The American Hospital: Trying to Heal in Someone's Workplace

They’re at work right now.

That’s your mantra when taking care of someone while they’re admitted to an American hospital.

They’re at work right now.

Those five words, if you can remember to invoke them through bitter tears of frustration, will grant you some patience and empathy with the people at work right now. Yes, this sucks, but they’re at work right now.

Did you ever see a spectacular foul-up by your coworker, but never tell a soul, because "well, the custie doesn’t work here, I gotta spend 40% of my life with [coworker]?"

You ever see a whole bunch of useless typing at your job?

You ever see someone work a job they hated just to keep their family in a nice place?

You ever pull off a heroic feat of continuous attention to make sure your coworker’s day wasn’t totally ruined?

They’re at work right now.

Medicine is, first, a workplace. A workplace like any other. In America, most workplaces are miserable places for the color temp alone.

The hospital is an especially miserable workplace: at the sharp end, it’s a lot of underslept malnourished-but-sugary-blood people (Americans) having a terrible day, cared for by a lot of people at work packing their holes with gauze and wiping down their poop-smeared weakened bodies, then sitting in a bad chair, typing in tiny text fields, and swatting away ten thousand dialogs on a balky Windows box.

Medicine is a huge, enormous, colossal, brobdingnagian workplace. Healthcare comprises 1/5 of U.S. GDP, a total churn of buying and selling tallied at four trillion dollars. 15 million people, about the population of Holland, work in Medicine.

https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical

Hospitals are very, very hard businesses to run, but they make a lot of money. They make a good portion of that "lot of money" by caring for old people.

Knocking on Heaven’s Door by journalist Katy Butler (she saw everything but the macro stuff firsthand, so this is one of like four modern nonfics I trust)

They’re at work right now.

Everyone in the building is at work. Sometimes nothing more, a comforting proportion nothing less, but still: they’re at work right now.

So act accordingly; you’re in someone’s workplace:

1. Be in a great mood, speak directly and concisely about what you want from the masked, gowned, caffed-up (adderal'd?) person at work in a hyper-air-conditioned windowless medical space station. Keep it simple and short and act as if you are very happy to see them, because they’re not allowed to let your charge leave without punching the right stuff in the right text fields. Be pleasant.
2. "Closed mouth don’t get fed" — be a cheerful pain in the ass; YOU are in a freezing room with your sad gramma running on zero hours sleep but they’re at work right now. "Oh yeah, room 215B, I was texting my friend, my bad, here’s your chux."
3. Get hit with a dumb rule? No backtalk, just ignore. Hospital staff learn quickly that to do their job they must enthusiastically agree to rules (liability...) and then ignore them. Break rules out of eyeline, and when caught, say "sorry I forgot this has just been so hard," repeat, as long as you’re not being a deliberate jerk, it’s hard to get expelled.
4. Ask someone with a keycard on a lanyard, preferably the attending/hospitalist, to walk you through the EHR log. They answer to The Log, so understand what’s in The Log and speak to them in terms of The Log, because you don’t sign their paycheck, The Log does. "Hey, can you show me the EHR for [loved one]?"
5. Do not leave your charge in the hospital alone overnight. Someone needs to be on that hard little couch to intercept the 5am blood pressure check; ask "can you please come back later?" and they will leave. Sleep, the limiting reagent for healing, is very hard to come by in a hospital.
6. Minimize contact with Medicine. The Christian Scientists on my dad’s side died 10 to 20 years earlier for their beliefs; they were at least directionally right.
7. For you, try not to end up in Medicine’s clutches if you can help it: whole, old, fresh foods, move around, get sun, get sleep, etc.