it out and bring it back to her.
I moved to another desk area and took a chair. I began to fill out this important form. Well, I started to fill it out. The form she gave me was the wrong form. It had absolutely nothing to do with healthcare proxies.
I reported this to her. She giggled and said “sorry about that Charles” and pulled the right form out of another drawer.
I said “please call me Jack."
Then I was off to see the resident in charge of beginning my day. And what a beautiful sight she was. Young, pretty, and friendly. What could go wrong?
She said “nice to meet you Charles.” I said “please call me Jack.”
She was then joined by another younger, less pretty, somewhat friendly “trainee” who evidently was there to see how these input meetings are to be run. We went through the “Charles/Jack” bit again and moved on.
As the lady went over all the questions I had previously been asked out front, she totally ignored me and began speaking to the trainee, complaining that this sort of thing (the asking of questions and writing of answers) was a horrid waste of the time of talented staff.
While I completely agreed, it was a little off-putting to feel so generally that I was clearly a large burden on the important tasks of the day facing these two young things.
As they were chatting, and I was answering questions, they put a band on my wrist. All hospitals do this. No big deal, right?
Except my band had the name of a doctor I had never heard of before. Flashing across my consciousness was the thought that perhaps my own surgeon shoved me off on someone else. Worse, maybe this guy was an obstetrician. So I got up my courage and asked.
“Oh, Charles”, says the lady. I asked her to call me Jack.
Whoops, wrong doctor.
Not to worry.
They will take care of it. I wasn’t encouraged as she did not rip the band off my wrist and replace it. She just continued with the questions.
When she finished, she told me an EKG would be needed and she bid me goodbye.
I reminded her about the bracelet. “Oh! Of course. Charles.” She would take care of that.
I quit the “Jack” stuff. I know a losing streak when I am having one.
In came the EKG lady. Let us just say not young, not pretty, reasonably friendly but more importantly, she seemed to actually know what she was doing.
She did not try to shave my chest. She made no move toward checking for rashes. She didn’t ask me to cough. She never asked me whether I had any relatives living in Baghdad.
She just did her job.
Quickly, efficiently and without fuss.
I knew I had a winner here. So as she left I told her the story about the wristband and asked for a new one. She said she would take care of that. The name “Charles” did not even pass her lips. Of course, neither did the name “Jack.”
I regret to say that in one fell swoop all the confidence I had in her disappeared when she left the room and never returned with any bracelet, correct or incorrect.
Time to meet the anesthesiologist.
What could possibly go wrong here? No one waiting in the chair outside his office-good sign.
Eight of those plastic things they nail to the wall to hold the files of all the people waiting to be seen…and all empty. Wow. No wait.
Dreamer!
He came out, introduced himself and as I got up to enter his office he said that I might as well just stay seated because no one had brought him my file. The assembly line had failed.
I thought if I could find a paper and pencil and pin I could write a name tag with JACK on it. But alas, they don’t keep any sharp objects in the patient area.
Your mind does tend to wander while waiting for an appointment. Some guys get their best ideas while in the shower. Me, my brain goes into overdrive outside doctors’ offices.
He came out again in about five minutes, noticed the plastic file containers were still empty, and went back in his office. On his next venture out he looked really disgusted and went down the hall in search of my file.
I didn’t even have time to ask him if he could get me a new bracelet.
I sympathized with his dilemma. He was to see a guy named Charles with a doctor who was not really Charles’ doctor on the list. And outside he had a guy named Jack who said the name of a different doctor when asked.
Maybe the whole staff was busy trying the figure out the mystery. This could be the stuff they hold seminars about. I could see my name in the medical journals. I could have been Mr. Mustard-in-the-library-with-a-candlestick as far as they know (you have to be a certain age to appreciate this).
So the meeting began. But not the way I thought it would. My wife and I walked in. He said something about the Ides of March. She responded with something from Shakespeare. He threw back another line.
Wait a minute. Wrong name. Wrong hospital. And now I am attending a seminar on Shakespeare!
What the heck. I threw out the only line I know from Shakespeare. I just up and said it:
“Out Out Damned Spot. “
Bad move.
They both looked at me like I had just passed a little gas and my wife said, simply, “wrong play.”
He asked me all the same questions again. You know, somebody could really be of value telling hospitals that asking these things once, copying them, and making the patient sign multiple copies, would save everybody a lot of time. Not to mention all the extra ink being used to cross out “Charles” and write in “Jack” on every form.
I toyed with the idea of introducing myself as “Ezekiel” when next asked but I figured they might have to shut down the hospital due to the turmoil another name change might cause.
When the questions were complete he shared with me everything that could possibly happen to me if my anesthesia didn’t work.
Then there was the bit about sticking a tube down my throat after I was asleep and the fact that it was often hard to do and I might have some tearing or pain there when I awoke.
He also mentioned that I would be choking a lot because it was hard to breath with a tube down your throat but not to worry because I wouldn’t remember the choking.
The basic bottom line was: you won’t feel it when I put it in or when I pull it out but you will know it has been there when the pain killer wears off.
We segued from the throat lacerations to a discussion of bleeding. Why stop there. We went over all the things that could happen to a patient while he is laying naked on a steel table surrounded by guys with very sharp knives.
Well, you get the idea.
I weighed whether to mention the bracelet problem and got brave.
I don’t think anesthesiologists really care who is doing the operation as long as they are giving you the drugs. He didn’t seem too concerned.
He kindly led me to the waiting room and said “goodbye Charles and good luck.” The “good luck” comment rendered me speechless so I didn’t even mention “Jack” or remind him about the bracelet.
The next lady was a lot of fun. She asked me if I had an allergy to latex. While I tried to figure out where this conversation was headed, the wife joined us.
That ended the talk of latex and we moved into a discussion of peanuts. I hadn’t had anything to eat or drink all night so I really wasn’t into the discussion of any food item. Frankly, I was still intrigued about the latex.
We did the “Charles/Jack tango” and then moved into the “who can get the right bracelet” quiz.
She handed me two sponges that I was to wash myself with the night before surgery. We discussed in intimate detail the places those sponges were never to touch. I would have appreciated more talk about latex at that moment.
She gave me a map designed to get me from the building in which we were to the building where I was to go next.
I am not going to use a lot of space to discuss this other than to say to you that if NASA had this map we would have a lot of fellows circling the earth in a never-ending orbit. The guy who mapped this route worked for the Vietcong years ago when they put in their tunnel system in the jungle.
A gang of beagles could not have sniffed out this route. I would have given anything to see a Labrador retriever standing in the hall pointing the way.
One good thing did happen, somebody came running up to me, snipped off my original bracelet and gave me a new one.
Right doctor now.
But I am still Charles to them.
I just surrendered.
It occurs to me being elderly and a little senile might make this kind of experience an adventure.
Having not reached that point in life yet (right!), the thought of this repeating itself on surgery day scares me to death.
What a surprise it would be to wake up and learn what body part they operated on. They have so many choices.
I ventured once again a question I knew would cause trouble: “how often does the surgeon operate on the wrong body part?”
The answer was more terrifying than anything Edgar Alan Poe ever put on paper.
Did you know right before you go into surgery they come in and have a conference with you so that everybody in the room is in agreement as to which body part will be sliced?
And just to confirm it, you put your initials in ink on the body part to be cut, you actually write on your skin and so does the doctor.
Then they put you out and roll you into the operating theater.
Theater?!
Somebody is carrying this Shakespeare stuff way too far.
Can you even guess what it cost the hospital in legal fees to get the recommendation that the doctors and patients sign the patient’s body so nobody makes a mistake!
“Nobody.”
Now there is a great yuk. One guy is awake, dressed in white (maybe an Irish/Iraqi surgeon) holding a scalpel looking for some scrawled signature in ink on the totally unconscious body atop the table in front of him.
And on top of that he is wearing a mask!
Who sees in this scenario any chance for the patient to make the mistake?
And should a mistake be made, the patient cannot identify the culprit because everybody but the guy on the table is wearing a mask.
What am I supposed to do, sit up and say “who was that masked man?” Maybe that is why they use the wrong doctor’s name on the bracelet.
I will just keep foremost in my mind that when I hear someone in the recovery room saying “Charles, can you hear me?” it will be a nurse who is part of the “system.”
If anyone says “Jack can you hear me?” I will know there is something seriously wrong.
The last conversation we had with the person charged with sending us off related to the safety of the hospital.
Basically, I was told to leave all my jewelry, watch and ring at home; do not bring your wallet; no need to bring any medical cards or medicine lists; cell phones, laptops, or anything of value because those things will be stolen while you are out cold.
In review: they don’t know my name, they don’t have me associated with the right heritage, they don’t know which doctor plans to operate, they don’t have my medical bracelet correct, everybody in the operating room will be masked and while I am there it is possible someone is robbing me of any personal belongings I might have left in my hospital room.
I leave this day of “pre-op” with an overwhelming sense of confidence!
As we drove out of the parking lot my wife said “well Jack, what did you think of the experience.”
I replied, “please call me Charles.”
