Hospitals, Some Politics, But Mostly Anecdotes

Part 1: How Hospitals have Changed

In the 1980’s, I did a rotation as an intern in an Emergency Room¹. We didn’t have the tools and technology available today. But the differences go far beyond that. I know that from the time I’ve spent in the last month in ERs with my husband.

Here in suburban Philadelphia, two hospitals closed several weeks ago, meaning that patients ended up at other local hospitals, causing overcrowding, delayed treatment times, patients in the ER (or ER overflow area) for days because no inpatient beds were available. It’s becoming increasingly critical nationwide. More info. Cliff Notes version: private equity buys and then closes hospitals; not enough doctors, nurses and staffers; and an aging population. Not often mentioned in discussion of hospitals (and also impacting other health care facilities) is the deportation of immigrants, who tend to provide services like maintenance, food service, and “aides” - all critical functions that tend to get overlooked.

We are lucky because the hospital system we utilize is not-for-profit². And the hospital we are closest to isn’t seeing patients from the closed hospitals since it is (for lack of a better term) “several hospitals away” from the area where the closed hospitals are located. The system itself is first rate in terms of the ranking of the hospitals. The care is excellent.

And yet, so different.

First and foremost, to enter the hospital ER, there’s security. This is true not just of the hospitals in the systems, but many of the ancillary facilities. While I understand the danger, as a wife, trying to get into the ER because my husband was brought by ambulance, I don’t want to stand on the line, and if I didn’t desperately need to keep my car keys, phone and wallet, I’d let them keep my purse if they’d just let me in - because every second away from him is physically and emotionally painful to me.

Segue anecdote:

I have been a patient, visitor, and overnight guest, at close to every hospital in the Philadelphia area, and I can tell you, the ER security check is actually funny. If you come in the main entrance of a hospital, they don’t make you clear security. And you can get to the ER from the main part of any of the hospitals. Just sayin’.

Back to Part 1:

And then there’s triage. Back in the day, initial triage was done at the front desk. People who had had a heart attack, were in labor, were bleeding profusely, etc., were immediately sent to a bed for evaluation, and everyone else answered a few questions, and asked to sit in the waiting area. As soon as a patient on a gurney was evaluated by a doctor, support staff took over for things like bloodwork and tests, and the doc moved on to the next patient, and as soon as possible, more people were brought back for triage.

Now, triage is accomplished by nurses and EMTs. They have a wealth of equipment we could only dream of back in the 80’s. Technology has advanced so that, for example, blood can be drawn in triage and some results are available in a matter of minutes, which helps inform diagnostic decisions.

Once in a bed in the ER, other tech is incredible. For example, if an x-ray is needed, the machine comes to the patient, and the results are instantaneous. As someone who has personally aligned and shot x-rays, and then developed them, this is lightyears ahead of what we used to do.

Under the best of circumstances, patients spend a lot more time in the ER than they did back in the day. While we did simple procedures in the ER, a lot of times we sent the patient somewhere else. For example, we could remove a bullet from the musculature of an arm, stabilize the patient, and release the person. But for a bullet in the patient’s torso, we’d immediately send the patient to the OR. I think you get the idea: the ER was relatively quick.

Now, though, patients are able to be evaluated by a lot of specialists, and some tests take a while to be undertaken and decisions on admittance are made. Sometimes as an inpatient, sometimes only for observation.

Part 2: The King of the Gypsies, and My Mom

Back in the 1960’s, my mom read an article about the King of the Gypsies needing to go into the hospital in NYC. The King, and his minions, didn’t really trust doctors or hospitals, but he had something serious (and for the life of me, I cannot recall what it was). My mother, and her mother, were likewise suspicious of a lot of modern medicine. So they really took this story to heart.

There were a limited number of visitors a patient could have at a time. Like 2. But the whole crew of gypsies came with the King to the hospital. They were in his room, they were in the hallways. The story my mom told me was that they brought candles and “healing herbs”. They hung scarves and talisman around in his room. When security tried to remove them, the story goes, they received “the evil eye” and retreated. He was never alone.

In the end, the doctors prescribed surgery and the minions said to just give them a couple days. I don’t know if it was spells or what, but, per my mom, he never had the surgery, and lived another couple decades.

This convinced my mother that no one should ever go to the hospital alone. And if they were going to do things, someone else should be there to say “no”, in case the patient couldn’t. Which leads me to:

Mom and the Hospital, Anecdote 1, a True Story

I needed to have my gall bladder removed. I didn’t want my mother to know. Don’t worry, when we get to “Mom and the Hospital, Anecdote 2, Another True Story”, you’ll understand why.

So I didn’t tell her.

An ex-friend drove me to the hospital, and my plan was to call someone the next day to bring me home.

What I didn’t know (and why she is an EX friend) was that she called my mother and told her.

After surgery, I was in recovery, and I was so very happy. Good drugs. I thought there was a fire, or at least in that half-sleep, I thought I heard a fire alarm. But no, all of sudden there were people making me sit up, calling my name, gently tapping on my face until I opened my eyes. My blood pressure had tanked below 80/50 and they were concerned. I told them I had low blood pressure, no worries, lemme go back to sleep. But someone sat with me and every time the alarm went off, she shook me and they were discussing what to do, and all of a sudden a grey lady³ came in. She said: “Jessica’s mother has arrived and wants to see her.” My blood pressure hit 200/120.

Mom and the Hospital, Anecdote 2, Another True Story

I needed major surgery and couldn’t hide it from my mother. She and my dad took me to the hospital. I asked that they just drop me off and leave, but no dice. They took me to a patient room, which could hold two patients. The woman in the bed closest to the door was there with a minister and two friends. As we came in, they were praying.

I got into the bed by the window, with a curtain between myself and the other patient. My mom glued to my side. The nurse came in with some paperwork. And then, the anesthesiologist. My mother looked at him, questioned his age, asked if he was board certified, and I asked her to leave. I thought she went and joined my dad in the hallway. The anesthesiologist and I discussed my allergies, and he left. The nurse came back and asked if I wanted to sign a DNR. When I said yes (and I swear it happened just this way, and if I could make stuff like this up, I’d have a future as a fiction writer) from behind the curtain, my mother yelled “She’s just a child, she can’t sign a DNR” (I was 37) and then, the curtain flung back, the minister said “Jesus loves you”, the women started singing “Nearer My G-d to Thee” and my mother started chastising them because we’re Jewish. I asked the nurse to kill me now as I signed the DNR.

You’d think that was the worst of it, but no. They told my mother that surgery would last 3 hours. They didn’t tell her that after I left her sight, I’d be taken to the “surgical victims waiting room” where we all discussed “what are YOU in for?” as they arranged the various surgical suites, thus delaying the start of surgery within that 3-hour window. In addition, there were complications, and the surgery lasted longer. Per my dad, at exactly 3 hours and one minute after they told mom “3 hours” she went through the “Authorized Personnel Only” door yelling “Where’s my kid?” and was hauled out to the waiting room by a security guard.

Part 3: The Politics of Health Care

My husband and I are very lucky. We have excellent corporate health insurance. If we owe a lot, we have an HSA. If financial disaster occurs, we can mortgage the house. But the probability is that my husband’s care won’t break us financially. He’s on his third hospitalization in a month, plus tests, procedures and chemo.

Most Americans are not that lucky. And yes, I recognize my privilege every minute of every hour of every day.

This is why you need to call your Rethuglican Senator and tell them to vote down the “Big, Beautiful, Bill”. If it passes, people will lose their health insurance - and yes, that means Medicaid AND ACA coverage. Not to mention the decrease in Medicare that will be triggered on 1 January 2026 because of the increased deficit. Further, more hospitals will close, leading to more overcrowding, fewer doctors, nurses and support staff at the hospitals that remain⁴. And when hospitals close, that contributes to health care deserts. Check out the maps. Not to mention the fact that hospitals support 1 in 6 jobs (directly and indirectly) in the country. Infographic.

Part 4: Why I Wrote this Piece

My husband took ill very suddenly. In this past month, he has been fighting for his life. (Not being histrionic.) I can’t make him better, but I can do everything I can to be helpful. So many people have been so very helpful in doing all they can to be supportive - and I cannot ever say “thank you” enough.

But I’ve had a “break” while he’s been in the hospital these past 4 days. First, I actually slept. A LOT. Safe in the knowledge that he is in an excellent hospital with superhuman nurses to ensure that he has everything he needs. People keep telling me to take care of myself. And so, I thought - what do I like to do more than anything? Write. I LOVE to write. So here we are.

I leave you with a question. For normal people, in times of stress, at the end of the day they want a glass of wine, or a beer, or a martini. Not me, what I want is an ice cold Yoo-Hoo in a glass bottle. Which they only have at the WaWa. You can get those crappy juice boxes of Yoo-Hoo, but it’s not the same. Most people either have never heard of Yoo-Hoo, or have tasted it and say “yuck”. So my question is — what is that food or drink that YOU like that no one else does? I’m curious.

And now I’m going to bed.

1. Yes, they call then “Emergency Departments” today - but I’m old.

2. If you’re a local: Main Line Health, and our pick fave of their hospitals is Paoli.

3. “Grey ladies” work in the waiting room, and give families information on their loved one.

4. Why fewer? Think “burnout”.