Friday, December 03, 2010

The Things You See in A Hospital...

One of the reasons why I haven't been around to spew my usual caustic bullshit (and why the caustic bullshit I did manage to spew was, in my opinion, of poor quality due to a lack of attention to detail) is that my mother has had a kneee replacement operation...finally.

I say "finally" because the operation was postponed once, having supposed to have been done Tuesday morning, but for the surgeon calling in sick. Well, in any case, it was finally done this morning, and having spent the better part of the last two weeks hanging around New York University Hospital for Joint Diseases, I've managed to make a number of interesting observations.

By the way, as I list these observations I wish to make one thing crystal clear; the people at NYU have been nothing short of brilliant professionals in all of their dealings with my mother and myself. The level of dedication displayed by the Staff --including the administrators, and right down to the security guards and facilities guys -- has been a wonder to behold. They have really gone above and beyond in a way that one would not expect, if one believed the horror stories told about our"Broken Health Care System" as told by by a communist in sheep's

I can, with complete confidence, predict the following;

When ObamaCare is finally implemented this level of quality service, covered by insurance -- private or Medicare -- will simply cease to exist.

Anyways, my observations....

The first one is the absolutly amazing amount of paperwork that one must do at each stage of the process before treatment can even begin. The Legal System seems to have made a concerted effort to innundate the Medical System with a deluge of paper that would make an ardent environMENTAList cry at the thought of all those sacrificed trees. It isn't just the usual range of CYA liability waivers, either; living wills, power-of-attorneys, HIPA documents, scads of disclaimer forms, treatment options that must be individually approved (all with their own range of all the other paperwork), organ donor forms, insurance forms, compliance forms, various releases, Medicare forms, and stuff I never even knew existed. All of it in triplicate, naturally.

I remember someone once telling me that closing on a house entailed your having to write a few hundred signatures. That's Bush League; try all the signatures necessary just to have your own blood siphoned off and stored for the operation...just in case it's needed. That alone entailed a stack of documents a quarter-inch thick.

Now imagine what happens when your surgery is rescheduled, and the 14,000 sheets of paper sacrificed are now invalid because they're dated incorrectly...and they have to be filled in all over again. Even your medical chart consists of enough paper to choke a woodchipper running on nitrous, and there's already a PC next to your bed where the same information is being entered, it has to be put on paper, too (paper, after all, doesn't break or require electricity). Somehow, I get the feeling that most of this is not so much medical necessity as legal make-work. I mean, after you've done you job and chased the ambulance, you might as well stick around for what happens next, just in case you can make another shyster buck, right?

Do you really think that sort of tangled, impenetrable (to me, anyway) sort of bureacracy is going to somehow go the way of the brontosaur when President Odickhead has his Eyedrops-and-BandAid rationing system fully operational? I'll bet it fucking doubles, easily, because there will be another three layers of rubber-stamp bureaucrats to employ at taxpayer expense, and more lawyers. Somehow, the people who have to keep track of all this paper manage to do so in a way I find amazing; I've spent my life trying to get computers to do what these people do (so that they don't have to, and thus, can be made redundant...and unemployed), and I'm telling you there is just no way thatyou can easily automate that sort of system short of a major investment in IT and software engineers that might signify a crippling investment for most hospitals.

If you expect the government to design such an automated system, it would cost three times as much, rely on carbon paper, crayons and cave paintings, probably require at least three chickens killed in a voodoo beastiality ritual, and be engineered in Mumbai, and fail miserably to the point where it would actually kill people.

My next observation has to do with the difference between the quality of Staff at a Private Institution (like NYU) and a public one (like a hospital run by New York City). I've been in city run hospitals before (and I have to admit, the better ones; I've never been in a hospital that serves the Urban Aboriginies...errr...lower-income community, for example), and the difference is Night and Day.

The NURSES were able to answer my questions about specifics, like the medications my mother would be taking, her physical therapy requirements, and made an effort to update me on her condition after surgery approximately every 90 minutes. If the first nurse I was dealing with wasn't available, another one stepped right in seemlessly. They were knowlegable, they were dilligent, they gave a shit. Not like the union hacks at the City-run hospitals, and while I have to admit some of those came close to the NYU nursing staff, the number of those was very small, indeed.

My mother's anesthesiologist and orthopeadic surgeon (Doctor Zuckerman, the Chairman of the Department!) both spoke to us before and after the operation and layed out every stage of the proceedure from start to finish,and answered every question, no matter how stupid. In fact, Doc Zuckerman even cancelled his vacation to stick around this weekend, since he had had to reschedule her procedure earlier in the week, and he's already -- not 8 hours after surgery was completed -- answered a page from my sister to answer HER dumb questions, too. Cheerfully, no less.

I wonder how that will work when ObamaCare makes every nurse and doctor little better than a Teamster?

Another observation; surgeons apparently smoke. An awful lot. When they had some time between patients, you could find a small knot of them across the street from the hospital enjoying a quick cigarette. I guess it's one way they deal with the stress attendant with screwing with people's insides, and at least they're not in the local bars when they have the time. You'll also find the surgical staff out there having a ciggie as time permits, too. Not all, mind you, but a fair number.

Take THAT Mayor Bloomberg! If you had your way, cigarettes would be banned, and those doctors -- the best in New York City -- would be across the street in Stuyvesant Park scoring crack, wouldn't they?

Another thing that I found incredible was the clientele. We're talking people with all sorts of maladies from a torn ACL, degenerative arthritis to shattered spines...and all of them seem to come and go from the hospital with smiles on their faces. I have seen a woman in a wheelchair regularly over the last week, whose spine is deformed in such a way that she sits in that chair like a folded ruler. Her chin, literally, hovers above her feet. She was singing to herself this afternoon (on HER smoke break!) and told me how much better she's gotten since she started going to NYU for her treatments and therapy...rather than the crummy old Veteran's Administration hospital she used to go to (as I understand it, she was involved in a vehicular accident while on active duty).

I can't imagine what sort of care our troops are getting at the VA if a woman in that bad a condition can find it in herself to sing in the process of what I gather will be a very long ordeal of repeated surgeries and various therapies. It's the hospital, she tells me; they do things no one else can, and the people there care about their patients, and their reputations. Heck, within 3 hours of surgery this morning, they already had my mother up on her new replacement knee trying to walk. If she had been in a City hospital, they would probably leave her lying in bed until she was a mass of sores.

If ever there was an example of just how outrageously good our medical system is -- despite all the obstacles, the hassles, the stupid and petty regulations -- NYU Hospital for Joint Diseases is it. I would highly recommend it to anyone who has a bum hip, knee, genetic defect, disability or was the victim of a cruel accident. These last two weeks have been an education in dedication and skill.

This is the EXACTLY the reason why ObamaCare needs to be strangled in the cradle.

Thank you, NYU!

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