“You’re OK, buddy. You got here in time.” Just prior to my being transferred from the ER to an inpatient room, those words from a nurse were far more comforting than what I’d heard from a podiatrist about five hours earlier: “Get to the ER. Now.” Foot cellulitis is not to be trifled with.
That was the first Tuesday in May. Ten days later I went home to continue my recuperation, where I experienced some minor complications at home. Overall, I was out five very eye-opening weeks.
Ten days provided me the opportunity to share a room with five other patients who were in one or two days each. I was the youngest of the group. The words “complicated” and “interesting” were applied to my case a few times, but even scarier words were spoken to my roommates. Fortunately, we all got to go home.
I was 19 the last time I was admitted. Some things change over 40 years; some do not. Hospitals have never been mistaken for four-star restaurants, and there’s nothing quite like being awoken in the middle of the night to get vitals. Nurses never cease to be caring, while physicians never cease to be hurried. But seeing that bag with the word “Vancomycin” on it being infused through an infusion pump was both different and comforting. It would be two days before MRSA was ruled out. I would remain on other IV antibiotics throughout my admission. And certainly today’s more aggressive approach to pain management is welcome.
Forty year ago, my chart hung over the end of my bed. Now COWs (computers on wheels) are the norm, both for medication administration and recording vital signs. And at least for a while, when anyone asks me my name, I will reply with my name and birth date. Nothing happened without that mantra being invoked.
I now know for a fact that that you can misplace electronic records just like paper. An MRI of my foot was taken, but when my podiatrist asked to see the report the next day, it couldn’t be found. Long story short: I had more than one patient ID in the system. The file was soon located, resulting in a slight delay in the process.
In preparation for discharge, a physical therapist spent time over two days to teach me how to use crutches. Just prior to my leaving, I mentioned to another therapist that I would have a PICC (peripherally inserted central catheter) to continue IV administration. “You can’t use crutches with a PICC!” I went home with a walker instead.
The upside of using a PICC is you get to go home earlier. The downside is its use can lead to complications. Mine did, but they’ve been addressed. Still, there is nothing quite like being at home with IV lines coming out of your arm and having to follow a procedure for administering syringes of medications every eight hours. I still haven’t found the words to describe how I felt, but warm and fuzzy are not among them.
Reflecting on these last five weeks, I cannot help but observe that with all of the technological changes over the course of my career, delivering healthcare remains an intensely human undertaking. What do I remember most? My interactions with the people I just wrote about. And I am again reminded of Cesar Caceres’ 30-plus-year-old charge to clinical engineering from his landmark book The Practice of Clinical Engineering:
“The issue is really how to increase the desired one-to-one relationship in healthcare delivery. Only that result can maintain or increase the quality of healthcare delivery.”
This in turn reminds me of the decades-old admonition that the secret to the care of the patient lies in caring for the patient. We must continue to strive to inform all of our professional decisions, tactics, and strategies in this light.
Rick Schrenker is a systems engineering manager with the Department of Biomedical Engineering at Massachusetts General Hospital in Boston.