(I’ve kept this story anonymous, but my friend gave permission for the below account.)
We have a close family friend whose mother was recently hospitalized. Our friend talked with her mom many times by phone every day, but decided to wait a few days to actually fly in. She doesn’t have the money or the vacation time to constantly fly back-and-forth. She took the calculated risk of waiting because she wanted to be present at discharge to help her mom move into a rehabilitation facility, which the doctors believed was the best option.
But her mom took an unexpected and drastic turn for the worse three nights ago. Our friend jumped on a 6am flight Wednesday, but her mom passed away before the plane landed. She never got to say goodbye to her mom, whom she deeply loved.
There is no villain in the above story of human tragedy. It’s the next part that really makes me sick.
Our friend took a cab straight to the hospital. She wanted to find out what she needed to do, and she had arranged to meet another loved-one, delayed but en route. When our friend arrived at the hospital, the staff simply deposited her in her mother’s hospital room. There, on the bed was her mom’s body, sealed in a zippered bag.
That’s right. Hospital staff left our friend in that macabre scene all alone, with no one offering her any consolation or checking on her in any way for more than two hours. She sat there in anguish and regret, calling me and others on her cellphone to secure whatever long-distance emotional support she could find, on possibly the worst day of her life.
I’m sure staff shortages and other challenges played some role in this episode. That explanation is no excuse. People die regularly in hospitals. Loved-ones regularly grieve when this happens. The grittiest and most low-tech facility can respond humanely, can establish sensible procedures to ensure that no one is left to grieve alone when they need human contact. That’s elemental.
We typically rank hospitals based on their technical proficiency. (This public hospital seems average on various national indices.) Failures in the cardiac cath lab are measured and harshly noted. Failures of human proficiency and simple unkindness receive less systematic attention.
We spend more than $3 trillion on health care. Yet we still fail to treat many people decently in their most agonizing and tragic moments. We can do better.
Ambroise Paré, surgeon to François I of France, put the doctor's duty as "Guérir parfois, soulager souvent, consoler toujours". In those days, cures were rare and medical failure the norm. Have modern health professionals grown so used to the normality of cures that they have become ashamed of their defeats?
I have no right to doubt this account, but that simply isn't standard medical practice. A newly deceased patient is usually cleaned up a bit and put in a new hospital gown, then placed on a gurney, the sheet pulled over them, and delivered immediately to the hospital morgue. Hospitals don't want other patients to see it, so it's a very quick trip to the elevator, often timed so that no patients or visitors are in the hallway during those 15 seconds. I've never known a hospital to use body bags nor to leave a dead patient in their room (except for a brief period, if a nearby loved one calls to say "I'd like to see them before you move the body, I'll be there in a half hour", and only then if it's a private room, which is pretty rare these days). We've got a lot of waste and inefficiency in our healthcare system, but this story has a whiff of exaggeration….we are certainly not spending three trillion on this. If it happened as described, it's exceedingly uncommon, and there must be some untold portion omitted. American hospitals simply don't put patients in body bags and leave them in their rooms.
It is weird,I agree. But I was on the phone with her in the moment.
Just imagine if hospital staff were government employees. It doesn't bear thinking about.
It's a very curious feature of the British NHS that it does not provide hospice care. This is done by successful charities, ever since Dame (IMHO Saint) Cicely Saunders set up Hospice Zero at St. Christopher's in London in 1967. I dealt with the hospice in Brighton during my first wife's last fortnight of life. The medical director of the hospice was an NHS consultant in palliative care, which looks like a large concealed subsidy. The key nurse at the private Nuffield hospital where Pat ended up (with good palliative care) was a Macmillan cancer nurse, funded by yet another charity. In my experience, this kludgy system works better than that in France.
Googling around I found this Canadian page on care of the body after death. It looks as if hospitals have some hard thinking to do on their responsibilities here.
You will forgive me if I take exception. I know a great many government employees, and I have myself worked for the government, as well as in the private sector, and in the course of my job I engage with many government employees and many who work in the private sector. And I find this sort of glib stereotyping inaccurate. I see no evidence that private industry employees necessarily are more hard-working or more dedicated, even though government employees usually labor under resource limitations imposed by lawmakers whose focus is elsewhere than efficiency. I know and have known many excellent employees who work incredibly hard doing the best job they can under difficult circumstances.
I stand ready to blame ineptness, inefficiency, disengagement, bad management and laziness wherever I find it, and it's to be found all over the place.
Sorry for the sharp response, but this sort of thing hits a nerve.
"Imagine if hospital staff were government employees." Okay. The reaction would be, "this is typical government incompetence. Get the government's hands off my healthcare!" Imagine instead that it's not a government run hospital. Then the reaction would be, "stuff happens, but government-run would be worse." (The second scenario does not require a whole lot of imagination.)
Although the Veterans Health Administration ran into some difficulties some time back, particularly for wait times at some VA hospitals, studies over the years have shown that the VA provides better care for less cost than most private hospitals. Most veterans groups support the VA, and oppose privatization, for this reason. Privatization is pushed instead by ideological organizations, some affiliated with the Koch brothers, for reasons having more to do with hatred of government than optimal healthcare for veterans.
One point in your favor, Rick Scott, a government official, defrauded Medicare of billions of dollars. Of course, he wasn't a government official at the time, but only became governor of Florida after his company paid a $1.7 billion fine. See? This is an example of government nunc pro tunc incompetence and corruption run amok! Just look at how badly the government ran President Trump's casinos, airlines, steak and wine-mongers, universities and USFL football teams!
"Imagine if hospital staff were government employees." Okay. The reaction would be, "this is typical government incompetence. Get the government's hands off my healthcare!" Imagine instead that it's not a government run hospital. Then the reaction would be, "stuff happens, but government-run would be worse." (The second scenario does not require a whole lot of imagination.)
Although the VHA was in the news a while back because of delays in some facilities, VA hospitals rate better on quality (higher) and cost (lower) than non-government hospitals. As a result of the scandals, there are of course calls to privatize the VA, but veterans groups generally oppose that, as they are satisfied with the care they receive.
Once medicine was a calling…and cure and research for it was sought with risk, sacrifice and dedication. Now much illness is curable, but medicine had become a business in which so-called conservatives deny it to the non-rich because moral hazard. Lucky Jesus and God didn't write off mankind because there wasn't any money to be made on his salvation.
There's an Irish curse: 'I'd give me cool corner in Hell to see thim dastards peck shit with a wooden bill like the rest of poor suffering bastards'
Your comment is well-put. I'd add that this is the inevitable result of subjecting all forms of human endeavour to the unyielding logic of the market. Things that used to be either wholly or partially public goods, end up getting privatized, and then "FYIGM" winner-take-all games take over. And then the "complementary goods" suffer the same fate. I have a friend who's a tenured prof (in a STEM field) at a good school; he periodically regrets his life-choices, b/c his (not-numerous) offspring will never have the opportunities he had (and he was just the child of a family doctor). When professors wish they'd gone to Wall Street instead, b/c they can't imagine providing for their kids' educations, it's a bad, bad sign.
I have no idea how we reverse this, but it's going to destroy us a polity.
The conservatives apply a Procrustean analysis to goods of life, then having stretched it or cut it down, they leave the wreckage behind with a dismissive wave that there couldn't have been anything there worth having, As someone pointed out, we are all disabled many times in life…in youth, in age, in sickness or genetic mishap. The ideal FYIGM world of conservatives and libertarians doesn't exist except in passing moments in our lives; they should be re-programmed with a few months bed-ridden or stuck in wheelchair. Perhaps too, live a hardscrabble year in one of those blasted dying flyover towns.