Citizen of the Month

the writing and photography of Neil Kramer

Tag: Cedars-Sinai

The Two Towers

March 15, 2010 / / 27 Comments

On Thursday, I was sleeping at my friend’s house (that is another story, one in which I will avoid discussing at the moment), when I received the Bat signal.

Literally.

I programmed Sophia’s ringtone as the 1960’s Batman song, because lately her calls mean someone is in trouble.

“Vartan is back in the hospital,” she said.

I wouldn’t say that I was surprised.  Even though we hired an aide, caring for my father-in-law has been difficult, especially as his decline continues.   My mother-in-law, looking ragged from the stress, still refused to place her beloved husband into a nursing home, despite the advice of doctors.

By Saturday, my mother in law was so exhausted, she was unable to visit her husband in the hospital.  I volunteered to watch over my father-in-law during the day.

It was freezing in the room.  They keep these rooms cool to prevent infection.  I wrapped an extra blanket around my shoulders.  My father-in-law was completely out of it, drugged up many times over.

I sat there, bored with listening to the whoosh of oxygen in tubes.   I went on Twitter, chatting with whoever showed up at the time.

That’s when I received the bat signal.   I answered the phone.   It was Sophia.   An ambulance was whisking her mother to the hospital.   She was having trouble breathing.

Husband and wife, both at the same hospital.   This is not that uncommon; I later learned this from one of the nurses.  For the next two hours on Saturday, I ran back and forth between the emergency room and my father-in-law’s room.

I think my mother-in-law will be OK after a few days in the hospital.   In fact, the first thing she said to Sophia when she arrived was to point at me and say something in Russian.   I assumed that she was touting me as a wonderful caretaker.

“What did she say?” I asked Sophia.

“She says you need to comb your hair.  You look like a homeless person!”

That night, I went to sleep at 7PM.

Today is Monday.  I’m currently in the Cedars Sinai Hospital cafeteria eating lunch.  My father in law is on the fifth floor of the North Tower.   My mother-in-law is on the fifth floor of the South Tower.   My father-in-law does not know his wife is so close.    It is probably better that way.

Where’s ICU?

April 4, 2007 / / 29 Comments

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Thank you for your emails and comments about Fanya, Sophia’s mother.  She is doing better, and was released from the hospital tonight.  

Fanya’s room was located in the Saperstein Critical Care Tower, which was opened last year after entrepreneur and philanthropist David Saperstein and his wife Suzanne made the largest donation to Cedars-Sinai in the Medical Center’s history.

“The Sapersteins have accepted a crucial role in the reinvention of our campus by providing us with the means to build a state-of-the-art critical care tower,” said [hospital President and CEO Thomas M. Priselac when he received the donation]. “The Suzanne and David Saperstein Critical Care Tower will combine the latest monitoring technology with staffing to provide the most fragile patients with the most sophisticated care available.”

The Saperstein Critical Care Tower is clearly important for Los Angeles.

Annual hospital admissions countywide are up 20 percent in the past 10 years and seven hospitals have closed since 2003, according to a new report funded by The California Endowment.  West L.A. hospitals have been hard pressed to keep pace with demand, particularly institutions like Cedars that draw patients from a wider area. Population growth, on top of an aging demographic more likely to become seriously ill, have only exacerbated the situation, said  Dr. Paul Silka, [medical chief of staff], noting that Cedars often has long waiting lists to schedule elective surgery.

While Cedars-Sinai Medical Center clearly has top-notch doctors and medical equipment, I was not impressed with the human aspect of the patient care.   For example, why did no one come out to tell us how the surgery went?  Why did no one tell us that Fanya was taken back to ICU half an hour earlier?  Why were nurses laughing loudly with each other all night, waking up the patients in INTENSIVE CARE?   Or why was Fanya not fed for fourteen hours?  Even though the doctor gave the order to give her food, the nurse forgot to inform the nutrition department.  It took Sophia three and a half hours of fighting with everyone to get Fanya some food after her angioplasty.  Is this the bad effect of “Grey’s Anatomy,” where the personal lives of the staff are more important than those of the sick people?  Like in many other big-city hospitals, the basic concerns of the patient and his family seem to be of secondary consideration.   

Nothing symbolizes this better than the Saperstein Critical Care Tower itself.  As you can see from the above photo, the $110 million dollar facility may be “state-of-the-art,” but someone forgot to put up a sign telling patients and their families which building it is and WHERE THE ENTRANCE IS LOCATED.

What’s Up, Cedars-Sinai?

April 4, 2007 / / 33 Comments

It’s been hectic.   My mother came to town.  We prepared for the first seder. I fought a cold.  My mother cooked a wonderful brisket, matzoh ball soup, kugel, etc.  We went over to the home of Fanya and Vartan, Sophia’s mother and step-father.   After the meal, Fanya had pains in her heart.   It was hurting her so much, that we called 911.   An ambulance came and she he was brought to the Cedars-Sinai Medical Center’s emergency room.  We sat in the waiting room for hours.  Tomorrow, Fanya is going to get an angioplasty on her heart and liver.   Wish her good luck!

Now for some bitching about the hospital:

Cedars-Sinai is a world-famous hospital.  Its proximity to Beverly Hills has made it famous as the “hospital for the stars.”  This is where Hollywood celebrities have their babies.   Frank Sinatra died at Cedars-Sinai.  Movie producers have their names on hospital wings.  So, why do Sophia’s parents always get poor service at Cedars-Sinai Hospital?  

Because of the language barrier.   

They are an older couple who can only speak Russian.  Now, I’m all for immigrants learning English, but after a certain age, it is just too difficult a task.  Sophia often works in court as an interpreter, where every defendant who needs it is guaranteed BY LAW to have a language interpreter, and from what I understand, it is the same with every hospital patient.   Cedars-Sinai says that they have interpreters on staff.  So, why are so rarely used?

I was sitting in Fanya’s ICU hospital room this morning.  Sophia left to get some paperwork for her mom.  I noticed that the reading on the EKG monitor was at zero.  I told this to the nurse, a grouchy woman who looked like she came from another country herself. 

“Don’t move your right arm!” she told Fanya.  “It makes the monitor shut off.”

“She doesn’t understand what you are saying,” I said.  “She doesn’t speak English.”

“NO ARM UP!” the nurse yelled at Fanya, lying there with tubes stuck inside her arms, as if that was going to solve the problem.

“Don’t you have a Russian interpreter on call or on the phone?” I asked.

“She’s not here now.  Don’t you know Russian?”

“No, and I don’t think it is my job to be translating for the hospital.  When will there be a interpreter?”

“Let me go see.”

She left and I never saw her again.

The entire day has been one mistake after another.   Fanya is a slight woman.  She had lost 25 pounds in the last 6 months.  She was put on a restricted calorie diet!  The staff didn’t bring Fanya any food until 3:30 PM because they “thought” there was an order not to give her food.  Then she never got dinner.  After Sophia spoke to 5 people, they eventually brought her, a diabetic, four juices and Melba toast with cheese, at 10 PM. They gave her pills for diabetes with orange juice!   This is just poor medicine, but had Fanya been able to communicate – she would have been able to point their mistakes out, before they made her drink sugary juice with a pill to lower her blood sugar!  It is scary enough to be in a hospital.  It must be terrifying for a patient to be there and not understand the language of the staff, and Sophia can’t be there 24 hours a day.    Sophia told the nurses they can call her anytime to help with the Russian, but no one ever called.  God help the person who has to go into the hospital without having a family or friends to speak up for her!

When Fanya first came to the hospital, a male nurse was trying to figure out what was wrong with another Russian patient, a disheveled elderly man who was sobbing.   The nurse was poking the man in different places on his shoulder trying to figure out what pained him.

“Baleet?  Baleet?” the male nurse asked, using the only Russian word he knew, meaning “pain.”

Eventually, Sophia asked if she could help.   She spoke to the guy in Russian and learned that he wasn’t in physical pain, but emotional pain.  His grandson had just died, so he drank himself into a stupor, and his family didn’t know what to do with him, so they drove him at the hospital.  With three Russian families in the emergency room, wouldn’t it make sense to have an interpreter readily available?

Cedars-Sinai built a a major new building last year.  It cost millions of dollars.  The medical center has the best equipment, which must cost a fortune.   But would it really cost that much more to have a few more interpreters?   The hospital doesn’t need to have an interpreter for every language on duty 24/7, but Cedars-Sinai is smack in the middle of the major Russian and Persian communities of West Hollywood and Beverly Hills.  Many of these are elderly people who don’t speak the English, and they end up getting less than mediocre medical care in a supposedly top-notch hospital.  There are Spanish interpreters in most city hospitals.  There are Korean-speaking interpreters in mid-city hospitals.   Why is Cedars-Sinai so stingy with their interpreters?  Have a donor put his name on the interpreters’ uniforms if it would help get more money!

I know Cedars-Sinai would rather be known as the “hospital of the stars” and promote all the A-list actors who go there after drug rehab.    I understand that UCLA Medical Center is stealing some of the “celebrity cache” from Cedars since it is located in the less immigrant friendly, more upscale Westside (oh no, Britney had her baby there!).  The truth is Cedars-Sinai is now more of a “city hospital,” which means catering to the immigrant community.  Sure, it must be an annoyance for the busy, overworked staff to deal with foreign-speaking patients (unless, of course, the patient is a member of some Royal family),  but shouldn’t effective communication be an essential part of medical care?

Update:  Fanya is doing better.  More complaining about Cedars.

Citizen of the Month Wants a Cure

October 25, 2005 / / 71 Comments

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Sophia:  "Neilochka, you certainly love writing about my breasts on your blog, don’t you?"

Neil:  "Of course.  They’re the most exciting things I’ve had to play with since my Etch-A-Sketch."

Note to God:  Are you crazy?  Why did you create the most beautiful things in the world, a brilliant piece of female anatomy that comes in so many tasty shapes and sizes — and then come up with this breast cancer shit?

Sophia:  "You know, it’s National Breast Cancer Awareness Month.  Why don’t you say something about breast cancer?"

Neil:  "Like what?"

Sophia:  "You can talk about me." 

Neil:  "I can?" 

Sophia:  "It’s been a year."

It’s been a year.

It’s been a year since they found cancer in Sophia’s left breast.

Last year was pretty shitty.  This is why I was so glad that the Jewish New Year finally came a couple of weeks ago.  Maybe this year will be better.  The year had ended with my father passing away.  It began with Sophia learning she had breast cancer.

There was no history of cancer in Sophia’s family, so it came as a total shock.  It was a time of stress, fear and uncertainty.  National Breast Cancer Awareness Month is a great idea —  except when your life was just turned upside down and you suddenly became a "patient" dealing with breast cancer.  Everywhere you go, you are reminded of the disease.  At the supermarket, there are banners hanging.  You try to escape to the mall, and everyone is selling pink bunnies, slippers, bracelets.  Neither of us knew much about cancer, but we sat down for a quick education.  We read every medical site and every book possible.  We got the best doctors at Cedars-Sinai.  Sophia had a lumpectomy and through her own research, found out about a radical experimental radiation treatment.

Sophia was so brave throughout.

It was a new experience for me, as well.  I was supposed to be the caregiver, the "rock,"  but I was probably more of a "big stone."  Although I was always at Sophia’s side, I had this slight little problem of always being more nervous than Sophia herself.  I wish I could have been more like Sophia was when my father was in the hospital.  She can be a "rock."  I never had the strength to demand the best of everyone in the hospital, the way Sophia did for my father.

In fact, I found the experience so stressful, that two days before Sophia was to have her surgery, I got so tense that I ended up at Cedars-Sinai’s Emergency Room myself!  I don’t think the ER nurses ever really understood why my wife was calling me on the phone cursing at me for being in the hospital.

Many of you have emailed me through the last couple of months, asking why Sophia and I are separated.  The most common comment is "You write about her with so much love and admiration." 

There’s no one I love or admire more than Sophia.  Today, despite everything she went through, she is more beautiful than ever.  But, she is still on medication and dealing with continuous treatment and the side effects.  Sometimes, she gets down on herself or fears for her future health.  But she’s a brave and strong woman.  And boy, is she funny too.  I think a good sense of humor is really important in keeping yourself healthy.  On Saturday night, we actually worked together on that recent post on my blog — the one about the flowers and the "sticker."  When we finished it, we must have laughed for a half hour. There’s nothing more exciting to me than seeing Sophia laugh and smile.

Sophia’s sense of humor helped her maintain a great relationship with her doctors.  She was especially friendly with her great surgeon, Scott Karlan and his caring staff.  After her surgery, Sophia thanked him by ordering him a marzipan cake shaped as two huge breasts, with one a little bit lopsided, like hers was after the surgery.

I hope Sophia knows how much she means to me — whatever she is right now — my wife, my separated wife, my friend, my blog editor-in-chief, my dance partner, or the straight man in most of my blog posts.

I think I learned to be a better "rock" during times of hardship, even if I didn’t always say the right thing.  I still try to "fix things" when I should just listen.  Once a week Sophia goes to a group at the Wellness Community, a great place, where people with cancer, their friends and loved ones can talk about different issues.  One of the biggest complaints heard very often is that people just don’t know how to talk to someone with cancer, either out of insecurity, fear or stupidity.

In honor of National Breast Cancer Awareness Month, Sophia’s group did something special for "Citizen of the Month" :they made a list of stupid things people have said to them.  Let’s hope that reading some of these will help us avoid making the same mistakes.

15 things you should never say to someone with breast cancer:

But you’re so young!

How long do you have?

And you have such beautiful breasts!

Oh no, what are your kids going to do?

You shouldn’t be depressed because if you get down, you’ll waste what little time you have left.

God only gives you what you can handle. 

But you look so good!

Two people just died in our office from cancer — these things always come in threes.

Oh, no.  That’s so weird.  I just saw Melissa Etheridge in concert last week.

I’m wracking my brain.  What could have you done to cause it?

Do you use paper or plastic? — because I read plastic can cause it.

At least with a double mastectomy, you’ll be even.

Don’t say the word.  Just say "C."

Now you’ll see if he really loves you for you.

I know how you feel.

Here’s something you can say:

Sophia, you’re amazing.  Congratulations on being a one-year breast cancer survivor — and getting healthier every day!

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