FALLING DOWN THE HEALTH CARE RABBIT HOLE, PT. 2

7 03 2009

As you may recall, the first installment ended with me being grilled by a clinic doctor about where I got my marijuana.  Although his information on the great herb was misguided, I figured I could trust him to report accurately on the condition of my heart and what to do about it, so I drove across town to Nashville General Hospital, also known as “Meharry,” becaue it is associated with Meharry Medical School, a “historically black” school that took on Nashville’s publicly owned hospital when the city could no longer subsidize it.

This makes it Nashville’s hospital of last resort.  If you’ve got money or insurance, you’re going to go to Vanderbilt or one of the other big private hospitals that made fortunes for Tennessee Governor Phil Bredesen and the Frist family.  If you don’t have much money, it’s Nashville General for you, over in the dark side of town.

On my way to the hospital, I stopped at a health food store and bought some soft tofu; I was planning to make chocolate tofu pies for our family’s Thanksgiving dinner the next day.  Now, you may be thinking, “”Chocolate and tofu together?!   YUCK!”  but I strongly suggest you blend a block of soft tofu and a tablespoon of honey together ’till they’re creamy, and then melt about an equal weight of dark chocolate  and stir it in quick before it solidifies…you will  have the nectar of the gods, my friends.  Alas, that particular batch of godly nectar has yet to be made.   I had no idea what was about to happen to me.

I parked in the garage at the hospital and walked into the emergency room, handing the desk clerk the results of the electrocardiogram that had been done at the clinic.  After a few minutes observing the people around me and wondering what had brought them there, an orderly with a wheelchair came out to greet me.  “I don’t need that,” I said.  “In the shape you’re in,” he replied, “we want you in it.”  Whatever…I let them wheel me into the examination area, where they did another electrocardiogram on me which, apparently, confirmed the results of the first one.  “You’re in atrial fibrillation,” a doctor told me, and explained, “that means your heart is beating in a very disorganized fashion.  In fact, you’re running at about a quarter of normal heart function.  It’s a wonder you’re able to stay awake and talk to me.”  For my part, I was surprised to hear that I was in such dire shape.  I felt tired, but thoroughly functional.  They sent me to the Intensive Care Unit, because, according to their standards.   that was where somebody with a heart condition like mine should be.  All around me, people were barely conscious, struggling to hang on.  I sat on a bed in my street clothes and read a book and fretted about how much this little adventure was going to cost me.

Cost is certainly an interesting factor to consider.  At the poor people’s clinic, they had charged me $30 for an office visit and $60 for the electrocardiogram; the whole thing took about an hour and a half.  When I received the emergency room bill, I nearly had another heart attack–my hour and a half there had cost me over $1100 dollars, most of which was paid to a doctor who charged $700 an hour to read my ECG and order a course of treatment.  I have no insurance, and have rarely earned over $1100 take-home pay a month, and here’s a doctor charging me that much for an hour and a half of his time.  If he works forty-hour weeks, fifty weeks a year, he’s making 1.4 million dollars a year.  I think that sums up at least one aspect of this country’s health care problem pretty succinctly.

So there I sat, looking very out-of-place in the ICU.  I had called my wife, who brought me the rest of the books I was reading at the time, my journal and a few other personal effects, and an excellent, home-cooked dinner.  Now, “hospital food” is a running, if ironic, joke–there you are, trying to get healthy, and they’re serving you the lowest common denominators of the supremely unhealthy standard America diet–overcooked green beans, mashed potatoes, and mystery meat, with some unholy gob of corn syrup and other fixins for desert–but when I told the dietician I was a vegan, and didn’t eat meat or dairy products, they sent me a big plate of iceberg lettuce two meals a day, and dry cereal with no milk for breakfast.  I am still trying to get an itemized copy of my hospital bill–I am very curious about how much I had to pay for all that lettuce.  Fortunately, my wife and friends  kept me fed over the course of my hospital stay.  By the time of my last meal in the hospital, an old friend who worked there as a nutritionist got wind of the fact that I was there and sent me a veggieburger with all the fixins.  It was a great meal to go out on–thank you, Karen!

Night came to the ICU.  It was noisy.  I was hooked up to monitoring machines, which beeped almost constantly and occasionally made alarm-level sounds.  One device I was saddled with was an automatic blood pressure cuff, which would activate every hour or two and squeeze my arm so hard my hand got numb.  I was awakened in the wee small hours for a blood drawing–no, I didn’ twin some blood, they stuck a needle in me and took some out.  Wake to experience pain!   Now try to go back to sleep!  Other people would ring their call buttons as they needed help or attention, and these were loud enough to rouse the whole floor.  It’s hard to imagine a less soothing environment in which to fall into a healing sleep–well, a subway station is noisier, OK.  But I did manage to fall asleep, somewhat to my surprise.  At home, I can’t handle ticking clocks.

Next morning, Thanksgiving morning, a conference with my doctor revealed my condition and a game plan.  I had severe atrial fibrillation, which had resulted in a lot of fluid buildup around my heart, otherwise known as congestive heart failure.  This was why I had been getting winded so easily.  I had apparently had a heart attack sometime in the last few months, as indicated by various chemical levels and the condition of my heart.  Aha…the August episode explained.  My blood pressure and heart rate were both dangerously high.  They were going to put me on medication to lower my heart rate and blood pressure and lessen the likelihood of a stroke, and give my heart a shock treatment to get it beating in regular rhythm.  And no, I didn’t need to be in the ICU, but I definitely needed to stay in the hospital until my heart rate was down and regular–and, due to the holiday weekend, the people who perform the heart-shocking procedure would not be in until Monday.  I longed for my friendly, quiet home environment, and said as much to the doctor, a thickset, dark skinned man with one of those three-letter African last names, which I wish I could remember. I could tell by the way he talked that he was definitely not from Nashville.

“Well, gee, ” I said to him,” if all I’m doing is waiting until Monday and taking some pills every few hours, couldn’t I go home and do that?   I feel fine, I don’t see why I need to be in a hospital.”

The doctor responded in his rich African accent, “Mr. Holsinger, you may feel fine, but you are a ticking time bomb!  You could explode at any minute, and if you explode, you had better be here.”

Reluctantly, I acceeded.  I didn’t know it, but–I was about to explode.

music:  The Rolling Stones, “Dear Doctor

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