Meghan O’Rourke in The Atlantic: Doctors Tell All—and It’s Bad.
Having watched my father in his last days, most of which were spent in the hospital, everything she says is true. Being in a hospital, even a smaller one like my dad was, is a terrible experience for all involved. The routines and lack of connection with reality can cause serious mental disturbances, especially in the elderly. Sleep is difficult at best, the food unpalatable and most of the staff, from doctors down to the maintenance folks, are overworked and seem distracted. It’s a truly awful environment.
It’s not all bad. My dad had been going to a podiatrist for months complaining of a painful toe. The podiatrist (I’ll refrain from calling them a doctor) misdiagnosed and mistreated it. Finally, they sent him to a rheumatologist who basically took one look and sent him to the emergency room. If not for that, he would have died sooner.
But he still spent months needlessly in pain. He wasn’t the type to complain so I didn’t think much of it until he finally admitted to me one day that he had trouble sleeping because of it. But by then it was too late, though we didn’t know that at first. That trip to the ER ended up being months of time in the hospital interspersed with time in a rehab facility before he finally passed. He never made it back home, even for a visit. But even in the hospital, getting pain medication for him required far more work than it should have. Since the doctor only stopped by for a short period each day (if at all), asking the nurse for something more than Tylenol required them to have to page the doctor so that he could prescribe something stronger. This would then allow the nurse to unlock the pain medication cabinet for a pill. And if he needed another one later, we would have to go through the same process again.
I don’t place all the blame on the doctors and staff. They were working within the system as it exists today. Most of them were kind and caring and did the best they could under the constraints they must deal with. But something fundamental has to change. After what I’ve seen, I hope I die of a massive heart attack or get hit by a bus, literally anything that will keep me out of a hospital or nursing home. It shouldn’t be this way.