CHAPTER 30: The Best
of People/The Worse Of People
September 28th,
2012
The
Best Of People
A funny thing
happened on my way to “recovery” from my recent hospitalization for a Diflucan
resistant yeast infection that closed off my upper airways, landing me in the
hospital for 8 days. Two days after
being discharged, sitting on my deck, writing on Facebook on this very
computer, my nose blew off! YES, that’s what I said…MY NOSE BLEW
OFF! One minute I was laughing at my
own bad jokes, and then my nose was gushing blood like a fire hose and I was running
for a sink, bathtub, well, anything large enough to hold it!
On my way to the sink
I had the forethought to grab the telephone, as I was the only one awake in my
house at 8:00am Tuesday morning (just 72 hours post-discharge from St. Joe’s
Hospital), cuz I suspected I was in serious
trouble, you see, this was no
ordinary nose bleed. A lot of things ran
through my mind as I stood there with my head inverted in the sink, blood
pouring from my nose like an open faucet.
None of them were funny so I won’t go there. Within a minute I realized this was not going
to stop and was, in fact following a dangerous pattern of gushing dark blood
with every heartbeat. I dialed 911, still with my head in the sink. Can you believe that 911 rang at least 10 times??? Where was everyone; not "open" yet; Monday
morning meetings; Mr. Coffee break? It
rang so many times without answer that I decided it was time to wake my
husband.
“Kevin,” I called out
C A L M L Y from the drain (knowing how tightly he is wired and how harried I can become in an
emergency). “I kinda have an emergency
here, and I would really appreciate it if you would slowly, calmly, wake up and
come out here and help me.” YES! That is exactly
what I said, and I was so proud of
having kept my cool at that moment because that is so not “hysterical LUCY”. What
he saw next, I could not protect him from…he entered a "crime scene"…and he was
still half asleep observing this nightmare. From the blood spattered and filled kitchen sink came a tightly clutched, still ringing, unanswered
phone, “Hun, it’s 911, it’s been ringing over 10 times with no answer, I need
you to tell them we need an ambulance for a really bad nose bleed." He said, “JESUS, all that’s coming from your
nose?” Then 911 answered.
He tried to answer
the operator’s questions, but the first one, "Where is the blood coming from," was
the big stumper. How does something so small (still
un-largened by corticosteroids) bleed so
hard and so fast? The next thing I
knew the 911 Operator was back in the sink with me. “Pinch off your nose, honey, just under the bridge,”
she said, advice a nurse would give to any "nose bleed". I did, and within 30 seconds I
was gagging, no…drowning in blood that was pouring down my throat until I
projectile…..(you can imagine the rest)….”OK, the ambulance has been
dispatched, honey, they are on their way.
Try to remain calm. Please, put your
husband back on the line.” And when I
handed him the phone, I saw him die a little inside. You see, my husband is a wonderful man, but
nobody…short of Emergency Medical Personnel unrelated to the patient…could have
“handled” this without panic and confusion.
Besides the grossness of the situation, was the sheer unfamiliarity of being
up close and personal with that much blood.
I myself, was impressed that I was still standing when the EMT’s
arrived.
The EMT’s arrived to
attend “the nose bleed” as they called it into dispatch when they arrived in
the kitchen. The next words were something
to this effect, “Holy crap….we’re not going to be able to stop this…we’re going
to have to get her to the hospital dispatch. From what I can see she has alsready lost at least 10cc's and that's what's still in the sink.”
YES, it really was that bad! I
think there were five of them (all fire department personnel). I’ll be able to tell you more later when I’ve
talked with my neighbors, as I was/am the talk of the neighborhood even one week
later. AND, most of my neighbors are really old, so at 53, with more scars and war wounds than stars in the Milky Way, and 4 hospitalizations AND an ambulance ride since I moved in two years ago, I'm an anomaly to them cuz they like these kind of things to talk about.
Two EMT's seemed to be
directly engaged in “triage and post-ride prep”, meaning “PACKING MY
TRUNK” for the ride to the circus. BUT, how to get it out of the
sink without losing even more blood or drowning the patient in the process? I remember ice on the Carotid and other
places; I remember twisting my titanium rod’d neck in positions I didn’t know
it still bent; I remember what seemed a bowling ball sized gauze roll being
shoved into the left sinus, forcing all the blood to first go down the throat
and eventually re-route out the right sinus, and into a lovely sherbet orange towel
I was awarded by EMT Clarke. Wahlah! “Get her on the gurney!” and away we went! Cul-de-sacs are great for gurney parades; 6 houses, great views from any front window.
Having the blood slow
to a leaky faucet drip from the right nostril was relieving enough to restore
my quipy jokes and self-deprecating humor, which my ambulance attending, Clark,
really appreciated. He came right back
at me, and humor always lightens the
load. When I got into the ambulance my
blood pressure was something like 291 over 99.
Within 2 blocks it had risen and he was radioing in that I was
“tachycardic”, with a dangerously high blood pressure and sinus
“hemorage”. Ahhh, there it was…
“hemorage” the word that said it all.
Within 2 minutes I had left the safety of my bubble, my community, and
was on my way to a hospital I had never seen before, Northeast Georgia
Physicians Medical Center in Gainesville.
Now, here’s the part
you chi-er’s need to read! The ride to
the hospital is about 30 minutes give or take a crazy lane of ambulance
blocking drivers or two. Halfway into
the ride my blood pressure was climbing and Clarke was beginning to panic. I closed my eyes, took deep breaths, and
focused on drawing all the chi of the universe from the horizon just outside
the beautiful country scene beyond the back window of the ambulance. I did that for 4 minutes or more, feeling
great relaxation with each exhalation and envisioning the Koi fish that swims
counterclockwise from my abdomen up and around my body, to the top of my head and back
down again, before Clarke became concerned, gently touched my arm and asked,
“Are you all right?” I told him "yes,"
that I was meditating, and just needed a few more minutes. He left me alone for at least another 3 and
when I was finished, I turned to him and said, “Please, take it again Clarke.” After channeling my chi my blood pressure had
gone from somewhere in the stratosphere to 152/51. Clarke was awed. My nose was no longer dripping. The sherbet orange towel was grateful. We were there. Once again, Master Shifu, I owe you a debt of
gratitude! It really, really does work!
The
Worse Of People
There is no good way
to write what happened next, without it sickening me all over again. So, I have chosen to include the letter I
wrote and subsequently sent to two administrators at Northeast Georgia
Hospital System. For every Yin there is
a Yang and both were startling demonstrated to me in my hours of need September
25th, 2012. I am not a
confrontational or adversarial person. Faced with it, I
flee conflict. I wrote this letter
because it had to be written. I wrote this letter, in the hopes that this never
happens to you or someone you love.
September
27, 2012
Ms. Carol Burrell, President
& CEO
Northeast Georgia Health System
743 Spring Street NE
Gainesville, GA 30501
Dear Ms.
Burrell:
I am a
relatively new resident of Hoschton, Georgia (just outside of Winder). In fact, I live next right next door to your
Braselton Medical Center on Thompson Mill Road, a serendipitous thing, since I
am critically ill with a progressive disease that is in its final steps.
I am
writing you because I had a medical emergency in my home Tuesday, September 25th,
and was transported by ambulance to your prestigious hospital, of which I had
heard and read many good things. I was
just released from St. Joseph’s hospital in Atlanta Saturday, September 23rd,
following an 8-day admission for a Diflucan resistant Candida infection in my
sinus’s and upper respiratory tract that closed off my upper airway completely,
triggering a life-threatening asthma crisis.
I tell you this, so that you will understand that I have personally
experienced a lot of hospitals, their ER’s, their wards, and their ID
& Respiratory personnel over the past 15 years of critical illness.
I am always
concerned about coming into the ER of a “new” hospital (new to me) where I do
not have a doctor or team of doctors on staff, but when you are transported by
ambulance, insurance does not honor requests.
“Besides,” I thought, ”it would afford me a good opportunity to see what
NGMS is like”, as I have been considering reassembling a medical team closer to
home; a good thing considering my five hospitalizations in the past 16 months.
I arrived
at your ER at approximately 11:00am, and was immediately triaged by the ER
team. From 11:20 to 12:00pm I saw nobody, and inquired of the nurses who
happened to pass by the door, if they could find out what was going on, as I
was in need of a Prednisone dose (severe adrenal insufficiency), and I am a
diabetic who had not eaten yet that day.
By 12:15 a
nurse, Lisa(??), came in and announced she would be my nurse. I gave her a brief history, which she was
polite enough to listen to…that is all.
She said that no doctor had been assigned to my care and that she would
go see if she could expedite that process.
She left, and I did not see her or anyone else for another 30 minutes,
until I paged the nurses for an urgent Accu-Check as I could feel that my
sugars were dangerously low. Lisa
returned and found that they were, 31. I
told her I had not eaten since yesterday, 8:00pm and I am an insulin dependent
diabetic. I BEGGED her to get me my
daily Prednisone dose as I am a steroid dependent asthmatic (21 years,) and I
am on a Prednisone taper (having just come out of St. Joe’s for a pernicious,
opportunistic infection in my upper-respiratory tract, making steroids
absolutely necessary for survival), often prompting these very dangerous
plummets in blood sugar for no apparent reason the minute the steroid dose
drops in my system; not to mention that I was in a serious medical crisis, and
have 0 adrenal function. Lisa shot me up
with 1GM of Sucrose IV, which I told here WOULD NOT BE ENOUGH for a sugar of
31 without Prednisone on board, and she left, NEVER to be seen again (not even for the usual and customary "recheck" or
a “howdy do, I got you a doctor”).
In the
meantime, a dynamic, young doctor, Mohak Dave’, finally came to evaluate me a
short time later. He rolled in with his
young, female entourage tagging along, and
never listened to a word I said. He
talked over me, talked condescendingly to me, and lied to me when he said he
would call my ENT at St Joe’s for a consult (I knew from my past that NEVER
happens and was simply a stalling technique).
I told him that the paramedics said I needed to tell the ER doc to keep
Zofran on board, as they were blown away by the amount of blood I had swallowed
and vomited in the ambulance where they administered Zofran via IV and said to
make sure I got it again within 4 hours.
I told him I was steroid dependent with no adrenal function, and was now
5 hours behind in my Prednisone dose, requesting that it be administered (40mg
orally or in any form he liked). I told
him that my ENT is Elizabeth Willingham, out of St. Joseph’s in Atlanta, and
that she had just cauterized a bleeding wound in my left sinus the day
before. I told him about my IgG
Deficiency, my port-a-cath, my IgG infusion therapy, and asked him to change
the gauze jammed in the left sinus and now literally dripping every ½ second
with blood into a nemesis trough because it was so over saturated that it would
hold no more. In 6 minutes or less (my
husband says I’m being gracious here) he seemed to indicate “yes”, though he
never said it. Then he told me, “I’m
going to call and consult with Dr. Willingham (MY ENT FROM ST. JOE’S???? whose
phone number I handed to him) first. I
don’t want to remove that gauze or disturb the clot right now.” Then he turned his back on me and
disappeared.
Several
minutes later, with my head spinning, wondering what bag of wind had just blown
into my critical care situation, showing no compassion, NEVER looking in the
nose, NEVER acknowledging the dangerously high blood pressure recorded by the
Ambulance Techs, NEVER asking about my eyesight, never evaluating me physically
in any way at all. I knew I was in
serious trouble.
Within 20
minutes, I was feeling sick again, and paged the nurse for an urgent
Accu-Check. I was informed that Lisa had
“gone to lunch”???? (Without ever rechecking my sugars of 31 first, or asking
someone else to do so?) Luckily for me a
VERY COMPETENT, COMPASSIONATE, ABOVE AND BEYOND nurse who happened to be
walking by my trauma room and heard the page, came in immediately with a
glucometer. She took my sugars (37),
asked if I had eaten anything (now 1:30pm), immediately got me orange juice, and then went out of her way to
find something for me to eat. I don’t
know her name but she was a pretty, Asian, darker skinned young lady with
glasses and long, thick black hair, who radiated calm, competence, and most of
all compassion. She checked on me
several times after that, eventually returning to shoot me up with the
remaining Sucrose in my IV, as she said “my nurse asked her to”. I never did see Lisa again.
At around
2:15 I was moved out of my trauma room to the other side of the ER unit because
they needed that room I was in for a “real sickie”. Still no word, sighting or treatment from Dr.
Dave’. (No Zofran, no Prednisone, still dripping gauze from the left nose, no
report on any conversation with Dr. Willingham because he NEVER made the call).
I asked the nurse who moved me to put a good word in with Dr. Dave’ for
me. I asked her to please let him I know
I just wanted to have my nose packed so I could go home. I am sure she did tell him that; I hope as
nicely as I said it (seriously); because my whole demeanor that morning was
light, funny, and compassionate toward your staff. Ask Anybody.
At 3:00pm
boxes of Rhino supplies were delivered to my room, so I knew my request had
been forwarded. At 3:30pm (my husband
was in the bathroom), Dr. Dave’ blew into my room again, saying nothing. He was now a “PISSED OFF STORM”, and I was in
his wake. When he stomped into the room, I told him he was a God sent. He did not even acknowledge me. He salined a sinus tampanade in a trough
without saying a word. My husband returned
and I mouthed, “He’s pissed off,” so he would be warned. That did not deter my outgoing, empathetic
husband from trying to strike up a conversation with nothing but sympathy for
the out-of-control situation we were witnessing in the ER all day. Dr. Dave’ did not acknowledge my husband in
any way either.
Then he did
what I can only describe as “extracted his revenge” for ????? my being in his
way all day? Dr. Dave’ brutally,
without words, warning, compassion, or tenderness jammed that tampanade up an
already badly irritated, bloody nostril.
I flinched tight and he slowed down just long enough to put his finger
on the plunger and quickly, without hesitation, plunge a great quantity of air
into the tampanade so hard and fast that I SCREAMED, grabbed his hand with the
plunger, and looked him in the face as if to say, “why?” Before he could quickly move from me as he
had all day, a reflex struck me; let’s call it a “God moment”. I gently grabbed his arm and said, “God
bless you. I know you’re having a bad
day and I’m sorry.” To which he turned
around, got in my face and said, “And thanks for your patience,” in a
way my husband said was meant to be snide and insulting. Then…GONE, having delivered no more than 10
minutes of ER care/attention to me over the course of 5+ hours, and pissed off
that it was that much.
But Dr.
Dave’ wasn’t done with me yet. Whatever
bone he had to pick with me, he wanted to make sure I remembered him, and I
will always remember him.
My pain level went from 2 to 12 the moment he inflated that tampanade,
yet he refused to prescribe any pain
medication. I requested a prescription
for Zofran, as the Ambulance Tech had
insisted I do, and he refused that one too.
I left your prestigious hospital crying, in extreme pain, and so
nauseated that I nearly vomited in the parking lot.
I cried
with pain all night, as the left side of my face swelled to twice it’s size
overnight, such that I could not open my left eye the next morning. I had gotten in on an emergency appointment
with my ENT Wednesday morning, and she was appalled when she saw me. You see, the tampanade is like a NIKE gym
shoe. The AMOUNT of air is easily
adjusted via an external valve, to accommodate the patient’s comfort. It is
meant to be a gentle pressure bandage to stop bleeding. Mine was left so over inflated that I had a large, gumball sized air bubble
protruding my left sinus that went from the bridge of my nose to the bottom of
the sinus. It was so over-inflated it
had blocked the tear duct, putting incredible pressure on my left eye, top
teeth, and sending nerve pain shooting into my left ear. All night I cried from one eye, and reflected
on my experience with Dr. Dave’. I wondered
if, as he lay down to sleep, he even gave me and my blessing a second thought.
My ENT
released some of the air from the tampanade, prescribed Zofran, prescribed pain
killers, prescribed blood pressure lowering medication, prescribed an
antibiotic, prescribed a sterile sinus wash “absolutely necessary” for anybody
with a sinus tampanade over an open wound with an already drug resistant
infection, and left it in place because it stopped hurting as soon as someone
took the time to let the pressure out.
Ms.
Burrell, I am nearing the end of my journey on this earth, losing a battle with
Common Variable Immune Deficiency (IgG & IgG Subclass 1&3) and
complications resulting from it. I
learned a long time ago that how I walk my journey, is so much more important than how long I have here. So, I try every day to bring love, laughter
and sunshine to my own life and to those who cross my path regardless of the
circumstances.
Corny,
idealistic, “good for you”, you might think, but then you likely haven’t been
where I have, at least not yet. I have
to rely on your staff when I am in an emergency situation, not only to treat
me, but to do so with the same dignity, respect, and compassion that I show
them, so I make sure I go out of my way to demonstrate that. I’m asking for, and expect nothing less in
return.
I did not
deserve the abuse I got at Dr. Dave’s hands, and I hope that when he tells you
his side of the story you can explain why, because if you can’t than you must
admit, something is seriously broken, and perhaps there is a way to fix or
salvage some promising young talent before it’s too late/perhaps it already is
too late.
For a day
or two, I actually lost faith in humanity Ms. Burrell. I haven’t allowed that to happen to me in a long, long time, because I KNOW that
life is too short, and there are a million “life suckers” out there waiting to
take. I never expected to have to fight
with one, in your hospital, in a dire moment of need. Ms. Burrell, without hope we die; without
faith, it’s hard to pick the heavy burdens back up and go on. I’m sorry to tell you this, but your ER made
it very hard.
