Citizen of the Month

the writing and photography of Neil Kramer

Tag: hospitals

Flying Non-Stop

July 21, 2010 / / 30 Comments

Vartan, my father-in-law, was taken to the hospital last week. The Cedars-Sinai Hospital emergency room was too busy at the time, so he was taken to a nearby hospital which is nowhere near the caliber of Cedars Sinai. Sophia was nursing a cold, so I drove down by myself to the hospital to see what was going on. It was 1AM.

By 3Am, Vartan had a room, but the nurses wanted to move him to ICU. The hospital was understaffed and lethargic. I excused it to the early hours. The patients seemed to come from lower income backgrounds. Was this my first taste of socialized medicine? I made a sarcastic joke on Twitter, saying that I was learning the health care hierarchy of LA: Cedars-Sinai for the movie stars, UCLA for the movie producers, and THIS hospital for the grips. (I was later told that the grips are unionized and have excellent health care) Maybe I should have said this hospital is for entertainment bloggers.

Two slight nurses came into the room to wheel Vartan to ICU. It took them ten minutes to unhook all the tubes and prepare his bed to be wheeled out. One of the nurses was having trouble managing the bed and the attached IV, so she asked me to help wheel the IV to the other wing. I was beginning to wonder if this woman was a nurse, or a receptionist doing double duty. It was an obstacle course to ICU, with wheelchairs in the hallway and humps that we had to maneuver over.

We finally reached the locked door of the ICU and pressed the intercom. A male nurse, the head of the ICU came to the door.

“What’s going on?” he asked.

“We’re bringing that patient.”

“We don’t have a room ready. Or an available nurse.”

“Oops. So, what are we going to do?” asked the nurse standing to my side.

The ICU nurse started to laugh, spurring the others to crack up as well. I’m sure they were all tired, and the situation was absurd. Vartan was lying there, equipment sitting on top of him.

There was only one big problem with this funny scenario. I was there, helping with the move. And I wasn’t laughing, despite my reputation as a “humor writer.” I was wearing a blue sweatshirt, so perhaps the ICU nurse figured I was some orderly helping, and not the son-in-law of the patient.

“What the fuck is going on?” I said.

If you know me, that is not something I usually say.

“I don’t see this as particularly funny,” I continued.

“Who is he?” the ICU nurse asked the others, pointing at me.

“I’m HIS fucking SON!” I said. I know I lied a bit, but sue me.

The nurses suddenly became very serious.

“And is this the usual procedure –” I said, my voice getting louder, “– to have family members helping move the patient to the new room? Does anyone know what they are doing here?”

“Perhaps you would like to wait in the visitor waiting room.” said the male nurse, pointing at a room down the hall.

“I’ll wait in the visitor waiting room, after my father gets a fucking room and I see that you know what the hell you are doing.”

Within two minutes, they found a room, a nurse, and Vartan was hooked up.

Of course, the next day at the hospital, Sophia and I noticed that Vartan’s feeding tube wasn’t turned on. We went to look for the nurse, who was apparently busy absorbed in watching the finals of the World Cup… in the visitor waiting room.

I don’t enjoy being pushy. In fact I hate when circumstances force me to do that. It makes me reflect on other parts of my life, as if you are alone in this world, and no one really gives a shit, so you have to force your way into getting what you want. I don’t want to live my life that way.

On the way home, Sophia and I stopped at Ralph’s Supermarket to pick up some groceries. One of the items we bought was a package of cabbage. Sophia likes to make stuffed cabbage. After we paid, and before we wheeled the groceries out of the store, Sophia checked over the receipt. She always does this, and I never do. She is not as trusting as I am. I even get a little irritated at times in supermarkets, waiting for her to go down the list, making sure all the prices match.

“Aha,” she said. “She charged us twice for the same package of cabbage.”

Sophia showed the recipt to the checkout woman.

“I’ll fix it in a second,” she replied.

There were three more customers on the line for this checkout woman, waiting to be helped. The checkout woman helped the first customer and then started taking care of the next customer, a burly Samoan guy.

“Hey, what about our refund?” asked Sophia.

“After I finish with everyone on line. They were here first.”

“What do you mean? We were here first. You charged us for an extra cabbage!”

“I’ll be with you in a minute.”

“Who’s the manager?” asked Sophia, getting angry.

“Calm down, lady!” said the Samoan guy. “And don’t be so impatient.”

Now, normally, I’m not the type of protective husband who defends his wife no matter what, especially when the opposition has broad shoulders. Usually, I am the one calling Sophia impatient. But this time, she was right. I’m sure the Samoan thought he was right, too, and I realize that people can see the same situation in different, Rashomon-like ways. But, the hospital experience hardened my heart. I didn’t care about the other guy’s rightness. We were right. We were tired. We bought a package of cabbage. The checkout woman made a mistake. She should fix it FIRST.

I told this to the Samoan guy.

“Ralph’s Supermarket made a mistake,” I said. “They should fix it.”

“Big deal,” said the deep-voiced Samoan. “Haven’t you ever made a mistake?”

“I’ve made many mistakes. And when I make a mistake, I take care of it. Immediately. Especially if it is a business situation.”

“And why should I get punished. I’m the next on line.”

“This is not about you. This is between us and Ralph’s. Ralph’s is not my friend. They fucked up. They need to fix it. You should be siding with us, so when this happens to you, you will get prompt service.”

“You’re just being selfish.”

“No, sir, YOU’RE the selfish one.”

Whatever. Not exactly fighting words. I said a lot more nonsense, even quoting the Constitution. At the end, they returned our money, and the Samoan called us assholes under his breathe.

When we stepped outside, Sophia was so in shock at my bravado that she was speechless. If she wasn’t so tired from the hospital, and we didn’t have ice cream that could melt, I bet I could have gotten laid in the backseat of the car.

Later, that night, I decided to book my ticket to New York for BlogHer. I had been going back and forth, thinking about taking two different flights. One was on Virgin America, and was a non-stop. The other was on American Airlines, with an hour stop-over in Salt Lake City. The second flight would save me $70. Normally, I would go for the savings. But I hate stopping over on a flight. Was it really worth the savings of $70.

If you don’t speak up, you get lousy service in the hospital. If you don’t speak your mind, you wait in line in the supermarket, charged for an extra package of cabbage.

I’m flying non-stop.

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.

It’s the Real Thing

January 6, 2010 / / 48 Comments

Tuesday Night

9PM – Sophia’s stepfather, Vartan, is not doing well. He is at a rehab center near Cedars Sinai in Beverly Hills. Sophia and her mother have been at his side constantly for weeks and they are exhausted, so I told her that I would stay all night and watch over him. Sophia told me to caress his hand and talk to him to help him sleep.

9:15PM – Vartan has an amazing life. He is older than Sophia’s mother. He fought in World War 2, and was a POW in a German camp. He went through turbulant times in the Soviet Union. He was a prominent cancer surgeon in Russia. He moved to America with Sophia’s mother because he loved her. Rumor has it that they fell in love while still married to others, and they waited decades until they were able to be together.

10:20PM – Everyone here seems to be elderly and in pain. If you’ve been to a place like this, you know what I’m talking about. If you don’t, it’s better off you don’t know.

10:30PM – The sounds. The screaming of the man in the next room.

10:45PM – In one day, I’ve gone from writing about the hormonal teenage years of early manhood to writing about the inevitable weakening of man because of old age.

11PM – I can’t wait until morning arrives, for the nurturing power of the sun. I know this sounds insensitive, but I don’t want to be in this place anymore. I’m getting dizzy. Don’t faint. Be a man. Be a man like Vartan. Think of all the stress that Sophia and her mother are under, doing this every day.

11:15PM – How many of my blogging friends are nurses? Kudos to you for the work you do.

11:30PM – There is another man in the room, in the other bed. He constantly watches sports on his TV. Every time I walk by, he wants to talk with me. He is lonely. He used to work for ABC Sports. He thinks that I am Russian. He wants to talk about the famous Olympic hockey game between the USA and the USSR. He was supposed to cover that Olympic event with ABC, but he was assigned to bobsledding instead. He has always regretted that day.

Midnight – Vartan is going in and out of reality. Sleeping pills don’t work. He tries to leave the bed. The nurses have to “soft restrain” him to the bed. It is painful to watch. At times, he knows who I am. At other times, he is in his own world. I try to decipher what he is doing in this other reality by watching his movements.

12:05PM – He is talking to someone in Russian. But this person is not there. Who is this person that he is speaking to? I don’t know.

12:10AM – He is petting what looks like a boy’s head. Or a dog? Perhaps it is a dog he had as a child? He is making rapid movements with his hands and fingers. Swatting flies? Conducting an orchestra? Writing on a blackboard?

12:45AM – The nurse enters, wanting to change the soiled sheets. What a tough job these nurses have! Still, it is a little sad that there isn’t more of a human touch to the caregiving at this facility. One patient seems interchangeable with the next.

12:50PM – Vartan is doing his hand movements, and the nurse just finds them an annoyance as she changes the sheets.

2AM – I decide the hand movements are Vartan performing surgery. I find that dignified. He senses that he is in a medical facility and is doing what he is trained to do. He is not just some old anonymous guy. He is a skilled surgeon, and he wants everyone to know that.

3:15AM – Earlier in the evening, Sophia had sent over some Chinese food from a local restaurant, but eating Kung Pao Chicken in this facility made me queasy, so I hardly touched it. But I’m just noticing that at the bottom of the bag sits a can of Coke. Not Diet Coke, but real Coke. Woo-hoo!

3:30AM – That was the best Coke I ever had. Seriously. This post could be a commercial for the intense power of Coca-Cola. This Coke was my escape out of here. It’s the real thing. It transported me. Coke does not belong in a rehab facility. It is the soda of youth. I close my eyes and I am at a summer picnic, drinking Coke. And there is BBQ. And women. Life affirming stuff.

4:10AM – Vartan is doing his hand gestures again. But, this time, I notice that during the movement, he brings his hand to his mouth, as if he is eating something. That’s it! He is NOT doing surgery with his hands. He is picking something — from a tree? — cherries? grapes? apples? — and eating them. He grew up on a farm. Is this eating of the fruit his equivalent to my drinking the Coke? Is he at a picnic too?

5AM – I try to calm Vartan down again by caressing his hand. He is a cool guy. He used to laugh at me because I sipped my vodka.

This is hard. Soon, I will go home and Sophia’s mother will replace me at his side. We’re all hoping that Vartan recovers.

Where’s ICU?

April 4, 2007 / / 29 Comments

saperstein.jpg 

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.

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