When Dad Goes to the Hospital

My father, who just turned 99 years old, was just released from a New York hospital after having an amazing, almost unbelievable, medical procedure. Last fall, a new technology became available in the US. This technology is a device which allows the heart's aortic valve to be replaced without surgery. It is called a TAVI or trans aortic valve implant. Engineers have developed a small heart valve which can be compressed and loaded onto a catheter. The catheter is then threaded through the iliac artery located in the groin. The catheter is advanced up the aorta until it reaches the heart. When it gets to the aortic valve, the new valve is released from the catheter. It springs open, crushing the old valve, replacing it, and anchoring itself in place. This incredible technology has given new life to people who are too old or frail for traditional valve replacement.

As I've written before, my father is one of those semi-bionic people whose life has been extended by cardiac bypass, stents, and a new aortic graft that allows blood to bypass a large abdominal aneurysm. And now he has a bionic heart valve.  All of this allows him to continue to live happily and independently with my mom--his wife of 71 years---and to continue to visit numerous diners in the state of New Jersey.

My father's TAVI, done at a highly regarded medical center, was just about a miracle. It was performed by some of the most skilled and most highly trained doctors in the world working on the very cusp of modern medicine.  I am awed by them and incredibly grateful to them. 

After leaving the high tech cath lab and spending an hour or so in the recovery room, my father was ready to heal. Following a two night stay in the cardiac care unit, however, he had not slept in almost 48 hours. The alarms in his cubicle and the cubicles of others went off relentlessly throughout the day and night. We were told that the bells and beeps could not be silenced, despite the fact that most of them were meaningless. He was wakened at 3 am for a sponge bath and at 6 am by doctors who were rounding before starting their day. At the age of 99, two days of sleep deprivation (following 3 hours of general anesthesia) is barely tolerable. We agitated for hours to have him transferred to a regular bed, but none was available.

The following day, a bed did open up on another unit and my father was transferred. But things got worse. There he shared a dark, shabby room with another patient. Within a few hours, his roommate "coded" and my father was picked up bodily and removed from the room while emergency teams sprinted in, deep frightening both him and my mother. When things finally calmed down, he was returned to his room only to find that there was something wrong with the water pipes. When we turned on his sink, a filthy black sludge poured out. We were told we would be brought filtered water.

The bed, like all hospital beds, was hard and smelled like plastic. It was impossible to sleep because of the automatic inflation and deflation of the mattress, meant to prevent bed sores. The sheets did not fit on the slick surface of the bed and kept detaching whenever my father moved or rolled. Light was sparse and the TV was either too loud or too low. The food that was brought was barely recognizable and largely inedible. Certainly, it was not healthy. There were cursory visits from nurses who were overstressed and overstretched. There was constant noise and no space. Tubes, trays, urinals, gowns and chairs crowded every available inch and made movement impossible without tripping. Neighboring rooms housed patients with worrisome coughs and isolation tags on their doors. Catheters and IVs that should have been pulled days before remained in my father, clear pathways for infection in any patient but clearly dangerous in someone his age. 

As has been our practice whenever my Dad has been hospitalized, my sister and I began an immediate campaign for early discharge. We spent days trying to convince nurses, physical therapists and doctors that we would take better care of my father at home. Ultimately, we were able to get him sprung and we fled with him, half dressed, in the first available wheel chair. We felt as if we were making a prison break and might be caught at any moment and sent back to our cell.

The moral of the story? Our understanding of healing and recovery lags far behind the advances we have made in medical technology. That this should be so is maddening and seems inexplicable, mainly because the needed changes seem so obvious. What would any of us want if we were sick with the flu? A wonderfully comfortable bed, light and air during the day and deep quiet at night, simple and healthful food, a constant and caring hand, a soothing touch.  Perhaps you might argue that such an environment can't be created in a busy hospital. I would argue that we should create the technology that allows this kind of care, not just the technology to which we give such undivided attention. 

In a larger sense, our American approach to health lacks a similar concern for healing. While we pay ample attention to the latest pill and the newest meter and gadget, we are not very good at working on healing ourselves while we still can. The same principles apply. What we need to do is obvious but we tend not to do it, relying instead on the flashy fix. But fixes are not healing.

As I write this, I am sitting on the couch with my father, mother and my sister in my parents' home. My father is nodding off while his favorite news program plays softly in the background. Tonight, he ate his favorite dinner and my mother rubbed his shoulders, made sure his clothes were comfortable and clean and fussed over him. Soon he will go to sleep in his own soft bed and wake up to a flood of morning light coming through the windows. There will be fresh coffee. And hopefully, he will heal.