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Medical Roulette

So, about a week ago, my Mother-in-Law refused to wake up.  She was breathing, eyes open, but not responding.  Father-in-Law called us at 6:30AM.  Ambulance.  Emergency Room.  Spent most of the day there.

As bits and pieces filtered in, it turned out that her blood CO2 was too high – she was not breathing deeply enough to expel it.  This was caused by a twisted bowel, causing distension, pushing up on the abdomen.  They decided to perform a procedure, similar to a colonoscopy, to straighten it out.

Now, although she was sleeping most of the day, she had been responsive when awake, the result of being on a respirator of sorts, clearing out the CO2.  We went with her to pre-op and, despite having fairly severe dementia, she got the idea of what was about to happen, so she sat up and tried to wriggle off the gurney.  We had to keep her there till the team took her away.

Knowing she and the medical team would be gone for a while, we went across to 7-11 and got Cokes.  When we came back, we found that the team wanted to talk to us urgently.  She was failing fast, the anesthesiologist said, wouldn’t make it through the night.  I went to get Brenda’s father while she started calling people to come to the hospital quick.

They took us to the recovery room, where she slept on a respirator, and gently tried to explain what had gone wrong.

But nothing much seemed to happen, nothing seemed to change.  Nothing.  The longer we stood there, looking at her, reading the monitors, the more it dawned on us that nothing had changed.  This was the way she had been all day.

It took some time, but the recovery staff finally came around to our way of thinking.  After a few hours, she was admitted on the ward.  By morning, they had removed the respirator.  She was able to expel CO2 on her own.  More surgery would be needed, but for now, all was well.

What had gone wrong?  Well, an anesthesiologist who had graduated, perhaps, in the bottom quarter of his class.  A chart that had failed to follow from the Emergency Room.  Professional pessimism.  The fact that looks can be very deceiving, especially where my Mother-in-Law is concerned – anyone who looks at her is convinced she will never walk again, while she spends day after day doing laps on Goodground Rd.

Every time I am thrust into the medical world, I come away depressed or frightened.  While they have made some truly stunning advances, in both medicine and information technology, there is always a sense that everything is horribly uncoordinated, mismanaged, and frenetic.  Five doctors in five hours – who is in charge?  Who is making the decisions?  What are they basing their decisions on?  Why can’t we get a straight answer?  Did things change?  When?

The fact that they are still relying on a physical chart tells me something.  You would think there could be a chip on the wristband where everything of importance would be written, to be read by every doctor, nurse, or tech who works on her.  Naturally, this stuff should all be backed up in the cloud, available anywhere.

But, there are issues.  Privacy laws, insurance companies, defensive (legally) medicine, state oversight, long-running traditions all conspire to create what I see as a dysfunctional system.  The people seem, mostly, great and concerned professionals, but like public schoolteachers, they are trapped in a system that doesn’t always work right.

I don’t know what the answers are.  I know what some of them are not, like centralized, bureaucratized single-payer systems.  But, if any industry ever needed competition, it is the medical industry.  We need to take the shackles off of creative minds.

Many, many thoughts on all this, going in many directions.  More later, I expect.


Categories: Pet Peeves, Technology, Trends
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