It had all been so easy when Jim was still around. Lisa’s ex-husband had many shortcomings, but being a critical care specialist sure came in handy. Any time her mom or dad had a health crisis, he was right there in the middle of it: advocating, interpreting, breaking down the complexities into easily digestible morsels of information. But then Lisa’s father died, and the emotional and physical stress brought the unstable union to a breaking point.
Years later, she sat in the ICU holding her mother’s hand and longing for the man that she had grown to despise. She felt a slight tenderness stir in her heart that was suddenly extinguished by picturing her previous husband with his new, almost teenage love interest.
Lisa’s mother suffered another stroke. The ventilator had been removed but her mental state was dubious at best. She was not eating. And the hospitalist was suggesting a feeding tube. Lisa recoiled. Her memories of her agitated grandmother socked away in a nursing home pulling on the plastic protruding from her abdomen was too much a burden to be replayed a generation later.
If only Dr. Phillips would come to the hospital. As her mom’s primary care physician, Lisa trusted him. But he abandoned his privileges years ago. He once confided that he no longer knew how to take care of such sick patients. Lisa missed his optimism and his gentle hand on her shoulder resting tenderly. He understood her struggles. The hospitalist was nice enough, but young. He seemed overly concerned with protocol and rarely spent more than a minute in the room without leaving to answer a page. He certainly had no advanced knowledge of the woman lying in the bed in front of him.
The family meeting was pathetic. Instead of the hospitalist, a palliative care nurse joined the social worker and other supportive staff. Thirty minutes later, Lisa walked out more confused than ever. Most of the conversation resolved around disposition: nursing home, home with hospice, or rehabilitation center. Each member had their own checklist of salient decisions that often seemed far removed from her mother’s wants or needs. There was no question who each participant worked for. The hospital, the government, anyone except for the poor helpless struggling patient.
Lisa thought of Jim again. If only she had an advocate. Someone who answered to her and her mother instead of the litany of outside interested parties. If only her doctors would lift their heads from the computer screen for just a few moments. If only someone with medical knowledge took a moment to see the forest from the trees.
The mice keep running through the maze trying to find the elusive cheese.
What the hell has happened to our medical system?
Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.