MEET EFFIE

This is a story about a little girl named Effie. She was about 10 years old when I met her, some 50 years ago. Truth is, I don’t really remember what she looked like—only that she was slight, mousey, somewhat unkempt looking, and subdued.

I met her in the hospital. I was in the ob/gyn ward for testing and a surgical procedure. Back then, hospital rooms were either two patients to a room (that was the more private level of care) or a ward of 8 patients. There was no such thing as a private room.

Since the testing I was undergoing was not painful or strenuous, when no tests were scheduled I was “free to roam”—within limits, of course. But I could walk around the ob/gyn area. And that’s how I met Effie.

Understandably, all of the patients in this area were women—and all were there for reasons relating to women’s reproductive health. The gynecological patients (which I was) were separated from the obstetric patients. So, there were no newborn babies or nursing mothers nearby.

In the course of my wandering around the area, I met a Puerto Rican woman, in one of the 8 bed wards. She was in her mid-50s—likely in the hospital for a hysterectomy. The nurses were very concerned about her because she wasn’t eating. Keep in mind, this was in the days before “get you in and get you out” hospital stays. You could be there for upward to a week for even routine surgery. So, her not eating was of concern. Because I am nosey, and was wandering around chatting with other patients, I quickly discovered the Puerto Rican woman spoke no English. The daily food choices were printed on menus in English and given to patients each day to circle their choices for meals. If nothing was circled, the default meat was beef. This woman did NOT like beef. After talking with her a bit (dusting off my high school Spanish), I learned that she had not been circling any choice on her daily menu. So, she constantly was served food she didn’t like. A bit of quick translation on my part—pollo y puerco—and she was able to give her preference and began eating again. (When the nurses discovered my “translating skills,” they asked me to tell the woman not to smoke with the oxygen tanks so close by!)

Back to Effie. As you can see, she was an anomalous patient. She didn’t need ovarian surgery, as I did. She didn’t need a hysterectomy as did the Puerto Rican woman. And, I assumed she wasn't pregnant because this was not the obstetric part of the hospital. So, what was her problem? When I talked with her, all she could tell me was that she understood she had a “growth” in her and needed to have it removed so she could get better.

Well, that piqued my curiosity. Growth? In a gynecological ward? It didn’t take much figuring to work out that she WAS pregnant. I was so stunned, that I asked a nurse—why does Effie think she has a growth and doesn’t know she is pregnant. The nurse explained (note: this was in the pre-HIPPA days) that a) the child had no sexual understanding at all. Obviously, she hadn’t been told “the facts of life,” including what it meant when she began menstruating early; b) she was about 8-10 weeks pregnant; c) she had been impregnated by her father; and d) the hospital was going to use a procedure which would cause her to go into “labor", deliver the fetus, and then go home. BUT she was NOT to be told why she would have all this done—that she was pregnant.

That’s the last I heard of Effie. I have long wondered what happened to her? Did she return home to be abused again? Did she realize, when she reached adulthood, that the pains were that she experienced as a girl in the hospital was actually “labor”? Where did she end up in life?

So, why I am telling you this long story? I am telling you this because this is a sad occasional reality. Pre-teen girls become pregnant because someone impregnates them. A medically safe abortion is a kindness for that young girl.  I am also telling you this story because it happened in 1970—before the Supreme Court decision on Roe v. Wade. Then, without abortion being legal and safely available, women AND girls who became pregnant had few options. Yet, someone found a way to have Effie’s wrong pregnancy terminated. Not that I think it was handled in a way that was psychologically healthy—but it was handled.

I leave you to draw your own conclusions about what criminalizing abortion will do. BUT one thing I can tell you—it will NOT end abortion. But it will end medically safe procedures. Like it or not, you cannot accomplish the end of abortion until you make it impossible for a woman OR girl to become pregnant.

The Last Report

Forgive my silence, dear reader, and the rather extended pause in the on-going saga of hospital care in the U.S.  I have been away--but my absence is testament to the fact that the recently inflicted treatment must have worked.


When my doctor said he wanted to try a new prescription for atrial fibrillation, he also noted there was something I wouldn't like: a hospital stay.  At the time, my only response was--no problem.  I just have two trips that I am planning to make, and, if I can fit in the hospital stay between those two trips--well, fine.


So, at the beginning of December we went to San Diego to see our son and daughter-in-law, then over Christmas we traveled to South Africa and met up with our daughter and son-in-law. The doctor didn't blink at my schedule caveat--so I am guessing he hears such conditions frequently.   His response--I think we can work something out.  And work it out we did.  Trip 1, hospital stay, and then trip 2.


As anyone who watches the myriad of health shows that have been televised knows, hospitals are places of great drama.  There are daily mini-dramas.  My two roommates are illustrative.


The first roommate came in very shortly after I was admitted.  She was wheeled in, and transferred to her bed. With her came a retinue of family--sons, daughters, spouses. Who knows who all was there?  All I could tell was that there was a hub-bub of activity on the other side of the room.  Since my husband was with me, I just rolled my eyes to indicate my puzzlement--and, yes, maybe intolerance.


But over the next two days, this family showed warmth and support.  You see, the woman was in her 80s.  She had been, until a few weeks before, a picture of health, quite independent and most certainly stubborn.  Then, she had a fall, and a subsequent stroke that leveled her.  She was hospitalized, and then a heart condition became apparent--she had multiple blocked coronary arteries.  


Her family members buzzed about her, trying to make her comfortable, tut-tutting if she tried to move or do something.  Even though the curtain was drawn, I could hear them saying "Mom, you can't do that" or "Call the nurse for that."  It seemed a bit over-done to me, but she was clearly the glue in that family's fabric--a true matriarch.


When no one was there, I went to her bed and said hi, and introduced myself.  I asked if she needed anything, and she managed a very weak hello followed by a demurring of help.


As it turned out, that seemingly overwhelming family was really tremendously supportive.  At one point, I heard the older son say to his sleeping mother--Oh, Mom.  It was a heart-felt cry.  Later, he came over to my side of the room and sat down and visited for quite a while.  Another son also made a point of introducing himself to both my husband and me.  For a brief two days, I almost seemed to be included in that expansive family.

When the mother went in to surgery, one son stopped by to see me, just to see how I was doing.


And, then, there was my second roommate.  With the matriarch in surgery, and being returned to a more intensive care room, the bed next to me was empty.  Soon, a second post-surgery patient was wheeled in.


What ensued was a circus.  First, with new patient in the room, all the staff departed.  Then the phone rang.  And rang.  And rang.  So , I said--through the curtain--just push the red button.  Meaning, of course, on the phone.  But new patient thought I meant on the device to call a nurse.  She kept saying, loudly, HELLO, HELLO.  Then she said GEORGE?  I finally got out of bed, went over to her side of the room and pointed out the telephone.  Of course, she had NO idea who I was, and gave me a wild-eyed look.


Then, a nurse came in (maybe in response to the call button) and said--Barbara, don't move around so much; you have to stay still.  As soon as the nurse left, Barbara tried to get out of bed.  That set off a loud beeping alarm which produced several staff members.   This happened multiple times, each time with an accompanying loud beeping alarm.  Every time they came into the room, they said (quite loudly)--Barbara, what are you trying to do?


Soon, another staff member came in, and began to ask Barbara some questions.  Herewith the conversation:


Q--do you know where you are?  A--I am at So-and-so's house.
Q--why are you there?  A--I am at a party.
Q--do you know what year it is?  A--(pause) 1998.
Q--do you know who is President?  A--Al Gore.
Q--aren't you in a hospital now?  A--(most indignantly) NO.


Oh, my.  Other than the startling news that Al Gore actually won the election (well, he did--but that's another story altogether), the whole conversation was most bizarre.  But, I recognized the questions as standard ones asked to ascertain whether or not someone has dementia.  Oh, and Barbara most certainly did.


Layer dementia on top of the disorienting experience of being in a hospital, and no wonder Barbara looked at me with wild eyes.


Most annoying of all, each time a staff member came in to see Barbara, they asked if she wanted her television on, and then JUST turned it on.  And turned up the volume.  I told my husband--I can't stay here another night if Barbara is my roommate.


Thankfully, when the doctor came in (finally), after initially saying I had to stay one more day so that I would have the requisite number of doses of the new medicine--and after being informed that in fact I had HAD the correct number, he agreed to discharge me.


Hospitals--places where life's dramas, both tragedy and comedy, play out.  I promise--this the last report on my hospital stay.


Next up, the trip to South Africa.

Oh, the Sights, the Sounds, the Smells...

Here I go again--relaying tales of being an impatient in patient. 

In addition to my initial observations, captured here, I offer now the feast of the senses that a hospital stay can bring to you.

The first thing that really strikes me is the SOUNDS.  There are dings, buzzes, beeps, muffled voices, loud voices, confused voices, footfalls, cart wheels, squeaks--too many sounds to be able to convey them in silent print.  We do live in an increasingly noisy world, but a hospital adds new dimensions to the world of noise.  Most of us are accustomed to hearing cell phones.  At least when it's your cell phone, you know how to identify the sound.  In the hospital, the sounds are simply baffling.  Is that beep coming from me?  And should I do something about it.  Most of the sounds trigger a staff reaction--understandably.   We patients are tethered and monitored and an errant sound might mean we are making a concerted break for it.

Next come the sights.  While a hospital is generally a sterile environment--not in the bacterial sense, but in the artistic sense--there is plenty to see in a hospital.  There are, of course, the ubiquitous fluorescent lights.  They are on everywhere...all...the...time.  Day and night.  My bed was closer to the door, so at night, the hall light came pouring in.  I drew the privacy curtain (huh! is that ever mis-named) not so much for privacy but for a bit of light dimming.  At home, I need a dark dark dark room to sleep happily.  There are many other sights--some potentially embarrassing.  Hospital gowns are not made for modesty.  The opening in the back can fly open at the slightest provocation.  Don't even try to keep your clothing on...any care requires some skin exposure.  So, you just learn to bare what you must.

And then there's all that measuring.  Your height, your weight, blood pressure, heart rate,  lung clarity, oxygen level, water intake, urine output.  Oh, yes, you get measured.  The urine part was...interesting.  You place a small plastic contraption inside the toilet seat, and when you have finished, you either put the plastic container on YOUR shelf, or you read and record the amount.  I asked to do the latter--even converting the ounces to milliliters (why oh why didn't the U.S. convert to metric?).  Several times, I went to the bathroom only to find my roommate's container still inside the toilet seat.  

Now we come to taste--which would be food.  Only, don't count on much.  I had checked into the hospital late morning, and--when asked--told staff I didn't need lunch.  BIG MISTAKE.  Supper did not arrive until much later than I expected it.  And by then, my decision to abstain from lunch was working against me.  When supper did arrive, it was a  box lunch.  With a bologna sandwich.  On white bread.  I thought--you have to be kidding.  On a cardiac unit, a high salt, low fiber sandwich.   Oh, yes, along with  applesauce and a pack of Lorna Doone shortbread cookies.  While the remainder of meals improved a tad, I was still mostly hungry.  My roommate even remarked that she had been in another nearby hospital recently, and the food there was much better.  

One more post to go on the fascinating world of hospital care.

Hospitals--Not for the Faint Hearted

So, I just returned home last evening from spending three days in the hospital.  Never fear, it was an entirely planned hospital stay--in fact, wedged in between a trip to San Diego to visit our son and daughter-in-law and another upcoming trip to see our daughter and son-in-law.

I am a Type A personality (if such labels still exist).  Patience is NOT one of my virtues, and anything annoying....well, it annoys me.  So, when the doctor announced that my recalcitrant blood pressure, that just would not come down, despite adding new medicines, needed yet another new medicine, he also announced--and you're not going to like this.  What? I asked innocently.  Well, you need to have it administered in the hospital.  All for to monitor my heart rate.  I mentioned a while back that I was rebooted and regained my sinus rhythm.  Premature announcement, as it turned out--even though it was true at the time.  Because, dear readers, I lost my rhythm.  Humph.

New med is designed to bring down BP and to help a heartbeat stay regular.  But, every now and then, it actually causes the heartbeat to go all wonky.  Hence, the need to wear a 24 hour monitor for several days. 

Hang in there with me: I am just getting to the good part.

Hospitals, I have decided, are not places for the faint hearted, especially not if one is NOT really sick.  For three days, I felt a bit as if I had wandered into the set of making of the movie "One Flew Over the Cuckoo's Nest."

Herewith some random observations.

• Check your modesty and need for privacy at the registration desk.  You will not need it.  You get poked, prodded, pummeled...well, maybe pummeled is a bit of exaggeration.  You have your "vitals" checked endlessly.  Even all through the night.  I would be in a sound sleep, only to hear a chirpy voice saying "Just checking your vitals" as I felt an ear probe measure temp, blood pressure, pulse.  Thank goodness that's where the vitals check stopped.  And privacy?  Nope--with a roommate (which I had) there were family visitors coming in at all times, along with a seemingly endless parade of hospital staff: RNs, nurses' aids, housekeeping, food services, social workers, the occasional chaplain, and -- is it?  It just might be a DOCTOR!  Woo hoo. 
• Forget efficiency and speed.  Things move at a glacial pace (pre-global warming) in the hospital.  I arrived, as ordered, late morning on Monday.  Not until three, almost four hours later was my medication regimen begun.  And, since it necessitated 48 plus hours of continuous cardiac monitoring, that time made a difference.  It was not until the second day of being in the hospital that someone from the cardiac practice came to see me, and then only because my husband called a number the practice had given us.  When the doctor did arrive, he pointed out to me that "this is a hospital and there are emergencies that we have to deal with; people arriving in the emergency department, with heart attacks, etc."  I meekly accepted it, thinking all the while--that my husband's call was the proverbial squeak that garnered the dollop of grease the doctor's visit represented.
• If you are interested in a retreat-like pace, slow deliberative moving toward an unknown goal, then the hospital is the place for you...except it's not a silent retreat.  More on that in the next post.