[Erika]

The weekend here tends to be a little slow with posts, so I thought that I would share this experience that I had from yesterday.

I have been growing angrier and more frustrated the more that I think about it so I’m writing this in an attempt to quiet and maybe transform those negative emotions into more positive ones. Sometimes writing alone will accomplish that and other times sharing it with others helps even more to lighten the load, so hope that you all don’t mind that I post it.

I own and operate a multi-disciplinary holistic health care clinic where I work as a Physical Therapist, Biofeedback Specialist and Nutritionist...as my own body allows.
Having MS has been a gift, in the sense that over the years of dealing with my own challenges, those challenges have helped me to better understand the challenges that others with health challenges face. I do my best to be a good health care practitioner and believe that begins with compassionate listening to others and having true concern for their well being. I do strive for that and hope that other practitioners do as well, but sometimes we can all fail in that respect.

There is some understanding of the reasons behind that failing and I'm always working toward gaining more but the events of yesterday weigh heavy on my mind even this morning. Someone fell through the cracks as it were and suffered for 3 weeks needlessly.

That someone is an elderly and rather frail woman who has struggled with severe osteoarthritis for years. She is a regular patient of mine and comes in for massage therapy on a regular basis every two weeks to help maintain mobility.

Both she and I were too ill two weeks ago to see each other, so a month had elapsed from the time that I saw her last. My heart sank when she struggled into the clinic yesterday with the assistance of a cane and her husband’s arm.

She could not stand erect and she immediately said that her right hip had been giving her extreme pain for the last 3 weeks. She said that she had been to her doctor a couple of times, but that she never did perform a physical exam or even touch her. Suspecting a hernia, the doctor had ordered x-rays and a diagnostic ultrasound and my patient said that the results of those had apparently come back clear. Her doctor had prescribed morphine for the pain but my patient said that it wasn’t helping. Her husband said that he had taken his wife to the ER twice in the past two weeks because of extreme pain but that she had been sent home each time after receiving shots for the pain.

Her husband and I helped the woman to get undressed and onto my hydraulic lift treatment table but it was not without some difficulty. She was just in so much pain that to find a way that she could move somewhat comfortably was tough.

My heart sank again when I began to assess and palpate the woman’s hip. There was a palpable and audible “clunk” on movement which caused her extreme pain and she began to weep.
I nearly did too…but more out of frustrated sadness; for I suspected that this poor woman had been suffering with a hip fracture for the last 3 weeks and that no one had caught it.

It was difficult to tell her of my suspicion because she was already at the breaking point emotionally. She immediately said that she was tired of going to doctors, the ER etc, only to be told that they could not help her and to be told that she just needed to take more pain meds. I comforted her and told her that I would make some calls and set things up so that she would be properly taken care of.

It was her PCP’s day off but I spoke with the nurse at the physician’s clinic and got the x-ray and ultrasound report faxed to my office. Those diagnostics were of the pelvis and I was disappointed to find that no assessment had been done on the hip itself. I called the doctor’s office back and spoke to a physician friend there who agreed that the patient should go to the ER for X-rays of the hip. He said that he was heading there in the next hour to do rounds before going home for the day and that he would check on her. I called the ER to alert them that she was on her way.

The patient’s husband called my office from the ER just as I was leaving the office for the day to read off what the radiology report said. The x-rays had revealed “a proximal shaft compression fracture of the femur with fragmentation”, and he wanted to know what that meant as no one was explaining it to them.
They had only been given that assessment on a scrap of paper by the ER nurse after being told that she would need to go to another hospital that had an orthopedic surgeon.

Seriously?
Where has compassion gone in the medical field?

These are two elderly people; he in his early 80s and she in her late 70s. Their children, some of whom I have met and strike me as being very caring toward their parents do not live in this town. The nearest one, their daughter, who they seem to see the most, is a 9 hour drive away.

Did anyone ask about their family or support situation? No.
Yet he too was on the verge of crying when I spoke with him when he called from the ER yesterday. Surely someone at the ER would have been able to pick up on it that these people needed some supportive help…but apparently not...too busy to notice I guess.

I know that it can happen and I do understand that such oversights are not necessarily intentional or malicious. It just seems to be the way that things are going these days. Everyone is so busy...especially in an ER on a Friday night. Yet even with that rationalization going on in my mind yesterday, a bit of mother bear still came out in me.

I asked him if he would come back to my clinic which is on the same block as the hospital so that we could get some things sorted out away from the bustle of the ER. I suggested that by the sounds of things that his wife would need to stay at the ER until they arranged for an ambulance to take her to the other hospital, which is 90 minutes away.

He then said that he had already been informed by the ER nurse that he was to take her to the other hospital once they got hold of an orthopedic surgeon. In the mean time, he was supposed to take his wife home and wait for the other hospital to contact them with an appointment date and time.

What? They weren’t going to be arranging for an ambulance even though she had just been diagnosed with a fractured hip?
Unbelievable!

I excused myself from the husband who said that he would come to the clinic and promptly called my physician friend on his cell phone. He was at home by then but after hearing of their situation, he said that he would look into it because he thought that she would have been transferred by ambulance that night; although he had placed her care with the on-call ER physician before leaving the hospital.

When the husband arrived, we called their daughter who spoke to her father in just the right way to put his mind at ease. I have no idea what she said but I could see him relax and the worry lines on his forehead ease. When he hung up he said that she would be leaving straight away and that she would drive through the night to be with them by morning.
I've met her and she is such a sweetie...truly she is.

My physician friend called back a while later to say that he had gotten hold of the orthopedic surgeon at the other hospital (luckily a friend of his), who had expressed concerns about potential blood clots from the fracture. The orthopedic surgeon would see her in the morning but suggested keeping her under observation until then. Arrangements were being made for the woman to stay over night in the ER, and to then be transferred to the new hospital in the morning via ambulance.

It had been a trying afternoon for all of us and with evening approaching I convinced the husband that it would be best for him to go home to try to get some rest; rather than staying at the hospital with his wife.
The poor fellow was so stressed with all that had gone on and worrying about his wife, that figuring out that he could take her their cell phone so she could call him if there were any problems, had escaped him as an option.

We left my clinic together and he wept a bit when we said our good-byes. He would be going back to the hospital to say good night to his wife, give her the phone and to tell her about the change in plans. I felt so bad for him to be going home to an empty house that night and asked if he wanted me to go with him to the hospital and then to his home. He assured me that he was just fine and that he was just so relieved that things had been taken care of; so I gave him my phone number and asked him if he would call me once he got home to make sure that he got there safely.

Then he said that he was so grateful for the kindness my physician friend and I had extended to two old people who didn’t matter.
“You matter!” I blurted out. Then added, “…and to more people and more deeply than you will ever know.”

I don’t know why I said that just then…the words just came out by themselves.
Thinking about it now, I realize that the needs of these two people helped to push me past my own self concern toward doing something that mattered more in that time.

I must admit that there was a part of me that rather than to get involved with their situation, was anxious to go home at the end of the day because I am nursing a cold and don’t feel too swift myself. But taking the time to help them has filled my heart with joy and hopefully I will remember that, so that it will help to change the way that I think and act in the future.

Ok…so now the anger is gone and I feel better about the events of yesterday. I just had to reason it out to find a beneficial purpose within the situation somehow.
Yes, I know…I’m a bit slow to ‘get it’ sometimes.
Thanks for listening .

With love, Erika

[SallyC]

Erika, you are such a good soul. God and I are proud of you.
Thank you for sharing that great story.

[Kitty]

That was such a sweet story. Thanks for sharing it with us.

Now, I think you should send it to the ER that fouled up so much. They need to read it.

[My3sons]

Erika, it's caring people like you that out weigh all the others that don't. It's why everyone needs to build a personal relationship with some kind of care person, esp. Dr.s, PT, anyone that they go to for any kind of care..like you. Thanks for being that kind of person. The world needs more like you!

Your post reminds me of a mug I have. It states:

A man on the beach where thousands of starfish lay dying in the sun saw a girl tossing them into the sea, one by one.
"Why bother?" he asked.
"You won't make much of a difference."
Tossing yet another starfish into the sea, the girl said, "I made a difference to that one."

Thank you for making a difference in someone's life.

[Blessings2You]

Thank you for sharing that story. The saddest things: wondering how this would have played out had you and your "connections" not been involved? And that the couple could have been any of our parents...or any of us.

At 77 and 63, my husband and I are by definition an elderly couple. I was always my husband's healthcare advocate (and also my parents') I dealt with the doctors, the hospitals, the insurance companies, the labs. I was on top of it. Now...I wonder how close I am to needing an advocate myself.

[Erika]

Thanks so much everyone. The more I have been thinking about the situation, the better I have been feeling about it; and your kind words help even more.

I know most of the staff at our local ER and most of them really are caring people. So is the couple's PCP. I think that it really was a matter of it being assumed that someone else had taken charge of diagnosing and/or looking after this lady's problem.
She is not a complainer, so it is also likely that it was assumed that she was not in as much pain as she really was. It was only because of my getting to know her over the years that the change was impossible for me to ignore.

Like I said, I think that she just fell through the cracks of an overburdoned health care system. Our health care system in Canada is not what it is cracked up to be...especially in small towns like this one where resources are stretched to the limit.

It seems that a lot of those who work in the health care field in Canada are in such a rush to keep up with the sheer volume of patients, that people cease to be seen as people, but are often seen as data on a computer screen or a diagnostic report instead.
As a patient myslef, I've experienced that, as I'm sure most of you have as well.

I think that the source of my initial anger and frustration was reliving those experiences through the eyes of people who were more vulnerable; and who couldn't advocate for themselves.

"And that the couple could have been any of our parents...or any of us."

That thought did cross my mind in the midst of things and I found myself caring for them as I would have cared for my Dad and Step mom...the similarity to their situation and that of my folks was that close. My folks only have each other, what with my brother and I living so far away.
I would be only too happy to help any of you as well; should you end up needing medical care in this hick town .

You are right Blessings, it seems that these days, an advocate is pretty much a necessity when it comes to situations like this one; although I must admit that I did hesitate to get too involved at first when petty self concern reared its ugly head .

Funny...once things got rolling though, my cold symptoms and the day's fatigue abated. Its times like that when there is reassurance that there is a 'Helping Hand' just waiting to come through.

Thanks My3sons. That poem really brings the message home.

I still might write a letter to the editor of the local paper though, suggesting that people establish a local advocate for themselves for these sorts of situations. We do have a large senior's center so maybe they would get something going like that...at least that would help the elderly in this community negotiate the convoluted medical system that we have.

With love, Erika

[doydie]

Erica you are a beautiful person inside and out and I am so glad that there ares till health care professionals like you out there looking out for the little guy. It just makes me so mad that some times it takes a high ranking official to have a family member with autism, breast cancer, etc that makes people stand up and take notice. I also believe that there a lot of people in the medical field that are in it for the money. It is a job. To some others it is a calling and a profession, not just a means to make money. God bless you

[karilann]

I'm going to "copy and paste" your story to my daughter's email. For what it is worth- she works in an emergency dept in a hospital in Chicago. She is a sort of liaison between patients and hospital staff and works with administration. I'm hoping this will be an inspiration to her. Thanks for posting.

[ewizabeth]

God bless you Erika! There should be more like you in the medical professions.

[Jules A]

Wow! I am honored to "know" you Erika. Many, many thanks for going above and beyond to do the right thing and offer comfort to this couple. I shudder to think the what-ifs had you not stepped in.

Bless you.