Jay Lake (jaylake) wrote,
Jay Lake

[personal] Medical follies, family edition

Sometimes they keep you in the dark and feed you bullshit.

tillyjane a/k/a my mom is not having her angioplasty this morning. The hospital committee has ruled it doesn't sufficiently address her symptoms. Mind you, this is a procedure she needs at some point in the not too distant future regardless, and right now it's the only option the cardiologists have come up with for addressing her symptoms, but as they have said, they're not certain.

This is closely akin to coming into the ER with a broken ankle because you have a bad hip, and the hospital refusing to treat your bad hip because it won't help the broken ankle. It doesn't make any freaking sense. And that after both patient and cardiologist have agreed upon it as the next step.

Her entire stay, both of them, at this hospital (part of a major West Coast provider that is both hospital operator and HMO) has been characterized by bizarre medical behavior that, while not rising to the level of malpractice, falls somewhere between incompetence and black comedy. This particular hospital system requires the hospitalist (ward doctor) be the single-point-of-contact and gatekeeper for all communications with specialists or other departments. This means the nurses, patients et cetera don't get to ask questions or see the specialists unless the specialists happen to think to come to them.

Which might be okay, except so far the hospitalists on my mother's case have been bizarrely incompetent. During her first admission, the hospitalist tried to send her home because she'd "had too much caffeine", and there was nothing wrong with her. It was also utterly clear that the hospitalist was either reading someone else's chart, or badly misreading my mother's chart. Later one we had the other hospitalist carefully explain the results of the first angiogram quite erroneously, directly contradicting in detail what the cardiologist who'd performed the procedure had told me and lillypond immediately after the procedure was done. On investigation, it turned out we were right and the hospitalist was wrong.

It's pretty clear that the nurses on the ward aren't very happy with the hospitalists and their gatekeeping. It's also pretty clear that the cardiology team is internally divided along some political fault line (I've never before heard a doctor badmouth another doctor in a professional setting). It's pretty clear the hospital has serious medical communication issues.

Meanwhile, my mom is not being treated. The current "plan" is to send her home, and if the undiagnosed and untreated cardiac symptoms recur again, to re-admit her and perform the procedure they have denied her today.

Unfortunately, because her insurance is tied to this hospital chain, she can't go anywhere else unless she goes out of pocket. Which isn't financially possible for her or our family. So we're stuck inside their web of lousy communication, incompetent hospitalists, and treatment denial.

Meanwhile, I am off to chemo and can influence none of this. Grr.

Tags: cancer, family, health, healthcare

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