It’s been over a decade now, but still my dad says it was the worst night of his life.
It wasn’t the night of his heart attack, or the night of his open-heart surgery (a quadruple bypass). It came after that, as he lay awake in the cardiac ICU, intubated and pumped full of fluid to keep up his blood pressure, unable to move or to speak as a result of the breathing tube that ran through his bloated lips and down his throat.
That night, the worst of my father’s life, was the night the breathing tube got caught. The air still flowed into his lungs, yes, keeping him alive, but where the plastic tube stuck against the back of his throat, he had the feeling of being continually gagged, choked, with every breath he took. Making matters worse: this gagging made him cough, and when he coughed it shook his organ-deep surgical wounds, causing excruciating pain, the likes of which he’d never felt in his life: “like a hot hatchet in my chest.”
On and on, for the entire night, with every mechanized breath, my dad gagged, until he had no choice but to cough, each cough another hot hatchet in his chest.
And nobody came to check on him.
Nobody came to look into his tearing eyes to see how he was doing. Nobody heard his coughs over the whirring machines. Nobody came close enough to his bed to see him wiggling his feeble limbs to get their attention. My dad was choking, (MY FATHER WAS CHOKING!), for six hours or more, in the cardiac ICU of one of Boston’s most prestigious hospitals. And nobody came.
Not until the shift change. The nurse in the morning looked in, and seeing his frantic distress, quickly discerned the cause. She adjusted the tube–just a few precious millimeters made all the difference in the world.
The nurse assigned to my father the previous night, we later learned, was in charge of just two patients–which doesn’t sound like a lot. But that night that other patient had been in need of truly urgent attention—he had nearly died—drawing all of the nurse’s energies. Apparently my father’s vital signs were holding strong that night–the gag-induced panic didn’t affect his automated heart pump or machine-controlled oxygen flow.
And so my father spent an entire night alone, feeling like he was on the verge of gagging to death, a red hot axe hacking in his chest.
Looking back on that terrible night, as we discuss the upcoming Question 1 ballot measure, my dad tells me he does not blame the nurse. “Those nurses were great overall, they really paid attention. But that night she didn’t have the help she needed. That other guy almost died.”
Nonetheless, the story of that night has gone down in family lore as offering up a lesson–the kind of lesson we cannot, must not ever forget. That the work of taking care of people is sacred. That paying close attention to those who are suffering matters. That the difference between a nurse who takes the time to look you in the eyes, and one who doesn’t, can be the difference between a night of manageable pain and a night of living hell.
It’s not an academic lesson, not in a family like ours that is full of clinicians–my brother and sister-law are both PAs, my mother, aunt and cousin, all MDs. I trust that hearing the story of my father’s needless torture has made them all more caring and attentive healers. Their patients are lucky to have them.
But as we are all now learning, even the best intentions are often not enough in a health care system that increasingly under-staffs hospitals, pushing nurses to shorten time with patients, speed up care–and pump patients through as if they were appendages to their paperwork.
Patients are more than pulses that generate profit. Patients deserve more than to be kept alive. They deserve to be cared for, their suffering taken as seriously as we would have others take ours.
And so there is a social and political lesson here as well. For as every sped-up worker knows: attention is a scarce and precious resource; there is only so much that one person can do.
It is simply not possible for nurses or other medical workers to give patients the care they need and deserve when they don’t have safe staffing levels. Let’s be clear: in true emergencies, sometimes even one patient is too much to handle.
So what happens to other urgent–but maybe non-life-threatening–patient needs when all hands-on-deck must be devoted to addressing just the immediate emergencies?
I’ll tell you what happens. Patients like my dad are left alone to choke and gag and cry silently for help all night even as that help never comes. A red hot axe in his chest.