Sunday, May 15, 2011

Hospitals: A Necessary Evil

As I type this first entry, I am sitting in the dark of mi madre's hospital room. I am her sole caregiver and have been so for more than a decade. This is my choice and I do this with great love, but I will not lie and tell you it is easy. We have been functioning below the Poverty Line for many years, primarily because I was unable to finish graduate school due to Mami's ill health. Then I became gravely ill myself and once I was better, Mami went into another decline. It has been many years since I held a paying job, but the job I've chosen to do is mostly satisfactory. It's hard. It's messy. It's scary on many levels. It's challenging. It's alternatively thankless and rewarding. It never stops being surprising.

Of course, I've screwed myself over. I was in my thirties when I began taking care of mi madre as a caregiver. Now I'm near fifty and my body is breaking down. Unlike mi madre, however, I have no child to care for me when I am old. As in the book, Like Water for Chocolate, I took on the traditional role of the unmarried daughter caring for the parent. Unfortunately, I will not have anything when my mother dies other than debt and my writing, such as it is. Most of the time I'm okay with this eventuality because Mami is a great deal of fun and mi amiga. Not enough people are able to say they are friends with their mothers and far too many believe I am very strange because I am so close to mine. I am sad for those who don't have a relationship like ours and I have worked to help friends repair their relationships with their mothers and will likely continue to do so the rest of my life. The key is seeing your mother as a person, not just as your mother. It's difficult, but doable.

So back to the hospital.

A week ago, Mami refused to read her Sunday newspaper. From that point she went into a rapid decline that was so fast it caught me off guard. By Wednesday morning, I knew I had to get her to the hospital. It took me until pre-dawn Thursday morning, but somehow I got her into passable condition, even through her fighting me, and got her into her wheelchair on the second try. I have no idea how I managed, but I was calling upon my ancestors for help so perhaps they gave me the strength I needed.

We went by taxi to the nearest hospital and they took her to the ER area immediately which meant I was HATED in the waiting room by those who'd been sitting there for hours already. I can't blame them. It was brutally cold and the seats uncomfortable. No television either. Everyone there was poor. A few, I suspected, were homeless. They had no way of knowing I was as poor and had already been homeless a couple of times in my life myself and that I was in no way passing judgment upon them, of course. All they knew was that we walked into the the ER and Mami was taken to a cubicle straight out of triage, no waiting, and that made them angry. Having been stuck in a cold ER with fresh gut stitches from surgery newly busted after a fall for twelve hours myself once years ago, I empathized totally with their positions.

We were in the ER for about sixteen hours. Then, because of a cardiac situation, it was decided to move Mami to a nearby hospital with better cardiac care unit.

I wish we were still at the other hospital. So far, I have little to no confidence in this one.

At the ER hospital, upon admittance, Mami was to have a coordinating physician to help us understand and organize all the other kinds of doctors Mami needs. They were addressing her urinary issues, her gastro-intestinal issues, and her heart issues. Here, however, the cardiac crew has taken over and her other problems are being shoved aside or outright ignored. Frankly, I'm about ready to spit nails.

The first RN Mami had in the CCICU was great. She was calm, assured, and instilled confidence. She made Mami and me feel secure and I was able to get some rest. The RN caring for Mami on the next shift, however, was not as good.

Chris, a pretty white young looking 26 year old boy with a habit of touching his male colleagues on their arms or shoulders even though he made great store of talking about his girlfriend, was charming enough, but he gave me a very bad first impression. As soon as he sat at the observation desk outside of mi madre's room, he became enrapt with his telephone and even though he closed the shade in an effort to disguise his actions, it was blatantly obvious that instead of reading Mami's charts or orders or what have you, he was texting back and forth.

Peeved doesn't even begin to describe my reaction. My solution was simple. I aimed my mean schoolteacher look in that boy's direction until he realized he'd been caught out and he did not get on that telephone again in my presence. He also proceeded to suck up to Mami, who is fond of pretty young boys, and it worked to some degree. Chris was bad at following through with some things, but he was good at explaining what he was doing. He believed me when I said he needed to tell mi madre what was going on so she didn't become afraid and that was good. He didn't, however, follow doctor orders exactly, letting her have liquids when her orders said she was NPO. She was thrilled about having tea and juice, but I cannot help but be concerned about orders being ignored in such a cavalier manner.

Another reason I am not thrilled with this hospital is that I was misinformed about when they were going to move Mami out of the CCICU. They did so when I had left the hospital to go home and get some things together for us and by the time I found Mami via the operator, Mami was in a panic and in tears when she heard my voice. I had been told they weren't moving her until morning, by Chris, so I was FURIOUS.

Then, of course, our apartment building had a fire alarm go off in the wee hours and for the first time since living there, the elevators shut down. For good measure, the water went off too. Lucky for me, I'd done laundry already and had clean clothes to put on. Unlucky for me, I had to put clean clothes on my stinky self. Then I had to carry a suitcase, a large insulated bag full of mostly bath towels, and my messenger bag down seventeen flights of stairs to get out of the building to get a taxi to the hospital. Mami cried when I walked into her room. Honestly, I once again think my ancestors helped me along. I'm sure of it.

Mami's day RN for yesterday was a very cute AfAm lady named Daricelle. Gorgeous dimples. Alas, she spoke in a high-pitched baby voice that made my ears bleed pretty quick. Okay, exaggeration, but I'm sure you know the kind of voice I mean. Daricelle was good in many ways, but she wasn't very good at communication without constant prompting and questions and it turned out she wasn't very good at follow-through either, particularly in the instance of Mami's request for pain medication for her arthritic joints. Per the next RN on duty, no note about such was left in the notes on Mami's chart.

The night RN, Brandi, an Anglo woman with another irritating voice, came in with attitude. In fact, she made me so angry with her rudeness to Mami at one point I ranted for a good fifteen minutes, speaking as clearly and loudly (no shouting, of course) as I could so that anyone listening outside the door would hear me. Mami was mad too. It's amazing the power one yields by having a laptop and the ability to write effectively. Mami and I have have been through too much to take crap from an RN having a difficult day. We are ALWAYS polite. Okay. I am. Mami hollers and mouths off when she is in pain or someone moves her wrong, but she never uses bad language or insults. She simply gets LOUD and says, "Make it STOP!" "I want you to go away!" And so forth.

Anyhow, I'm pretty sure Brandi, RN, got the big clue after my rant because she's been sweet as pie ever since. I, of course, have been even more excruciatingly polite than usual. That's how you know I'm ticked, by the way. The more excruciatingly polite and distant I am, the less I think of a person. I learned that trick from watching my late father, a minister.

Oh, typing of thinking very little of people, I haven't mentioned the doctors here, have I? Well, yesterday we had Dr. Kim come in for about a minute on his own very early, and then he came in with his boss and other interns/residents/med students for a grand total of about thirty seconds. Dr. Kim had looked at Mami briefly when he was alone and poked about a bit. His boss, however, didn't do anything but shout at us (they all think Mami is deaf because she is old and that I'm addled because I'm her caregiver) about them scheduling her CT scan for Monday.

That's more than enough of an introduction for now. I'll try to fill in with non-medical saga items. I have a couple of wonderful cookbooks with me for entertainment and one of them is truly hysterical and in just the first ten pages or so had me laughing aloud. More on that later.

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