Darth Venomous has an open thread below and it was mentioned in the comments that Senator Ben Nelson [D/hypocrite-Nebraska] had rolled over for the nationalization of the health care system. His prior pro-life scruples vanished in a haze of earmark payoffs. I commented about his political future, and the future of the health care system when this kicks in. I also mentioned getting clearance from Misha to post something about the possibility of Democrats’ next political step. This is not what I need to ask Misha about. This covers the health care system, and what we are about to lose.
Some of you know that I put out an email newsletter. It has been on hiatus for most of the year, except for the odd edition, because I am taking care of a daughter who had an encounter with necrotizing fasciitis. I turn up in blogs to take care of my writing jones.
I am going to quote from two editions from back in 2006, where medical care was the center of attention. We almost lost one of our family, who I mentioned in the Open Thread. He was saved by both a miracle and a quality of care that no bureaucrat cares to deliver. I also mention my daughter’s encounter with the Brit NHS, which I have laid out here before.
I am a wordy bugger, as you well know. It holds in my own newsletter too. Bear with me, if you will. The journey will, I hope, be rewarded.
First, what came out as the “Miracles and Wonders” edition:
This is the age of miracles and wonders.
I know that it is not my line, but it seems to match our lives. Miracles and Wonders. What a time.
We have become used to medical miracles. We think that anything can be cured, and we are then so shocked when Death triumphs. But there are limits to what medicine can do. Thankfully, there are miracles, and there are wonders.
I have just come back from two days at Sky Ridge Medical Center, where we spent the time with Spike.
Miracles and Wonders.
Last Monday, he suffered a total pulmonary collapse while being driven to Denver. Coming down the mountain, they stopped at the Sedalia Fire Station. Our nephew, Josh [Patty's son] is an EMT/Firefighter there and saved his life by buying him 8 minutes. There is a story which I won’t go into, but let there be no doubt that he is not the kid I watched grow up. He is now a man.
Miracles and Wonders.
Just as the ambulance got to the ER, they lost Spike. CORE-ZERO, Code Blue, whichever phrase they use for cardiac arrest. Those 8 minutes meant his life. 8 minutes would have meant that it would have happened on Interstate 25 instead of in a fully equipped Emergency Room that was ready and waiting for him.
They brought him back, and took him to the ICU, pouring antibiotics into him. His lungs were locked up with pneumonia, the pneumonia that the VA had overlooked. His eyes were fixed and dilated. The gaze of a sojourner to that land from which none return. And the doctors were sure that he would not last the night. They gave him less than a 5% chance of making it that long. Jeff was met by that ominous line up in a hospital, standing side by side; Doctor, Chaplain, Social Worker. Yeah, we’ve seen that before.
Miracles and Wonders.
They did not know of the miracle and wonder, and steely determination that is our family; especially Patty. Patty, and Jeff, and Josh, and Lina, and Chris, and Erin, and Genia and Genia’s daughter Katy. And that was just the first wave. All night, they talked, they cajoled, they supported; they would not let him go. They bound him with chains of love to this world. The doctors said he would die. He stayed alive. The doctors said that the movements that they saw in response to their questions were just involuntary reflexes. They did not believe.
And come the morning, he was still there. Come the morning, his eyes were no longer fixed and dilated. And come the morning, he tried to sit up and speak [couldn't because of the ventilator airway].
Miracles and Wonders.
As more family arrived, and expressed their love and determination that he would not die, he got stronger. Even under sedation, he reacted to what was said. And he got stronger. By Thursday, his lungs began to clear, his white count started coming down, and they began weaning him from the respirator and the sedation. His grown sons from his first marriage were there. And the weight began lifting from us all.
We got there Friday morning. I think the hospital is ……. bemused …… by the phenomenon that is our Clan. I think it is that so many die alone, so many families are numbed by shock; that they are not used to seeing a family that does not give up on its own. They allowed us up to 12 at a time in ICU, because they realized that whatever we were doing, it worked.
Miracles and Wonders.
Karla, and I got there Friday, and despite having been the one to try to prepare everyone for what he would look like, my first thought was that he looked like hell. We took over in the room, while those who had been up all night were grabbing some food and some sleep. I looked at the readouts, to see what his status was, and while I have seen a lot better, I have seen a lot worse. Good O2 saturation, pulse, respiration, CVP; EKG looked hinky with intermittent PVC’s and sinus bradycardia, but things were working. When he awoke a little, he could respond with small nods or shakes of his head. His eyes would open and you could tell that he was still in there. So we took turns, when he was awake, talking to him, reading to him, keeping him focused on our world. We were joined by some cousins whom Spike had not seen for years, and we kept with him when he awoke. As the day went on, he seemed to become stronger with each hour.
In the evening, after they had gotten some rest, we were joined by Patty, most of the local members of the family, and another miracle. Spike has been married three times. We met him when he was on his second marriage with Barb, and had never met his ex or his two now grown sons. His sons, whom he had been estranged from for a long, long time, came. They came expecting to have to do the all too common duty of ordering the plug pulled. Instead they found that Spike was not alone, was being cared for by a rather large family who they had known nothing about, and they were both taken aback and amazed. And they fit right in.
What sons! We jokingly referred to them as “The Boys”, but they are fully grown men in their 30’s with families of their own. God, they are sons to be proud of. These are good people, squared away, heads and hearts in the right place. And you know. The estrangement is over. Spike has his sons again, and they have a dad. [and incidentally, Katy has been "adopted" and now has two "Big Brothers"].
Friday, as Spike became stronger and more aware our hardest problem became the ventilator tube; that kept him breathing but also kept him from talking. He wanted to talk, especially when his sons Glen and Will came in. It took some patience to keep him from trying to take it out. He was not ready. They were weaning him off of it, but not till Saturday at the earliest. We left Glen, Will, Josh, Genia and Katy on the late shift, and went to get some sleep. Early Saturday morning we found all the above exhausted from being up all night, but that morning the doctors had ordered the ventilator tube removed.
Spike’s first words were a hoarse croak, “My boys, my boys”.
We knew his body was on the mend, but we were worried that there was neuro damage from the lack of oxygen. A little later that day, we got the results of one of the strangest neuro function tests that I have ever heard.
I’ve mentioned that Spike is a performer at heart, and sings some rather obscure songs. There is also the odd poem or two. He is partial to the works of Robert Service, who wrote of the Alaskan gold rush. Most people have only heard of one of his many poems, “The Cremation of Sam McGee”. I had brought my copy of the collected works of Service, and among the things I was reading to him was, the “The Cremation of Sam McGee”. Early Saturday afternoon I mentioned that I had been reading to him, and that was one of the poems. He looked at me, and then began reciting the thing from memory, with expression and feeling [albeit somewhat dimmed by the fact that he was croaking more than a bit], just like he did when he was performing it. All four printed pages worth. Genia came in partway through, and all she could do was stand there, just out of his line of sight, smiling and tearing up. Yeah, Spike had come through it all right.
From that point on, our corner of the ICU Waiting Room became a celebration instead of a death watch. From Monday on, we had been preparing ourselves to suffer a loss of one of our own, and to be holding a Wake in his memory. Instead, our family had grown, and Spike had his sons back again.
Four days. They are talking about trying to release him in 4 days.
The doctors, the nurses, and even the Chaplain keep using the word “miracle”. It gives every sign of being that. It was a miracle aided by some of the finest medical care I have ever seen. I will speak more of Sky Ridge Medical Center, perhaps tomorrow.
We are home now, with lighter hearts.
Miracles and Wonders, indeed. Medical science is a wonder, but it has its limits. And beyond those limits is the realm of miracles. The doctors gave up. Our family, our Clan, didn’t. Patty, our dear Patty, was there first
and is not one to be trifled with
. She will wrestle with Death itself if need be, to protect our own. As will they all. And they did. And I am so proud to be related to them.
But they did not do it alone. I, and they, called for help. And from the response we got, and from the effect that we got; yeah my family got that help. In spades. It may have been a quiet thought in the darkest hours of the night. It may have been the lighting of candles or Joss sticks. It could have been an offering up of a mass. Or maybe it was just the calling of good hearts to another whose time was not yet over.
There are things that go beyond that which we think we know. “There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.” The doctors had all but given up, and yet something helped us hold fast to Spike and bring him home. I don’t think that it was all us. There was more, and it was felt by all of us. It lifted us up, and once he could understand it lifted Spike up too. And I do not think that it would have been possible without those who I am honored to call my Gentle Readers.
You are Miracles, and you are Wonders. And we are grateful.
And now that the scene is set, here is what I wrote the next day; describing the medical care and the hospital. And when you read this, remember, this cruel, evil, heartless, Kulak private purveyor of medical care accepted the pittance that the VA kicked in as payment in full.
I have redacted the name of a former employer in this repost.
1) In the Miracles and Wonders edition I said that I would return to the topic of Sky Ridge Medical Center.
What can I say? Well, it is the newest hospital in metro Denver [although technically I think it might be in Douglas County] and it is unlike any hospital I have ever seen. And I remind the Gentle Readers that before I became employed by the Sovereign State of Colorado; I spent a number of years as Field Supervisor, Training Officer, Bomb Search Officer and general dogsbody for the [ name redacted] Security Department. [redacted], which was owned by the private hospitals themselves, is now called [redacted]; and at the time I was working for them had 17 hospitals in their system. I had to know all of them, intimately, all three shifts; as well as knowing my own home base hospitals of St. Joseph’s and St. Lukes. Yeah, I know a wee bit about hospitals.
When you walk in, you think that you are in a luxury hotel. Damn, they take care of patients and their visitors, well. And they take care of their employees. That is one reason that the patients get such good care.
In the ICU, which is all I saw, but I heard about the regular rooms; the place defines “state of the art”. Everything seems to be datalinked to a fare thee well. I speak Medical. The Gentle Readers will remember that we have spent more time in ICU’s than most people ever do in the last few years. There were things there that I couldn’t figure out at first glance. Even the displays and diagnostic readouts I did understand, were amazingly modern.
I noted the staffing. Here at home, there are 8 beds in our hospital’s ICU. When all 8 beds are filled, they may have 3 nurses assigned to the unit. They are running their butts off trying to get things done. I did not go through the entire ICU at Sky Ridge, but it was big [more on that later]. From the look of things, they staff one nurse per patient, with nurses seeming to be partners; i.e. two nurses will have neighboring patients and they will help each other for the things that require more than one person. [UPDATE add a couple of extra ICU floater nurses per shift to that count]
With so many nurses, it is easy to seem not rushed and more competent. Yet, I really had the feeling that these were the cream of the nurses in the area.
The rooms. ICU rooms in most hospitals are small and cramped. There is barely room for a chair or two alongside the bed and IV’s. At Sky Ridge, the rooms are bloody huge. There is room to move around, to sit, to stand, room for your things. I mentioned that they allowed up to 12 of us at a time [usually we had 4-5 at a time there during the day.]. There was that much room. And yes, while our family was not considered the normal group; they have a philosophy that the “support system” is vital to recovery. They want the family there. In Spike’s case, our presence was vital to holding him here. The nurses and the hospital understand. Now, mind you, it helps that we do know how to be relatively well mannered when necessary, and that we have a bunch of EMT’s, nurses, and medical people in the family [although by the time it was over, even Katy who is a high school student was explaining what was what to visitors]; but they believe in having the family there, wholeheartedly.
I was told that the regular rooms are just as spacious, because they are all singles. They believe that single rooms promote faster recovery than having 1 or 3 roommates who are also sick. Each room has a futon couch that folds out into a bed, so at any time your friends or family can stay. Once you are in a regular room, you can eat on a regular schedule, but also can order from [get this] room service, within medical dietary restrictions [can't order a steak if you are on clear liquids], because they think it speeds recovery. And for a really minimal cost, your family and visitors can eat from room service with you.
They have a hospital concierge! Visitors and families frequently are from out of town and strangers to the area. Guess what? If you need something, the concierge will help you get it, at no additional cost. The idea is to concentrate on recovering health instead of worrying about where to do laundry.
Morale. Hospital work is drudgery. And it shows on at least some of the staff in every other hospital I have seen. Literally every hospital employee I saw at Sky Ridge seemed glad to be working there. Even in the hospital cafeteria [and you would not believe the cafeteria, the quality and variety of the food, or the ambiance.] I was talking to a young woman who was at a station cooking one of the daily specials to order. You could hear and see the pride in her voice and manner as she talked about the new state of the art cardiac care center they had built. She was a cook, and yet the patient care team was something she felt she was part of. Damn.
I grant that the quality of the workplace is also a tool for attracting and holding the best staff, but it seems to be working.
They only have their Level III Trauma certification [working on II]; so I will agree with Jeff. If I am hurt, shot, stabbed or squashed, send me to Denver General where they do Trauma. But if I am sick, send me to Sky Ridge.
Now there is a reason that I list all of these. Sky Ridge is a private hospital. While like all American medicine it is tied to the government with red tape, it is private. And it is quality.
Name me one government agency hospital for civilians that is known for quality.
OK, time’s up.
Spike almost died, in large part because the VA could not recognize pneumonia on an examination. For those who aren’t medical, there are classic sounds in a stethoscopic examination of the lungs. If you hear what sounds like crackling cellophane in a bunch of fields in the lungs, you want an x-ray now, because y’all got pneumonia present. The VA is, like all civilian government medical systems [and admittedly some military] real heavy on Chairborne Commandos and Admin types, and the actual patient care people are kind of a budgetary afterthought. That tends to attract those who are not the “best and brightest”.
I remember that when Ceilidh was in Britain; she got a close up look at government medicine. Chelsea and Westminster Hospital is one of the newest and most modern in Britain. It is in Kensington, which is the neighborhood where there are two royal palaces and the upscale Brits live. While the Royals don’t go there, those who are immediate hangers on probably do.
Their wards are open bays like old style barracks. Their nursing staff is a) desperately short-handed, and b) handicapped by the detail that many do not speak English. While she was there after clearing their ICU, due to a total lack of beds in female wards, they placed her in a male [largely geriatric] ward. She watched two old men murdered by the medical staff, because it was cheaper to do so. I use that word with specific intent. In this country I would want to slap cuffs on a whole bunch of people. I would be tempted to make them need medical care themselves by the time we got them to a cell.
In the bed next to her, there was a man on a respirator, similar to but probably a lot more primitive than the one that kept Spike alive. A doctor with a covey of hangers-on came up to his bed and told the man; “You are not likely to recover if we put you in ICU, and you have no family to take care of you if we send you home. So we are going to have to turn off your respirator. You’ll be dead in about 2 hours.”. And he did, right then, reach over and turn off the respirator. And with the man fighting desperately for his life to stop them, they forcefully removed the ventilator tube. Then they left. For the next couple of hours Ceilidh and the entire ward listened and watched as the man slowly suffocated. The chilling thing is that it apparently was considered normal.
In the bed across the aisle was an old man who was wheezing away. He had had a broken hip. In the British satrapy of the EU, in the realm of the Lord Protector, there is a waiting list of a couple of years for the surgery to repair a broken hip. While you are waiting, you are bedridden at home and in pain. Most do not survive the wait. This man had. The man’s wife, who sat at his side all day, told Ceilidh the story.
In the middle of the surgery, the anesthesiologist had let him come up too far, and his gag reflex had kicked in. He vomited, and aspirated the vomitus. Thus, aspiration pneumonia. Treatable, but not easily or cheaply. So they were letting him lay there and die in a regular ward, unattended. Later, in the middle of the night, he had sat up, the noise waking Ceilidh, and had stared her in the eyes gasping out, “I’m dying!”. He then fell back on the bed. He did not die right then [the next day he did], but that convinced Ceilidh to check out of the hospital and get back to the University’s London Centre.
The complaints about the abattoir that is the British National Health Service are endemic. That year [ when Ceilidh was there ] in their budget; Lord Protector Blair “fixed” the system the same way that Bush and Congress want to fix the border. They promised to hire another 120 doctors and nurses, nationwide. And another 2000 administrators to watch over them and “remove inefficiencies”.
Just a few weeks ago, I linked in GLEANINGS to a report that Britain was about to cease treating premature babies, because it took too many resources for a single patient. It is easier and cheaper to let the babies die.
Across the Channel, in Belgium and the Netherlands, euthanasia, involuntary euthanasia, is now the norm to reduce medical costs. In Canada, people die on gurneys in the hallways waiting for days for hospital beds. Their vaunted medical system only keeps on semi-functioning because those who can afford it come to the United States. It is so bad that even their ultra-liberal courts have ruled that in Quebec the conditions of their medical system constitute a violation of their constitution.
Yet, the American Left insists that having the government take total control of the medical system is the only “fair” and “cost efficient” way of doing medicine.
Let us go back to Spike’s experience at Sky Ridge. He is a grizzled old fart. He has both age and mileage working against him. He is not rich. Sky Ridge was the closest [thankfully] hospital when he went down. He is under the VA system, which means what little recompense that the hospital gets is going to come from them, and from Medicaid.
Yet, he got the same care in the ICU that Bill Gates would have gotten there. They busted their butts to save someone that under the Brit, Canadian, Belgian, or Dutch system [or Hillary Care with its boards to determine if it someone was socially valuable enough to be treated once they were 40 years old] would have been left to die or actively killed for the good of the system.
The difference is something that shows we are doing something very right.
A thought occurred to me, while in the ICU with Spike. When archeologists dig up the remains of early man; one of the markers as to when we became “human” is in the graves. There is a level when they start finding graves, lovingly made, of individuals who were old, or crippled, and who had to have been cared for by others even when they could not care for themselves for a long period of time. That care, that compassion, that willingness to protect the most vulnerable, is one of the things that separates us from pack animals.
Places like Sky Ridge exemplify the best of the human in us. Europe and Canada are being reduced to animals.
There are those in this country who would bring out the animal in us.
If we are to be reduced to animals, let us be Sheepdogs, and let us deal with the Leftist Wolves.
LC Subotai Bahadur, Lord Pao An