I grew up in a house where a bad cold carried the possibility of being a life threatening infection. My mother, a medical doctor, seemed to make a lingering cough and sore throat into one of the multitudes of diseases she had seen on the wards. Perhaps due to those exaggerations, I went in the other direction where every ailment would more than likely go away on its own given enough time. I mean that is the purpose of our white blood cells- to fight infections.
After a routine colonoscopy (though young, I have IBD), I curled up in pain in the fetal position arguing with my mom that I did not need to go to the emergency room. Half bent over, I hobbled along; I made it to the backseat of the car where I continued to lie in the fetal position. When we arrived at the local hospital, two security guards met us by our car to provide us with a wheelchair if necessary; my parents deemed that it was necessary.
I am a certified phlebotomist (the person who draws blood), an EKG tech (the person who puts stickies on your chest to check your heart), and a licensed x-ray technologist. The following experience was a role reversal in that I became a patient. Frequently as a healthcare provider, I only see a patient in one section of care, the one of my trained expertise. For the first time, I got to walk in the hospital booties of a patient.
The Great Wait
Nothing feels like a greater paradox than an emergency room wait being 5 hours long. It becomes more like the we-will-get-to-you-whenever room. The emergency room was packed as though there was a mega sale on healthcare. “Get your free CT scan today. We’ll poke and prod you with needles until you feel like a voodoo doll.”
During the wait, I had my blood pressure and temperature taken periodically. I was also registered. As though the wait was not torturous enough, the tv played Titanic on repeat.
I consider myself fairly patient, but even I started whining at the wait. Pain is relative, and so I started comparing it with the time. “It’s not bad enough to sit here,” but my parents stated we weren’t leaving.
Eventually, we made it through the two electronically controlled doors. The ER tech rolled me to a room and then left me there to my own devices. I locked my wheelchair and lifted the foot rests. After making the five steps to my prepared stretcher, the wheelchair temporarily resided in the doorway. My mom’s anxiety kicked in as she peered around looking for any healthcare worker to solve the dilemma. Eventually, she put it in the hallway outside my door.
Inside the ER: a barrage of new faces
Shortly after changing into the gown, a man appeared. He introduced himself as a nurse and stated he was not my nurse. He started my IV, took my blood and my history, and then he disappeared never to be seen again.
A new man entered my room and introduced himself as the doctor. We discussed my history a bit more thoroughly, and then he talked about tests he would order. He washed his hands and answered my questions with a smile. Then he too disappeared beyond the doors.
I finally met my nurse. She jovially introduced herself. She then hung a large plastic bag of fluids and handed me a cup for my pee. After the bag had emptied into my vein, I sought out the bathroom. She unhooked my IV, and while covered by the thin piece of cloth, I felt exposed on my way to the bathroom. When the nurse returned to find my full specimen cup, she expressed a great joy as though she were a young kid receiving gifts on Christmas. She hooked me back up to the IV and skipped off to run a test.
A large machine rolled up and stopped in front of my room. The x-ray tech arrived with the portable machine. I sat upright, verified my name and date of birth, and we exchanged a minimal amount of words. She placed a hard plate behind my back, laid an oversized piece of lead across my lap, and instructed me to take a deep breath when she was ready to expose. Just as quickly as she arrived, she removed the plate from behind my back, laid the bed back down to its previous position, and away she rolled with the machine.
A new face knocks on my door and unexpectedly sweeps me away, stretcher and all, to the CT department. A CT in many ways is like an x-ray. Granted, it doses the patient with more radiation, but it’s fast and provides diagnostic information. After getting me onto the table and discussing the necessities, she flushed my IV and prepared the iodine contrast. After the two breath holds, they started the contrast. A rush of warmth ran down through my body, warming it from the inside out. While warned of this effect, no words can compare to the sensation. After the scan, the tech came out and flushed my IV. I hopped back onto my stretcher. I eagerly agreed to a warm blanket, and then I was back in my ER room.
My nurse returned with new bags to hang from my IV pole. She told me the blood results showed a high white count. Typically the white count doesn’t exceed 10k, but mine was 18k. They started me on two drugs, in addition to the standard saline solution. She told me that she was in the process of getting me admitted.
The doctor briefly popped back in to tell me I was being admitted because my white count was too high. The CT scan found the inflammation in my colon and inflammation in the walls of my ileum (small intestine).
A flash of a woman in human form appeared. She told me she was preparing everything for my admittance, and then *poof,* she was gone.
Room and Board
The woman who took my blood pressure in the ER waiting room appeared and wheeled my stretcher up to my room. It was 4:30 am. I hadn’t eaten in 2 days due to the colonoscopy, and I had yet to catch a moment of sleep. My exhausted parents said goodnight.
Shortly after finding myself in solitude, a new nurse introduced himself. He explained how the system is in the process of being updated, but as of now, he needed me to answer all of the questions I had already answered downstairs. For the next 10-15 minutes, he stared at a computer screen, clicked and typed. I made it upstairs only an hour or two before shift change. I would be receiving another new nurse soon. In the meantime, I tried to catch a few minutes of sleep.
In my half asleep state, I heard two people enter my room. One was reading off my history to the other. I rolled over to face them and said hi. Then they were gone again.
About an hour later, the nurse practitioner sat down in the chair next to my bed. After his introduction, he began discussing the results of the tests. He said I had an ileus (when the bowel stops contracting, and food is unable to be pushed through). The treatment is bowel rest (bowel rest=clear liquid diet). When lunch time came around, I got to order apple juice and hot tea. I was content with that because even though I hadn’t eaten in two days, I did not feel like eating. My belly was still slightly distended, and I had minor abdominal pain.
I then saw two different doctors, one was a general physician, I imagine an internist, and the other specialized in GI (gastrointestinal). Throughout all of this, they had contacted my GI doctor, the one who had performed the colonoscopy and diagnosed my ulcerative colitis. The GI doctor spent more time with me than the internist. He sat on the end of my bed and drew a diagram of the GI tract to aid in our discussion. He said he would defer to my specialist and we would follow that treatment.
The nurse practitioner came back in to give me the update. He spoke with my GI specialist too, and we found out I had an infection. I was to start two new medications. Then I was told if I could tolerate solid food, I would be discharged. I had to schedule a special MRI called MR enterography, which is used to see detailed pictures of the small intestine. That experience deserves its own blog.
So what did I learn being a patient?
As an x-ray technologist, I briefly spend time with patients for their studies. I likely never see them again. As a patient, you see so many new faces it’s like the revolving door in reverse; instead of new patients, you see new healthcare workers.
Everyone in healthcare is so specialized now that for the different tasks needed, there is a different person. As a patient, the only person you have a chance to build a rapport with is the nurse. However, they are often busy treating multiple patients, so they pop in and out. Although healthcare has started to move in the direction of treating patients as guests, certain facts remain. A patient is unwell, and that is why they are there. The healthcare team addresses that first and foremost.
Even though I saw a multitude of faces, they each treated me with respect and care. While the interactions were brief, I still remember each of their faces. I think that is the goal I strive for with each patient. Taking that extra moment to get them a blanket, or make a joke. Treating patients as both patients and people should be the distinction of good care.