Don's Nightmare Hospital Experience – That Ended Well
"Too many hospitals look like mausoleums. This one feels like it." This quote is from a man who was laid out next to me in a not so private hospital recovery room. A right heart catheterization had just revealed my CHF. I didn't push the conversation. I wasn't in the mood. And I'd already spent nearly a full month in ICU in the same hospital about 23 years earlier. They saved my life in that hospital so I wasn't going to question or get into a conversation about the appearance of his mausoleum. Besides, I'd just been told I had a terminal disease. Possibly he was just making me feel a bit morbid.
During my first stay at that hospital (23 years before) I hadn't expected to be there, so I had no time to prep, or ask questions, or understand what was going to happen to me.
Again, I came in not knowing what was going to happen, only that they were going to try to figure out why I wasn't breathing well.
My first visit to this hospital had been because of an emergency run from a northern California ski area after an incredibly horrible experience at the ski area's hospital. As hospitals go, the guy next to me had it all wrong. Maybe he didn't have his glasses on or didn't really understand the kind of care he was getting. I laid there after his empirical statement and thought back twenty three years.
It was a harrowing adventure in what could be described as the very worst hospital in northern California, an adventure that ultimately turned out acceptable in one of the best hospitals. Nevertheless, it began in an abyss of darkness punctuated by severe pain and a nearly lost life.
Learning how to deal with hospitals, and the lessons that I've absorbed since 1974, have taught me a great deal about what we patient's can expect at times, and how we should handle difficult situations
or better, why we should appreciate the basic kindness of nurses and doctors. Hospitals in and of themselves are not really the challenge. But sometimes procedures and policies might seem to get in the way – especially if we're in pain or worse, seemingly without hope.
On March 6, 1974 my life nearly ended on a ski slope where I was "sweeping" the mountain in my ski patrolman's role. I had been up there all day working on a film but when packing to leave, the on-duty ski patrolman Skip Lambert, asked me if I'd make the last sweep to ensure everyone was down. He was terribly ill with the flu, and I could see that. The patrol leader had gone into town for supplies and would return soon he said. He also said they'd closed down early because very few skiers had shown. But mountain policy was to sweep before nightfall. I agreed to help.
Halfway through the sweep and while crossing the top ridgeline of the area, I spotted a skier in trouble about midway down a steep slope. I took off to help her.
Just as I arrived I slowed, but it was spring skiing in California and that meant a lower snow pack and slushy snow with a few twigs and rocks jutting up here and there.
My left ski tip snagged one of those twigs, which looked more like a crawling vine. I went down straight ahead and hard. I was barely moving forward so my binding didn't release. However, my ankle did,
along with my talus severing (ouch) and a few other major damages like my tibia and fibula snapping like toothpicks. When I looked down at my foot, it was facing one hundred eighty degrees in the wrong direction. I could have gone into shock right there but had enough training and experience to belay that for a while. I was in trouble and understood the challenge. I needed help.
The weather was changing as well. Snow began to fall. The accident happened at 2:15 PM. I know that because my watch must have struck a rock when I went down and it was smashed, stopping at that hour. The woman I'd come to help was up by the time I'd figured out that I was the one in trouble, not her. I asked her to get help for me at the bottom. She blew me off and said, "You're the ski patrolman, get your own help." She skied off and in fact did not report my accident to anyone at the ski lodge below.
I could not walk or move very well so I started to crawl down the hill by reaching out and pulling my body forward. It was exhausting. I was losing strength very rapidly.
A half hour later the ski patrol leader, John Marhanka, came up the slope in a tracked snow vehicle searching for me. Our rule was simple. The "sweep" must submit a report after clearing the mountain. John knew it took about thirty minutes to sweep and I'd been out for about forty-five or more. He rushed me to the local hospital.
And that's where the real adventure began.
Getting Help Isn't Always Easy
When we are admitted to a hospital, we expect the best care available and that includes from the non medical staff who check us in. At least that's our hope. In some hospitals the system works very well. In others you may find yourself challenged.
John deposited me in a chair at the hospital entrance where admitting was located. There were no other patients, staff or doctors around. Only one young person, a very young teenie-bopper check-in who sounded a like she had just arrived in the area from the San Fernando
valley. Currently she resided on the other side of the counter. She was on the telephone speaking with her boy friend. John got her attention for a few seconds. She shoved a form at him and then turned away from him to continue her conversation.
For the next six hours.
John sat down next to me and did his best to fill in the form. He returned it to the counter but the space cadet on the other side paid him little heed. He sat down next to me and then said,
"I'm going to go look for help." He went down the hallway and returned a while later. "Nobody here." He sounded worried. "I'll be back," he said. He left the building to find help elsewhere.
In 1974 Paramedics weren't yet established throughout the country. In 1972 there were only 6 operating units in the United States. Randy Mantooth's show, Emergency, which ran from 1972 to 1977 was largely
responsible for brining public awareness to the need. By the show's ending in 1977, every state had established emergency assistance programs (Paramedics as we know them today) in at least a few cities.
Meanwhile, the pain had hit me full force. I fought off shock as best I could, but I don't think I was one hundred percent successful. Severe mind numbing pain overwhelmed me. I felt like a captive in a very tight cell; I could not walk, I could barely sit up, and speaking became a near impossibility. My leg felt as though someone was grinding it with a saw blade and smashing it with a hammer at the same time and it was swelling a great deal. I frantically motioned to her for help, but she would just turn her back on me and pretend I wasn't there. Normally I would have probably been a lot more forceful, but I had no power. I was as they say, toast.
I screamed at her, pounded the floor with the ski pole that Marhanka had given me as a crutch while on the mountain, but nothing worked. She was either drugged or absolutely insensitive to the man in the chair (me) who was losing consciousness and some blood (internally).
Six hours passed before a very good friend, John Nunan came through the door. It was dark outside and snowing. John Nunan had heard from John Marhanka that I was in trouble. The patrol leader had gone in search of him. John Nunan was as good a friend as you'd ever want and a terrific skier as well. When he came through that door and saw the admitting clerk still on the phone (same conversation) he nearly blew up the place.
He put an end to her conversation and got me admitted. But still, I had not yet seen a doctor or nurse. I realized however that I had probably passed out a few times in the chair. Nunan was also the first to realize my wife had not been notified. She was still at home in the valley. He took care of that immediately.
John had come from a party at his place. As my luck would have it, attending that party was a world famous orthopedic surgeon, Dr. Robert F. Cathcart, the inventor of the Cathcart hip prosthesis, commonly used to replace the ball portion of the hip joint. John called him; it was getting very late at night - doctors are used to that. He in turn grabbed another surgeon to assist and they came quickly to the hospital. (The duty doctor still hadn't shown. More about him later.)
Dr. Cathcart had X-rays taken and they discovered a break bad enough to warrant amputation, but he preferred to save the foot or at least give it a try. "We can always amputate later if it becomes necessary," he said.
From that point until the next morning I remember nothing except that he showed me the X-rays prior to surgery and pointed out where all my bones had broken and where my ankle was under the ball of my foot. I was half conscious and all I could do was marvel at the sight. I'm not sure the news penetrated my brain. At that point they were just "pretty pictures."
The next evening when I woke, my leg had so much pain that I still find it difficult to describe. (It has literally never gone away.) I reached down and felt a leg-long cast and did my best to look at it.
What I discovered was unsettling. It had bivalved. That means that the cast had split in half lengthwise due to my leg swelling so immensely. That in turn had split the cast open.
Why wasn't someone in the hospital concerned about the cast? Had they not come in at all during the day? What had transpired while I was unconscious?
I learned the answers later.
The two excellent surgeons who did the surgery had me rolled into ICU after successfully putting me back together. It took them a bit more than six hours. Dr. Cathcart had told the on duty doctor that he was to
NOT to put a cast on my leg. Besides his oral instruction he'd also issued it in writing. He specifically ordered that I was to remain rigged the way he had supported my leg. In my mind and more than likely yours,
that should be enough. Unfortunately, it wasn't.
After Dr. Cathcart left, the on duty doctor who had arrived well after the surgery began, immediately put a cast on my leg. He had intentionally violated the attending surgeon's orders while I was still unconscious.
After I woke and discovered the bivalved cast I pressed the red button for the nurse. It took a while but she showed up. When she saw the cast she ran out for the doctor who was the same doctor who'd put it on.
He immediately had me taken to the operating room (OR), where someone allegedly ran the juice through my arm that would knock me out. Then he announced he was going to amputate my leg.
Outside it was snowing. Heavily. Inside for me at least, the clouds parted. My insurance report reads, "Patient had been anesthetized. However, upon hearing the doctor declare an amputation was in order, patient broke his restraining strap, grabbed the doctor by the neck and said that if he cut his (patient's) leg off, he (the patient) would cut the doctors head off. Patient was transported via ambulance down the mountain to Kaiser Permanente in Sacramento."
Actually I cleaned up the language here just for you. As a former Marine I still possess knowledge of a much stronger and more emphatic vocabulary and apparently I used it.
I woke for a few seconds while in that ambulance ride to Kaiser and a nurse sitting alongside me patted me on the arm and said, "Don't worry, they do marvelous things with prosthetics."
Fourteen days later I woke again in the ICU of the very same hospital that had just been declared a mausoleum. I immediately reached down to see if my leg was gone.
A young and well-trained Kaiser orthopedic surgeon saved the leg. I learned later that I had gangrene so badly when I arrived via the ambulance that he estimated I had about twenty minutes of life left.
That's why that hospital could never look like a mausoleum to me. And it is also why I respect the efforts of competent medical staffs.
Okay, So What's This Got To Do With My Hospital?
The odds are, that if you've never been in a hospital before for any procedure more serious than a bent nail, you just might find yourself challenged beyond anything you expected and those challenges become difficult because they are unexpected. The phrase "we humans are not perfect" fits into most arenas of life. However, in our minds a hospital is supposed to be a place where we get well and we assume where we will be treated well.
The admissions experience alone in some hospitals can prove either horrendously complicated or as smooth as you'd want it.
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