The goal for all of our patients is to get them healthy and out of the hospital as quickly and as safely as possible. Well, we currently have a patient who has been admitted since June. That's correct, they have not been out the walls of the hospital in nearly four months. No fresh air. No warm sunshine on their face other than what filters in through the windows. They came in very sick and unfortunately had one complication after another.
As rocky as the medical course has been, the social issues are even more touchy. Just imagine this: You hop on a plane from Canada for a nice visit to see your family in the States. As you share old memories and laughs you suddenly collapse. Thankfully, you can't remember the whirlwind of being rushed to the emergency department and then flown hours away for more medical care. When your mind finally begins to clear you are surrounded by white coats trying to explain your new circumstances. You can't make out their medical terminology, and in fact, you can't make out anything they are saying because you don't speak their language. For days and weeks you nod your head to be polite and treasure the few minutes a day that they take the time to use the interpreter phone. Some days are physically exhausting; other days are emotionally draining. Not only are you sick, you are lonely. Some days you wonder how this will all end. You are sure you've ruined your family's future as you wrack up hundreds of thousands if not millions of dollars of medical bills. And of course there is no health insurance to cover these expenses. You can no longer eat. You struggle to breath. You can't understand the doctors let alone the television. And your family is hundreds of miles away. Why are these people surprised that you are falling into a depression?
So here we are. What do we do now that they are almost "stable" yet still so medically fragile with a long road ahead? The standard answer would be to transfer to a skilled nursing facility or a rehab center for additional therapy. Unfortunately, the reality is that these places can't really afford to take uninsured, foreign patients. It is a limited resource after all.
Our thoughts wonder how different it would be for this patient if we could just get them home. All that medicine and therapy has too offer will be available from their socialized system. Now, how can we cross that border? Trust me, we've been working with who and what we can, but it's, of course, more complicated than I can begin to imagine. After exhausting our other alternatives, the best plan for now is to get the patient healthy enough to make a 14 hour drive with some family across the country and across border to the nearest Canadian hospital. Even as I type this I hesitate knowing all of the extraordinary things that would have to happen for this to be a safe journey. I know how wiped out I might feel after that road trip let alone all that they will have to deal with along the way. Feeding tubes. Medications. Dressing changes. Stools. The Foley. Suction devices. DVT prophylaxis. And on and on. This is going to require super-human strength.
As rocky as the medical course has been, the social issues are even more touchy. Just imagine this: You hop on a plane from Canada for a nice visit to see your family in the States. As you share old memories and laughs you suddenly collapse. Thankfully, you can't remember the whirlwind of being rushed to the emergency department and then flown hours away for more medical care. When your mind finally begins to clear you are surrounded by white coats trying to explain your new circumstances. You can't make out their medical terminology, and in fact, you can't make out anything they are saying because you don't speak their language. For days and weeks you nod your head to be polite and treasure the few minutes a day that they take the time to use the interpreter phone. Some days are physically exhausting; other days are emotionally draining. Not only are you sick, you are lonely. Some days you wonder how this will all end. You are sure you've ruined your family's future as you wrack up hundreds of thousands if not millions of dollars of medical bills. And of course there is no health insurance to cover these expenses. You can no longer eat. You struggle to breath. You can't understand the doctors let alone the television. And your family is hundreds of miles away. Why are these people surprised that you are falling into a depression?
So here we are. What do we do now that they are almost "stable" yet still so medically fragile with a long road ahead? The standard answer would be to transfer to a skilled nursing facility or a rehab center for additional therapy. Unfortunately, the reality is that these places can't really afford to take uninsured, foreign patients. It is a limited resource after all.
Our thoughts wonder how different it would be for this patient if we could just get them home. All that medicine and therapy has too offer will be available from their socialized system. Now, how can we cross that border? Trust me, we've been working with who and what we can, but it's, of course, more complicated than I can begin to imagine. After exhausting our other alternatives, the best plan for now is to get the patient healthy enough to make a 14 hour drive with some family across the country and across border to the nearest Canadian hospital. Even as I type this I hesitate knowing all of the extraordinary things that would have to happen for this to be a safe journey. I know how wiped out I might feel after that road trip let alone all that they will have to deal with along the way. Feeding tubes. Medications. Dressing changes. Stools. The Foley. Suction devices. DVT prophylaxis. And on and on. This is going to require super-human strength.
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