For two harrowing weeks, I experienced the health care system from the other side. My grandmother, visiting from India, had a fall that turned into an emergency room visit that turned into an electrolyte imbalance that turned into an idiopathic neurological problem that turned into a coma that turned into her unexpected death. Less than two weeks after what seemed like a routine fall, she died.
The ten days my grandmother spent in the hospital confused all of us. One night, she got two CT scans and an MRI (she was under-insured and no one gave us a straight answer about billing). She saw a doctor roughly every twelve hours, and we relied mostly on her nurses for information about her health and schedule. We got excited about an occupational therapist who never showed up. A young, probably exhausted resident ordered an extensive procedure without explaining it, her attending canceled it, the specialist ordered it again, and finally, it was not performed. We had to remind her health care teams to change her, move her, give her medications, and even take the necessary labs. My father and I ensured that one of us was always in the room, but we were both moved almost to tears on several occasions by the difficult of receiving not only care but also basic information about her status.
A year ago, I would have cursed the hospital for this treatment. Now, I understand how tired the resident must have been, and I know the feeling of waiting for your attending, worried about asking a stupid question. I know that a hospitalist can see two dozen patients a day. I see how hard nurses work. I vaguely understand the process of making a differential diagnosis, and I know that when a pattern is not easily recognizable, the process can be arduous, didactic, and, yes, expensive.
What if my grandmother were a young woman with children to care for? What if her son were not able to take two weeks off of work to be with her almost full time? What if she did not have physicians in her family who could use back channels to advocate for her care? Even with family friends with privileges at the hospital, her son by her side, and a granddaughter in medical school, my grandmother languished in the hospital for a week before leaving without a diagnosis. It’s not just the “others,” the “healthcare illiterate,” who are scared and confused in hospitals. My father is an educated, highly successful man, and he was flummoxed by the doctors’ schedules and recommendations. I am a medical student, and I felt helpless every moment I was there.
The hospital, where we gossip, laugh, share stories about our weekend trysts, is not a terrifying place “for other people.” It is a terrifying place for anyone who is there because they are sick, or someone they love is sick. The difference between our patients and ourselves is nothing more than circumstance.
I hope that our system evolves so that an unexpected hospital visit does not have the possibility to bankrupt a family. I hope that we are able to incentivize bright, hard working people like the nurses I met to need the growing needs of our health care system. I hope that medical research continues to expand the edges of our knowledge, laid so painfully bare by this case. Most importantly, I hope that my peers and I remember that we are on our side of the hospital bed not because we are special, not because we are intrinsically better or even different than those we care for, but because we are a little bit luckier. I hope we remember to care for our patients and their families as though they are our own, because not so infrequently, they are.