Medical Care in 2024: You Can’t Always Get What You Want (or Even What You Need)

I naively (and arrogantly) thought there were ways to avoid some of the pretty bad encounters my brother and friends have had recently with our medical care system. I even took the liberty to create a list, but only #1 ended up being helpful, as I learned January 20. I spent a total of 16 hours at two ERs, which I guess was standard waiting time to gain admission for a 3-day stay in Evanston Hospital. Granted, it was a weekend, which is the worst time to get sick. My bad. Here’s my original list, with revisions:

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.

There are two ERs near where I live, both part of the same system as most of my doctors. I went to Skokie Hospital, the one that specializes in orthopedic problems and is usually much less crowded. Indeed, there were very few people in the waiting room. But that was highly deceptive. I was in a great deal of pain and kept telling the triage nurse, but she claimed the rooms were all taken. After eight hours, I was finally invited into the hallowed space, only to discover countless open rooms, but almost no staff. When they offered to admit me after a total of 11 hours, there was no way I wanted to stay in that hospital.

After I came home from ER #1, it was clear that I was weak, at risk of falling, and not safe at home. Fred called the EMTs, who took me on my first ambulance ride. I naively thought coming to the Evanston Hospital ER via an ambulance meant I would be seen right away. Not true. They put me in a wheel chair where I joined the throng of desperate, sick people who had been waiting for hours to be seen. Since I had already waited so long in its sister hospital ER, I thought I deserved some credit for time served. No such luck. After five more painful hours, I made it into the inner sanctum. While there was plenty of staff, every room was filled. I was finally admitted to the hospital, but there were no rooms. (See #1 – lots of sick people). I dozed on the cot, had some tests which I don’t remember, and was moved to the world’s smallest hospital room on the neurology floor.

Remember those bags women packed to take to the hospital when they went into labor? After hearing many ER nightmares, I created a checklist for a potential trip to the ER. Of course, my list included phone, chargers, glasses, hearing aids, and a book (because I never leave home without one).

This was not a bad plan, but there was only one outlet I could reach, reserved for my phone since the room phone was broken. Everything else was plugged in – somewhere. Never really read my book – too hard to concentrate. Glasses and hearing aids, however, were very useful.

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.

Curses, foiled again. My list was complete and accurate, but once you are in hospital, all time is suspended. Meds showed up according to the nurse’s schedule, not mine. But here is a somewhat useful bit of advice. Before giving medication, they scanned my bracelet QR code. Thus, I felt I had the right to check things out on my side. Before taking a pill, I always asked what it was for if it was not part of my regular list. While I always thanked whomever was helping me, by day three I became “difficult” and rejected medications like a blood thinner injection (as I was going to the pain doctor the next day for a steroid injection) and insulin because, as I kept telling them, I’m not diabetic.

One side note I was not expecting – all of the nursing staff were young men. While they needed to accompany me to the bathroom because I was using a walker, I found it impossible to do what I needed to do if they stayed in the room. Even when I shooed them out, I didn’t like them standing right outside of the door either. I assured them I would pull the help cord when I needed them to get me back into bed. I wondered if men felt this way about female nurses back in the day.

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.

Once again, I was partly right here. Dry shampoo and a hair brush were helpful for morale. But the hospital gowns were the worst, especially when wearing two of them for “modesty” when walking with the PT. After the nurses returned me to bed double-gowned, I became so tangled up I couldn’t move, So, I asked to be escorted to the bathroom and changed into a short-sleeved housecoat with a zipper up the front and my own underwear. I was much more comfortable in my own clothes, and none of the staff objected, as they still had access to any part of my body they needed to reach.

What did I learn from my personal experience with our healthcare system:

Medical transport vans have their own wheel chairs. No need to borrow one like I did.
The PT is your friend. Mine was wonderful and even figured out how I could safely enter/exit our car that has bucket seats. I ordered a wheel chair pad, slapped a sheet of that blue film she gave me to secure it, and no more medical transport vans needed.
ERs are terrible. Sick people have no other choice, especially on weekends.
Never pull a person by the arms to help them get up from a fall or out of a chair or bed or car. Use a gateway (transfer) belt (or any belt you have on hand) and gently pull from the back.

Having a concierge doctor is useless when you are in hospital. I was very lucky to have a knowledgeable Hospitalist in charge of my case for the duration of my stay, and my husband is a doctor as well as a great advocate. My brother and friends have not been as lucky, leading to care that lacked continuity.
Most hospitals have endured mergers and buy-outs (NorthShore is soon to be Endeavor) and are managed with a business rather than medical model. The state of medical care in our country has definitely deteriorated. Be careful out there.