Monday, May 17, 2021


Just got back from ultrasound and had another triumphant poop. I also figured out the toilet's bidet function, so I enjoyed that. A senior doc came to visit this morning; he re-emphasized the need to stay on pills for the rest of my life, to lose weight, etc. 

Little else to report for the moment. My boss will be coming by shortly with yet more stuff I need. More news as it happens. 

Oh, yeah: the doc said I'm here until Friday. 

ADDENDUM: I'm getting a CT scan soon. More on that in a bit. 

ADDENDUM 2: Three ultrasounds and one CT scan later, I have no idea whether I'm done for the day. No one lays out a schedule or tells you what's coming next. 

I've come to realize that life for a patient in the hospital is a mix of the rigid and the flexible. Every four hours, your neuro check. Meals at 7 a.m., noon (unless you're getting scanned like me), and 6 p.m. BP and blood sugar tests at seemingly random intervals. Also at random intervals: the arrival of a bright-eyed nurse to say you've got a scan "now," with "now" meaning "sometime in the next hour or two." I'm a creature of routine, so getting three ultrasounds and a CT scan today was not pleasant, and not knowing exactly when they'd happen was even more unpleasant. And I still don’t know whether the day is over. 

Why three ultrasounds and not just one big one? I wouldn't blame you for wondering. Near as I can figure, each part of the body has its own ultrasound room: lower cranium, neck, and heart. Stupid, but there's another truth about hospitals: they're atomized bureaucracies. And with so many moving parts, things sometimes fall through the cracks. I was almost wheeled back to the wrong floor earlier today. A male nurse almost directed me to the wrong scan. (He initially said CT but meant my third ultrasound.) Doctors and nurses work shifts, which means different people have to keep track of the same things. It's a miracle the system works at all. I'll say this: overall, it works. But it's clumsy. I wonder if there's a way to make it better. 


Daniel said...

Nothing quite as satisfying as a good bidet spray after a you know what. Did the CT reveal your Modified Rankin Score (hopefully zero or one)?

Kevin Kim said...

No one said anything, but I'd put myself between a 1 and a 2.

Daniel said...

Hospitals are a complete mess, organizationally and operationally. Highly specialized outpatient clinics that see only a limited number of patients for a limited number of hours each week. Inpatient wards that handle dozens of admitted patients with teams of doctors making one or two rounds per day. Add to this the nurses, nursing assistants and orderlies who do most of the actual heavy lifting (literally and figuratively). And that's just the operational side. Organizationally, they are torn between treating the patient and making a hefty profit (watch out for the line-item charges when you are discharged). You'll find that you have been charged for every last band aid, every little pill, and every diagnostic test. (Obviously, everything costs 10x less than it would back home, but still...) End of rant! Probably the last thing you wanted to hear now, but this just about sums up my observations after visiting at least half a dozen hospitals for several years now (usually as the care coordinator/driver/lunch buddy for my 71-year-old mom). Hope they eventually inform you of the results of all the ultrasounds and CTs.

Kevin Kim said...

If you go back a bit in my archive, there's a post about how Korean hospitals keep prices down by being more capitalistic than American facilities, not less. I quoted an article that talked about this; it was the first time I'd heard such a thing. I had always assumed Korea followed a European-style single-payer paradigm, but the numbers never added up. In Europe, "free" healthcare comes at the cost of taxing you to death, but in Korea, my taxes on each paycheck are under what they'd be in the States. In Korea, it turns out, most hospitals are privately owned, and by extension, drug companies engage in more competition, driving prices down. So that explains the "factor of ten" issue you mentioned. One of the alt-media people I listen to has been saying this for a while: the US healthcare system would improve if it were more capitalistic.

John Mac said...

Sounds like you are being taken care of, if not efficiently, hopefully effectively. I had to look up the Modified Rankin Scale. So, if your assessment is no worse than a 2, it sounds like you got lucky. I assume treatment/therapy can also reduce that number, right?

Man, I don't envy you being confined until Friday, but hopefully, this will be a once-in-a-lifetime experience. Get well soon!

Daniel said...

Definitely agree with you on this. Korea is a great example of a single-payer, multiple-provider model. Compared with the US, Korea's medical system offers greater choice (no HMO in-network hospital limitations), lower costs, and improved transparency because of a mix of free-market capitalism (allowing patients to shop around) and government regulation where necessary (to keep hospitals and insurers from overcharging lower-income patients). Sure, bedside manner could be better and consultations are often cut short for the sake of efficiency, but overall the system seems to work just fine.