Thirty-four years separate my son’s visits to the intensive care unit following severe head traumas. The difference between them underscores the reason for the rising cost of medical care.
As a pre-schooler my son landed in a plain room of an older hospital. The nurse opened the door and physically took his vital signs. He had a gastric tube, and that was it. The brain surgeon verified every day that his brain had not started to swell. I waited about a week for my son to open his eyes, make a sound or move.
By the end of the week, he was moved into the pediatric ward where he roused enough to pull out the feeding tube and pass a gag test. He sat in his high barred crib played, ate and identified objects. The doctor sent us home. During a follow-up visit, we talked about physical therapy to address the weakness on his left side. He went to a couple of sessions. The therapist showed me exercises to do at home, and that was it.
Fast forward 34 years, and my son again landed on his head. After our flight, we walked into a room filled with machines, tubes and monitors. He wore a neck brace, had a device to keep him breathing and a tube to deliver fluid to his stomach. The bed undulated to reduce bed sores. Monitors tracked his heart, lungs and brain. The surgeon had inserted a probe to detect any brain swelling. His nurse sat at a desk that looked directly at a wall of windows into his room and her other patients’. I could see her and indicate my concern if he needed her as he did during a choking spasm. I stood at his side and murmured, “breathe, breathe. Take it easy now, just breathe.” I indicated to the nurse that he needed her immediate attention. When she entered, I started to step back. She shook her head and said, “keep talking to him.” She worked on the equipment. I patted his arm and talked.
One afternoon the nurse extracted a sample of his stomach contents to assess the vigor of his digestive system. “We have to be sure that it is working before we put more in,” she explained.
One by one, items left the once crowded room: the neck brace went first, then the tube to keep his airways open and monitors for his heart and brain. Finally, he left the brain trauma ICU and went to a rehabilitation hospital where the staff tagged him as ‘at risk for falls.’ That meant he entered a room with a camping tent encapsulating his bed. The tent zipped shut to keep him safe. Before the technicians could get him settled in the bed, he stood up and promptly fell. Situated in a wheel chair with a restraining strap that clipped at the back, he reached behind and undid the clip. Fortunately, his brain soon woke up, and he could protect himself.
Good timing, too, because he began breathing heavily. He mentioned it. He called for help. He landed back in another ICU ward with blood clots in his lungs but a less intense level of monitoring.
Looking at the two head traumas, three decades apart, I quite understand why we see the increase in the cost of medical insurance. Besides staff, training and equipment, transforming an old hospital room into an ICU unit requires major reconstruction. A closed room will not do in this day of constant electronic monitoring.
Hopefully we will see a day when the two political parties put down their agendas for the good of the people and find an affordable solution to the current problems.