Wednesday, July 17, 2013

Rage, Rage Against the Dying of the Light

The line is Dylan Thomas. He wrote it when his father was dying. We want them to fight every step of the way, even when it seems counterproductive or futile...but is this for their benefit, or ours?

My family began another medical odyssey with my mother on June 23rd, when she fell and suffered a spiral fracture of the femur. This isn't technically a broken hip, because that would have been easier- both on her and to repair surgically. The break was below the femoral head, the knob at the top of the bone where it meets the hip. I saw the initial images at the local hospital- it was nasty and fragments were floating around inside her upper thigh; the fracture itself resembled a length of unspooled ribbon where the bone should have been plumb-straight.

One of the more frightening moments, because I'm the one who was with her when she fell, secondary to being unable to initially raise my father via cellphone (it was a Sunday morning and he was fishing), was Dad standing in the driveway bewildered as the EMT on the ambulance crew asked where to take her. This kid was maybe nineteen and he added, "Well, there's no point in taking her to (the hospital where my father has been chief of staff several times). They can't do anything here. There's not a decent doctor in the whole county." My anger flashed white-hot as I gestured to my father and spat, "Allow me to introduce DOCTOR AIREDALEPARENT, who was the first chief of staff there!" He at least had the decency to go white as a sheet as I finished with, "Take her to the hospital. We'll get the images there and make a decision. GO. NOW."

I opened the directory on my iPhone, found the contact information for my father's classmate who is an orthopedic surgeon, and called him. By the time Mom had been x-rayed and given morphine at the hospital, he had hooked us up with a young surgeon with whom he used to work who specializes in hip and femur fractures in the elderly. Off we raced to The Big City.

Three weeks out, there have been...complications...there are other things in play that I'm unprepared to air at this juncture.

There's something else that I'm going to harp about here, and about which if you don't care, you SHOULD: lack of coordination of care. As one of my nurse friends pointed out, the medical establishment now considers it your (the patient's) responsibility to ride herd on everything that's happening in the course of treatment. We have an advantage that most people lack: my father's a doctor, and as a direct result, my sister and I are perfectly willing to verbally castrate anyone who's falling down on the job. We have a Road House mentality: we're nice until it's time to not be nice, and when we reach that point, the medical persona in question will feel it. If we, who recognize what's going wrong, are reticent to speak up until it's reached fever pitch, what happens to those who don't recognize the mistakes, or catch a thread of dangerous, life-threatening laissez-faire?

So here we are. I've had to add a layer to my persistent facade for this situation. I just have to keep pushing forward, always forward, sometimes against the tide, constantly raging against the dying of the light inasmuch as it's my purview. It's not much, but it's all I've got right now.

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