In a Hospital Stay, No Time to Rest

By Caitlin Kelly
New York Times : August 7, 2007

Grand Central Terminal may be synonymous with noise and haste. But as I recently discovered, it can be a lot quieter than a hospital bed.

On the busiest day at Grand Central, I might visit the bakery and newsstand, buy a train ticket, drop into the bookstore and drugstore before picking up some flowers and maybe buy a coffee for the ride home. That's about seven transactions, all brief, that I choose to initiate when I have time and energy.

Contrast this with my recent stay in a 235-bed suburban nonprofit hospital where I faced at least 34 separate interactions, most of them convenient for everyone but the patient.

Although I had visited this hospital's emergency room several times over the years, and had two knee operations as an outpatient, I had never been admitted. I arrived at the E.R. with a 103.8 fever and unbearable chest pain, which blood tests eventually showed to be strep pneumonia. I was admitted within a few hours and given intravenous saline and antibiotics.

My bed, clearly designed for long-term patients to avoid pressure sores, inflated and deflated constantly, a noise I could silence only by turning it off and losing the ability to adjust its height or angle. The room was semiprivate, and my roommate a deaf and partly blind woman of 93 who spoke almost no English.

Like any patient exhausted by pain, I desperately needed plenty of rest.

At 11:50 that night, my roommate, frightened and disoriented, sat down on my bed, grabbing at me, yanking at her IV and oxygen tubing, pleading for a "cuchillo," a knife. (I speak Spanish.) As a career journalist, I have faced many odd situations, although never while tethered to an IV pole.

This was just the start.

Preadmission, dopey from painkillers, I had stayed lucid long enough to share information with the intake clerk, the triage nurse, two E.R. nurses, the emergency doctor, the X-ray technician and the admitting doctor. The E.R. physician was worried by the density of the infiltrate on my right lung, warning me it might be a "mass" - possibly lung cancer.

I needed a CT scan, adding three more conversations, the volunteer wheeling me there and back, the CT technician and another physician injecting the iodine.

Every interaction, no matter how brief, takes energy, something many patients have very little of, even while we try to be as pleasant as our pain, weariness and fear allow. Several nurses and physicians, including two pulmonologists, tried to cheer me up before my scan results, a gesture I appreciated but couldn't respond to because I was simply too frightened about the possibility of lung cancer.

Thankfully, the test showed I only had pneumoniaa disease that puts more than a million Americans into the hospital each year. Now, I hoped, I could finally get some rest.

But sleep proved frustratingly elusive. Cellphones rang day and night. Patients, nurses, physicians and visitors talked loudly. Outside our window, cranes whined and clanked on a construction site, and workers' voices clearly carried up five floors.

Add to this ambient noise the daily crowd moving in and out of our room. Someone asking if I wanted television, phone or Internet service, a chaplain, phlebotomists coming to take blood, the young woman changing our linens, orderlies, the janitor and ever-changing nurses.

Almost everyone had a question that needed answering, and quickly, not easy when you're scared, tired, in pain or heavily medicated. Each encounter required my attention, a decision and my civility at the least. No one wants to be the monosyllabic "difficult" patient, but it takes a lot of energy to be friendly to so many people.

Then there were the all-day, high-volume conversations of my deaf roommate's family and friends. Her son came to visit after I had spent much of the previous night racked with coughing. It started up again while he was there.

"Does she always cough that much?" he asked her.

"Night and day."

"She sounds bad."

To my relief, I was soon home again, the only sounds audible from inside my suburban apartment bedroom birdcalls and distant traffic.

Several of those unplanned visits offered great comfort, like a young male nurse offering me hot tea and a turkey sandwich at 3 a.m. and a gentle 15-year nursing veteran who swaddled my aching chest to ease the pain.

But the next time I really need a rest, I'm going to try to stay home.

Copyright ©2007 The New York Times Company

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