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In Like a Lion

I was fetched from a hospital stay today and carried home through the blow of a big wind, safe in the shelter of my husband's wing. The first of March, 2021 came in like a lion indeed. The wind has been fierce for hours, you can feel it rock the bones of the house. Power is out as I write this. For hours or days, we don't yet know. Que sera sera.

I've gone four days without real sleep but I'm not ready for bed. There is too much racing around in my head, too many moments to sort, too much self advocacy (and medical ptsd) to reset from, too much worry still on my family's faces.

The hospital sent me home with scant patient education on my condition, they leave this all to your primary care provider now. I am aware that I have the privilege of walking away from the medical emergency with a good chance of fully healing what ails me, and a range of medical and non medical approaches at my disposal. But I really wish I had read that piece online about not eating 2 hours before bed time before I had that 9:30 snack. It is the kind of general information the doctor who treated me has in his head but there is not time now for quality patient education in a hospital setting. Everyone I talked to was getting paged to be some place else, even the surgical tech who was called to set an IV in my tired vein was paged to a code, so the tape was crooked and caught my skin all night. And every one is doing the best they can.

The hospital is no place for whiners. And if you don't ask for what you need it can kill you. I hoped never to be a patient in this hospital because it is the place where I served a chaplaincy internship. I had walked every floor at all hours. The work of chaplaincy is entirely inclusive of the human lifecycle, from welcoming babies to blessing the dying and the dead. Celebration, solace, and all the in~betweens. During those months I lost the veil that separates the public from the staff in the hospital, I had seen behind the curtain in this very building and could not unsee. I did not want to be 'in the bed'. And I was ill enough that I was also grateful to be.

A stay in the Pandemic Hospital is not the same as any other hospital you've been to before 2020. And the entire medical provider community are not the same either. Every one has gone over some sort of edge. It is not just burn out. It is not something I have witnessed before. What I saw from the mask up on every face I encountered was a new and hard earned evolution of emotional intelligence. I come away certain that each and every community in the nation has a responsibility to attend to the healing of our healers. Their repair and respite needs to be a top priority.

And here's the thing. When you are the non-covid patient in the hospital bed, a year into the pandemic in a relatively calm moment after the vaccine has begun rolling out, and you can see how weary every one is, it can be super hard to ask for what you need. My list of symptoms and hurts seems trivial when I can see people have this hard year etched in their faces. There is not a great deal of curiosity about how one thing leads to another, just a test and a new med to take. A bandage for symptoms but no substantive advice for getting well.

I knew that before I let them show me the door, to get answers I'd have to ask for more. I understood that my newly high blood pressure presents a fall risk and as the spine surgeon I consulted just before the covid gates came crashing down (who works in that very hospital) would affirm, any fall for me holds a clear and present danger of paralysis. I had two questions to clarify before heading home and asked if they would send the spine surgeon's PA to rule something out and give follow-up advice.

I asked the hospitalist who came in on rounds in the morning. I asked the consulting GI doc who took my history prior to endoscopy. The next morning I asked the next hospitalist who came in on rounds. My request was news to her. She tried a lie and said neuro doesn't consult on the floor. I raised my eyebrows skeptically and kept my mouth shut. When the doc left the room the nurse told me I should give up. So I emailed a friend who is a retired physician and asked for help crafting language that might be better heard. After the endoscopy the hospitalist came back to schedule my discharge. I tried again, knowing full well that once I put a risk of being paralyzed by a fall on the table (which is not exaggerated with my spinal cord injury) the hospital had a liability issue.

Forty five minutes before I was released the neurosurgeon's PA stopped in for a chat. She listened, took my concern seriously, saw I was not asking for more than an informed conversation and an idea of who to follow up with, and affirmed that it was reasonable to ask for the check in. I went home a lot less worried. And since my presenting condition on admission was stress related it is pretty darn nice to have neutralized an anxiety with an action plan, one that someone without the PA's neurological insight could not have helped me formulate.

So a happy ending, I guess. I felt the care I received was excellent, up to a point. There were some pandemic related gaps because every one is tapped out, staffing levels are sparse, and even as worn out as they are staff are required to communicate a sense of ease to patients. Which must be truly exhausting. Meanwhile, I have tested negative for covid as part of my hospital entry protocol but many hospital workers travel floor to floor, room to room, and even with masks and hand cleansing protocols a patient in the bed doesn't really know what is coming through the door. And I am disconcerted to know that 40% of all hospital workers, locally and nationally, have so far refused to be vaccinated.

This was not my first hospital rodeo and like I say, I've lost the veil that separates patients from what goes on behind the sliding curtains and between the charted lines. One positive thing I noticed was that even in the oldest wing of the hospital the bed I was in had a mattress designed for post-surgical state of the art comfort, with self adjusting air-pockets to reduce pressure points and prevent bedsores. If you have ever endured days or months in a hospital bed you will know this is revolutionary. I spent those long slow hours imaging a campaign to secure funding from new billionaires to reduce suffering in every nursing home bed in the country by equipping each room with one of these mattresses.

It was in the midst of resolving the nation's bedsore crisis that I stumbled into the real moment of healing that came during this hospital stay. It was the middle of the night and even with the door to my room closed I could hear the nurses down the hall, they must have been gathered in the nearby hub of the unit. They were being way too loud for the middle of the night but I did not care. I was hearing the sound of people making each other laugh, co-workers sharing familiarity and joking. After almost a year of isolation with my family, in a hospital itself recovering from another covid surge, the ordinary sound of colleagues having fun, singing a little, laughing and being too loud in a quiet place, maybe not caring… this was music to my ears. This was the healing my psyche most needed.

I will repeat here at closing, what I saw from the mask up on every face I encountered was a new and hard earned evolution of emotional intelligence. The hospital staff I encountered, in every role they played, have learned to convey a whole face full of expression from only the bridge of the nose to the hairline. And underlying all of this nuance is a weariness. The public has let them down. The government, especially, has let them down. I come away certain that each and every community in the nation has a responsibility to attend to the healing of our healers with as much commitment as they have attended to our healing. Their repair and respite, and repair of the health care system, needs to be a top priority.

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Shanti Vani
Shanti Vani
Apr 27, 2021

Dina, this is your experience, right? We met at NHFA conference before COVID-19. My experience working as a Respiratory Therapist for 11 years ended on March 29, 2020. The things you describe here about how harsh the system is are so graphic, so true. I was one of the hospital employees trying to make sense of it all, being called to the code while in the middle of treating a patient, having to do CPR on frail patients in their 90s who were just trying to die, but no one had any advance directives to show and the spouse was just alone and baffled by the turn of events. Ah, Dina, I know it's so hard on everyone and hearing…

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