A Hospital Almost Killed My Brother

Let’s get the personal blame game over quickly. My brother has just started peritoneal dialysis for advanced kidney disease. That part was going pretty well, with him being able to do it correctly at home, with the support of his wife and the dialysis center. He is 75 and she is 73, so there was a steep learning curve. But his nephrologist felt he could master it, and he seemed to be on the track to being able to do it himself while he slept, the ultimate goal. But he did a foolish thing. He went to some large group gatherings unmasked. And he got COVID.

When he was having difficulty breathing, they decided to drive to the closest hospital. Unfortunately, this was more of a surgical-center with a lovely lobby and fancy accommodations. Our father was sent on the path to his death 12 years ago there, and things have not improved. With the exception of the ICU, which put my brother on a ventilator, gave him excellent care, and likely saved his life, once he was moved to a “regular” floor, they did their best to send him on the same path as our father.

None of his regular doctors were consulted, as they were affiliated with a different hospital system. Different hospitalists were in charge of his case every few days. His wife also came down with COVID, so he had no advocate there for him that first week. For unknown reasons, and without his knowledge, they removed him from several of his important medications, including what he took for gout and prostate issues. PT was unable to do more than move him to a chair, and every day over the next almost three weeks, he grew weaker. He developed a bacterial infection, for which they never found the source, although there is a pretty good chance the first nurse who attempted his peritoneal dialysis contaminated it by not cleaning the port properly and then dropping the dialysate. After that, they sent nurses from their nephrology department, but the damage was done. They wanted to send him home, even though he couldn’t walk, was very weak, had stairs in his apartment, and his wife was limited in what she could do to help by her age and her own physical condition. Finding a rehab to take him where there was someone trained to do dialysis was challenging, but finally he was transferred.

The rehab discovered that, in addition to the missed medications, using the wrong strength dialysate, and allowing him to become dehydrated, he had developed a bedsore. But my brother is determined to regain enough strength to get home. And I think he will. But it could easily have ended very badly.

How to Avoid Bad Hospital Care

Take COVID, Flu, and RSV risks seriously, especially if you have an underlying condition or are over 65. Get vaccinated. Mask. And ask the staff of any doctors’ offices you visit to mask in your presence. Avoid indoor crowds, especially when you are not sure others have been careful.
Choose an ER where most of your doctors are affiliated. It may not be the “best” one, but at least your regular care team can be involved.
Remember those bags women packed to take to the hospital when they went into labor? After hearing many ER nightmares, I have created a checklist for a potential trip to the ER. Of course, my list includes phone, charger, glasses, and a book (because I never leave home without one).
For any trip to the ER or hospital, always have a list of the actual current meds you take and when you take them. My online list is always filled with medications I no longer take.
Bring whatever toiletries you need to make you comfortable. Often enough, trips to the ER end up with long stays in “no man’s land,” even if a patient is not admitted.

I’m not outing my brother’s hospital. It’s in another state and could be any understaffed, poorly managed one which has endured mergers and is managed with a business rather than medical model. The state of medical care in our country has definitely deteriorated. Be careful out there.