As I reported a few days back my son (who is in his early twenties) recently broke his back in a bicycle accident. He came very close to losing his life and had a very close shave with paralysis. Even now, he's not entirely out of the woods but the remaining risk is low.
Collectively we decided to not go the surgery route – a
pathway also recommended by the neurologist/spinal specialist. Surgery has its
own risks but if successful the risk of paralysis (which remains due to the
slight possibility of movement within the broken vertebrae – and thus damage to
the spinal cord) would be eliminated. However, he would have hardware in his
back and if you're familiar with spinal dynamics a fused section will generate
problems down the road. I can't even begin to count the number of people I have
encountered over the years who have expressed frustration with back surgery –
because all too often it becomes almost a chronic process with subsequent
surgeries and a life of pain becomes almost normative and expected.
The surgeon admitted that if he took a mercenary attitude he
would simply insist on the surgery. He would be able to wash his hands of the
problem, but if it were his own son he would eschew it knowing the misery
associated with it and the long and painful recovery. In some cases, there's no
choice and if my son's situation changes it may end up being the only option.
The recovery is prolonged regardless of the choice we make, but
the surgery would be worse and with heightened risk of complications. My son
will be in a restrictive brace for the next few months – a clamshell as they
call it with a connected neck brace. He's all 'locked in' and cannot move with
his chin and neck held in place. It's not pleasant but he's young, more
flexible than most, and while miserable I think he's dealing with it rather
well. He can walk and move between bed and a high-back chair and thankfully he
can use the bathroom unaided.
To our surprise once he was stabilised – they wanted to send
him home. He spent Saturday night in the trauma center, Sunday in an Emergency
Room cubicle, and when a bed became available he was admitted late Sunday
night. Because we live in a rural area, the nearest Level 1 Trauma Center is
about two and a half hours away in Pittsburgh. There's a Level 2 closer to us
(in Erie, Pennsylvania where they took Salman Rushdie), but our son needed top
level trauma care and we're thankful that he's got one of the best spinal guys
around. But for us that was rough, long hours of driving to and from the city (while
perpetually exhausted) and of course you get beat up paying for things like
parking ($22 a day). And yet, it could have been worse – a lot worse. The
travel was made a little rougher by the fact that I have to do all the driving.
Unfortunately my wife cannot drive at night due to eye problems and yet I also believe
it's my responsibility anyway to take on the dangers and stresses of driving. I
see too many men abdicate these basic responsibility and leadership tasks and
take a passive role even in the mundane tasks of daily life. I'm not saying a
wife can never drive – I'm not a Wahhabi or aspiring member of the Taliban. What
I'm saying has nothing to do with subjugating women but I do believe that while
women have their burdens they also have their blessings and privileges (as it
is with men), and one of them is to be protected and free from having to take
that kind of active role with the responsibility and danger – which is
certainly present with driving. But I digress and I wouldn't bind anyone to
what I'm saying – it's mere food for thought.
We're also thankful that the rest of our kids are more or
less young adults at this point and are able to be both autonomous and helpful
in running the house and taking care of things. And of course now that our son
is home, we can't imagine if his mother/my wife was some kind of career woman
or worked outside the home. She'd either have to quit or I guess we could bring
in some kind of home-health caregiver – a stranger. But to be honest, watching
the hospital staff we have grown rather paranoid as more than once we were
given bad information and had to intervene as people did not understand the
nature of his injury and the doctor's orders regarding the brace. One physical
therapist said it could be taken off while sitting up. When I later spoke to
the specialist he said 'Absolutely not!'
You have to watch it as the bureaucracy is complex,
communication is often poor, and I find there are a lot of poor listeners out
there (which is hardly surprising). If I might digress again, on a connected
note to listening skills and the decline of attention span, driving into
Pittsburgh I counted dozens of people driving 75 and 80mph staring at their
phones, sometimes in heavy rush hour traffic. It seems like this phenomena
keeps getting worse and traffic deaths are on the rise, and yet no one seems
willing to do anything serious about it. I'm sure I'm not the only one to
notice but to me it seems like it's actually getting worse.
My sister-in-law who is a recently retired nurse marvels that
more mistakes aren't being made as the younger crop of nurses lack the
necessary gravitas required to do the job, the ability to concentrate, make
proper observations, and administer medications. And everyone (it seems) from
the retail world, to professional settings, to the medical world is constantly
trying to sneak peeks at their phones. It's an obsession and it's all the more
visible to you when you don't have one. It's as if the world has gone mad.
Prior to the accident I've spent the last couple of weeks
working in a nearby town and I feel bad for this little girl living next door
to my jobsite. Her obese mother (who seems to perpetually have a cigarette
dangling from her mouth) simply stares at her phone all day. It's no
exaggeration! The kid is trying to engage her but she cannot be torn away from
that screen even while walking down the sidewalk. The poor girl doesn't have much
of a chance in life with that kind of parenting.
Returning to the matter at hand, our son was discharged on
Thursday evening. A friend of mine thought it was some kind of Acts 5 miracle.
God is certainly to be praised in this and all things and we are not unthankful
for my son's progress but this wasn't a miracle. This was dollars and cents and
the nature of the insurance-dominated medical bureaucracy.
Initially there had been talk of sending him to a 'Rehab'
center for a short-term stay however he didn't meet the criteria. If he had a
secondary condition – a wound, cancer, or something like that, he would have qualified
but in his case he did not. To be fair, there wouldn't be a lot for him there
anyway as he's not ready for rehab or physical therapy. That's months from now
when the brace comes off. It would have been nice to have had a little more
time to get used to the brace, work through the logistics of it, and spend some
more time in a medical environment getting his pain management and mobility
sussed out. But without the rehab option – just like that, it's time to go
home.
It felt like we were being rushed out the door and the
medical personnel admitted that it was primarily due to two factors. First, the
insurance industry will not pay the hospital bill unless certain criteria are
met and once he's stable, they want him out. Second, and this is legitimate –
there's a shortage of beds and thus there's pressure to free them up. The
medical system is overwhelmed right now and yet some of the reasons are not
being made abundantly clear to the public – some rather glaring points I'll hopefully
touch on in another post.
He had just received his brace and taken his first steps, and
it felt like we were being pushed out the door. It was frustrating and we
scrambled to compose (what became) a fairly long list of questions and points
of clarification regarding his brace, care, movements, and so forth. We also marveled
as apart from some quick thinking one could easily get lost in the swirl of
information and find themselves at home lacking answers or unprepared. We had
to move furniture and scrambled to make preparations. You have to be very
conscientious and deliberate. Thankfully my wife and I make a good team if I do
say so. We complement each other and after twenty-five years together we can
just about read each other's thoughts.
And let's just say it's not easy to get a hold of people if
you need help or have questions. You have to navigate phone menus and then the
gatekeepers. One tires of explaining the entire scenario and subsequent events
over and over again and then being questioned and doubted – and then given
ambiguous or unhelpful answers. Many readers will be familiar with what I'm
talking about.
Once again (in the grand scheme and often in the particulars)
it's a case of profits being put over people and one also gets the impression
that there are too many bureaucracies at work and privatisation does not fix
this. The multiplication of players not only multiplies the opportunities to
cash in and make money off the pain and suffering of people – it decentralises
the process, a process that desperately needs to be streamlined and provided
with clear top-down authority and guidance.
In some cases it's outside vendors or contractors – again, some
of which are desperate to get involved and tap into the money, whether they're
needed or not, or actually provide any 'services' or not. In other cases, it's
internal hospital dynamics and the way in which these departments are
structured. We can already see the billing is a mess and likely to turn into a
disaster. For-profit hospitals also play their games when it comes to billing,
and it doesn't lead to better health care. In some cases for each department to
check its box – another examination is done. It got to be almost ridiculous as
multiple doctors came in doing the same thing over and over again, asking the
same questions, each evaluating him with (supposedly) a slightly different
emphasis – and each department sending out a bill.
In my son's case, he actually has a full time job that provides
health insurance – which is increasingly rare in the blue collar world. And yet
the deductibles are high and then at some point he may face another dilemma.
He's going to be in the brace for three months and then likely out of work for
another three months beyond that. He drives Class A trucks (big
tractor-trailers), however his company works exclusively with flatbeds which
means there's a degree of physicality with his work that is not found with the
drivers that you see for say a company like Wal-Mart. They back in box
containers into loading docks, open the doors, de-couple the trailer, and drive
away. In his case, he spends a lot of time strapping, chaining, climbing up and
down off the trailer (in all types of weather conditions) in order to secure
large loads – everything from lumber, to wood pellets, to steel and different
components at different stages in the manufacturing process. Thankfully it's a
regional orbit and so while he sometimes works very long hours, he's home every
night and is off weekends. It's not a bad situation.
I'm not sure if or when he's going to be able to return to
doing that kind of work which involves a lot of cranking, pulling, jumping up
and down and so forth. It's physical and they have some drivers quit for that
reason. They also have to cover a lot of their loads and the canvas tarps are
well over a hundred pounds and require strength to position, unfold, and
secure.