My Heavy Heart is With You Tonight Uncle

     I have a heavy heart tonight as Uncle is in critical condition.  I wrote about him in a post a few weeks ago.
     Dealing with a cancer diagnosis is extremely difficult.  Dealing with the medical profession is almost just as difficult.
     I was horrified as my Aunt relayed this morning's events to me.
     First a little background.
     On January 27,  the results from a blood test that Uncle had the day before, showed that his sodium count was dangerously low.  He was weak and unresponsive.   My aunt called Uncle's Oncologist.  On his recommendation she called 911 and Uncle was taken by ambulance to the emergency room of our local hospital.
     The emergency room was filled to capacity that afternoon.  Every cubical was filled.  Patients were lined up on gurneys in the hallway.  Every chair in the waiting room was taken.
     I understand that unless a patient displays life-threatening symptoms, care has to be administered on a first come first serve basis.  I also understand that the goal of the emergency room doctors and nurses is to treat people and then release them as quickly as possible to make room for the next patient.
    For example, the woman in the cube next to Uncle had apparently been there for a couple of hours.  Once her condition had been diagnosed and treated, she was told by the nurse that she was going to be released.  The woman complained to the nurse that she was still in pain.  The nurse explained to the woman that since the doctor had given her a prescription for pain medication and for an antibiotic, there was no further treatment that they could offer her.  She was then advised to follow up with her own physician.
     Apparently, the woman had been transported to the hospital by ambulance.  She did not have a phone.  I heard her ask another patient if she could borrow her cell phone.  The woman was unable to get in touch with her husband and did not have a way to get home.  The nurse told her to get dressed and informed her that there was a phone in the waiting room that she could use.  Within less than a minute after the woman left, the room was occupied by the next victim patient.
     My uncle has stage IV pancreatic cancer.  My aunt, of course, told the emergency room staff of his condition.  He was in a great deal of pain.  He had been treated and diagnosed  in that same hospital only days before.  However, the emergency room doctor (who looked like he was 12 years old) would not administer any pain medication until they ran a battery of tests.  Blood tests, CT scans, EKG's and X-rays.  Why?  Why were any of these tests necessary?
     When the results of the tests finally came back, the doctor came into the cubical.  He told my aunt that there was no evidence of a heart attack (huh?) no evidence of pancreatitis, (what?) and that my uncle probably had indigestion.  He gave him an antacid to drink and wanted to send him on his way.  I am not making this up.  I was standing right there.
     My aunt told Dr. ER that Uncle's doctor wanted him to be admitted. Dr. ER. said "Why?" My aunt told Dr. ER about Uncle's sodium count, which I am sure she had also told more than one member of the ER staff multiple times.  Dr. ER said, "That didn't show up in any of the test results."  My aunt insisted that Dr. ER call Uncle's doctor.  Dr. ER agreed and to do that and left the cubicle.
     Not more than a minute later,  a nurse came in with an IV kit.  She told my aunt that Uncle was going to be admitted.  She said that according to the blood test results, Uncle's sodium count was dangerously low.  Why did the nurse know this but Dr. ER did not?
     I understand that the goal of hospitals these days is to treat patients and then release them as soon as possible.  The goal for Uncle was to stabilize him, get his sodium levels up, and try to build up his strength so that he could start a regiment of chemo therapy.
     Five days after he was admitted into the hospital, Uncle was told that he no longer needed their care and that he would have to go to a rehab facility.  The rehab that he would be admitted to is across the street from the hospital.  The criteria my aunt and uncle's insurance company uses to determine if he would be eligible for transportation from the hospital to the rehab and then back to the hospital for chemo is this:  "Is the patient able to sit in a chair?"  The nurses and aids were able to get him out of the bed and into a chair, so I guess that qualifies as a yes.
Next, "Is the patient able to walk 80 feet?" A nurse and an aid were able to get my uncle up out of the chair.  With the help of walker, the nurse and the aid, he was able to walk 80 feet.  So I guess the answer to question no. 2 was yes also.
     The problem, though, is that my 72 year old aunt, even though she is in great shape, would not be able to get him up and walking,  then into her car, then out of the car, then into the rehab center.   Even though the rehab center is right across the street from the hospital,  it is going to cost my aunt and uncle $107.00 because the insurance company will not pay for the transport.
     Back to today's horrible events.
     My aunt received a phone call from the rehab center at 3:00 this morning.  My uncle was calling for her.
The nurse at the rehab told my aunt that they could administer a tranquilizer or he could go over to the hospital.  When my aunt got to the rehab and asked Uncle what he wanted to do, he said he wanted to go to the hospital.
     As my aunt described the next course of events to me, I felt sick to my stomach and my heart ached for Uncle and my aunt.
     When they got Uncle to the hospital my aunt said that he screamed in pain for three hours.  The on call hospital doctor would not administer any pain medications because Uncle's blood pressure was dangerously low and the doctor was afraid that the pain meds would make his BP go even lower.    My aunt insisted that they get in touch with Uncle's doctor, which they finally they did.  Uncle's doctor instructed the hospital staff on how to raise Uncle's BP.  In a matter of a half hour, they were finally able to give him pain medication and make him comfortable.
    Tomorrow he is going to be admitted to the Hospice wing of the hospital.  But today, while he was still in the CCU, the doctors wanted to do another CT scan.  Again I ask WHY???
Are they padding the bill? Is it CYA?  Or is it both?
     My heart is heavy tonight. I know, though, that if Uncle makes it through the night, the dedicated and caring Hospice staff will make sure that Uncle does not suffer needlessly. They will make sure there that he is comfortable and that there is no pain.  After all isn't that the kind and humane way to treat Uncle?

Here is today's entry from Anna's Diary:

Monday February 11 1929
Home until two.  Went to Belleville Ave for baby's new shoes at Murdoch's. Brown one for $5. Elsie and Minnie came. Had tea at my house with strawberry tarts.  Home all evening.  Radio good.

[J. T. Murdoch: The business was established by J.T. Murdoch, Sr. in 1888. It is currently owned and operated by the fourth generation of Murdochs.]