New York-Presbyterian / Weill Cornell Medical Center

The BBQ Pit
1

This hospital apparently once had a really good reputation.

So when I got the call at 4:30 am on Friday that my father’s memory care residence was sending him to the hospital, I thought he was going to the right place. And I forced myself into consciousness and made my way to the hospital.

Now, my father is incompetent. There is no question about this, and I have all the necessary paperwork. I have his health care proxy, his power of attorney, I am the trustee of the trust that holds all of his assets, and I have been appointed his guardian. None of this is contested, it’s all been gone over by a whole bunch of lawyers, and I always have all the documentation with me. I keep it, along with his Medicare and insurance information and a list of his medications, on my phone.

Also, the memory care facility, as is their practice, send an aide in the ambulance with him to the hospital with all the necessary documentation.

So I get to the hospital at around 5:15 am. I’m told by a receptionist that nobody can go in to the ER to see a patient until 9:00 am. Fine, nothing I can do about that, but I tell the receptionist that I’ll need to speak to someone on the care team, preferably a physician, because of the health care proxy and all that. He says he’ll send them a message.

9:00 am rolls around, nobody in sight from the care team. But I go in and find my father, who’s on a stretcher in the hallway. He’s very confused, doesn’t understand where he is or why he’s there.

10:00 am comes and goes. Then 11:00 am. I mention to the nurse at the ER desk that I’m still waiting to see someone. I’m quite polite about it. I mean, really – I just identify myself and say I’m hoping to speak to his care team. She says if I’m going to be “aggressive,” she’ll have me removed from the ER.

Okay, then.

Noon comes I’m told that visiting hours are over, and I’ll have to leave the ER. So back outside. And I do mean outside. According to the new receptionist/security guard, because of COVID, nobody is allowed to wait in the waiting rooms.

So still waiting to talk to someone. I remind the receptionist that I’m still waiting.

Another hour. And a miracle happens. Someone calls me to talk to me. He agrees to come to the front of the hospital to talk in person. I’m happy.

He shows up. I introduce myself. He does not reciprocate. I ask him who he is. He says “John.” Hmm. “Are you a doctor,” I ask? No, he says, I’m a medical student.

Holy shit. We talk. Turns out he’s been sent to get my father’s medical history. Which I give to him, as best I can. But that’s all. I still don’t know why my father is here, or when or if he’ll be admitted.

He also, by the way, leans on me hard to sign a blanket DNR. He shows me the form. It gives all discretion to the hospital. Yeah, fuck that. I’m not signing it.

More hours. No more communication. More hours. I go home to get some sleep. I come back in the morning. My father is still in the same bed in the same hallway.

I request to see a doctor. I ask what treatment, if any, he’s receiving, and if he’s being given any meds. Nobody in the ER can or will answer my questions. I request to speak to the physician in charge of his care. Again.

More hours. Noon passes. I can’t wait in the ER anymore, so I’m back outside.

More hours. And then finally a doctor agrees to speak to me. I’ve been keeping track of the time. It is now thirty-two hours since my father was brought to the hospital.

Anyway, he explains why my father is there. Sounds like the care facility made the right call in sending him to the hospital. He says they’ve done a number of tests, and he explains them to me. And okay, they’re just tests, I don’t get upset that consent was not sought (even though the hospital knew there was a guardian with the health care proxy), because tests are fine, that’s why he’s here, etc.

I ask when he can get a bed. He says, it’s tough, we don’t have any. I say this isn’t good for my father, he’s confused, he’s scared, he doesn’t understand what’s going on. He says, well, we do have a lot of open beds on the 14th floor. We have plenty of beds there. Great, I say, can we get him in there? Sure, absolutely, he says. That’s the private pay floor. I actually call to find out how much it would cost. Okay, that won’t be happening.

I’m a bit shocked to find out that a hospital has a large number of empty beds (apparently that floor has a capacity of a hundred beds), but is holding them back in case a rich person, even a rich person with a fairly trivial illness, wants them. Seems to me that’s kind of like a food bank having plenty of food, but holding it back from poor hungry people in case someone comes along who will pay full retail price for it.

I mean, it’s one thing for a hotel to hold out for the highest bidder, but a hospital? This seems like a shakedown.

Oh, well, nothing I can do.

I hang around. Nobody else talks to me. I go home to sleep. Lather, rinse, repeat. A different doc talks to me (it’s now Monday). He says they’ve been keeping my father around for one more test, that’s all – he’s stable. I’m angry. One test? They can’t do that? He says, well, we’re busy, the endoscopy team is only here certain hours, on and on, endless bullshit.

I ask for a list of any medications he’s been given. I want to be sure that he’s getting his regular prescribed meds.

He is. And they’ve added two fairly significant meds. One for the condition that brought him here. The other is a zombifying drug. I ask why would you give him this? He says, well, often old people with dementia get confused and agitated in the ER (no shit – you had to go to medical school to figure this out?), so we just dope them up as a matter of routine.

I’m angry. No issues of consent? Or even ethics? You routinely dope old people to make them easier to manage? Can that even be legal?

More time. More sleep. Back at the hospital. Tuesday morning. I go to the ER to see him. They tell me he’s not here anymore. WTF? Where is he? Hemming, hawing, nobody knows, nobody cares. About thirty minutes later they come up with the fact that he’s been admitted. He has a room.

This is Tuesday. Remember, he came here at 4:30 am on Friday and has been on a stretcher in a hallway since then. But at least he’s in a room now.

So, I wait around. About 2:00 in the afternoon, another doc agrees to talk to me. Still waiting for the same test. Wait, wait, wait. At least I can stay with my father until 9:00 pm now that he has a room. So I do. And then I go home.

I’m on my way back on Wednesday morning when my phone rings. It’s, well, let’s call her Makena, because she has one of those stupid last-name-as-first-names with a made-up spelling. And she won’t tell me her last name (which, parenthetically, I hate . You’re a grown-up in a responsible position, don’t try to hide your identity. It’s chickenshit evasive bullshit.). She identifies herself as the hospital social worker. WTF, I think, but okay, whatever.

She tells me they’re discharging him. I say great, so what was the outcome of the test we’ve all been waiting for? She says she doesn’t know, but she’ll ask the doc to speak to me when I get there.

Okay, great, we’re getting somewhere and he’s going home. Or “home,” I should say.

So I get there. I hang around. Finally a doc comes. Actually, a doc with a whole team of medical students and a PA and a couple of people who don’t have any ID badges. And I’m sure each and every one of them will send a bill, but I’ll deal with that later.

So the doc talks to me. He hasn’t had the test. They haven’t been able to get it together enough to do it. So they’re sending him home. And I’ll have to get him back as an outpatient for the test. Which is a fairly big deal. He’s wheelchair-bound, and will need transportation. Which, in NYC, is a few hundred bucks a pop for those rides.

Including, apparently, the ride home to his care facility. Now we see what Makena is all about. She may have some kind of degree that allows her to call herself a social worker, but really she’s the collection agent for the hospital. We have to go over a bunch of stuff to make sure they get paid. Oh, and by the way? The ride back home? Not covered by insurance, and they’ll need a credit card up front. Or I can just take the fucking subway back with my father.

So I pay. And get him back home.

Six days in the hospital. Four of them on a stretcher in a hallway. All spent waiting for a test he never got. Everything still up in the air. And I’ll have to take another day off, get him in for the test. And back. And moving my father around the city is no small task, believe me. And not cheap.

And I’m really, really angry that they medicated him into oblivion just for convenience, without even bothering to talk to me or get any kind of consent.

Fuck New York-Presbyterian / Weill Cornell Medical Center.

Oh, also? I have to say, the medical staff of that hospital has a really, really relaxed attitude about wearing masks. I mean, really relaxed. In that a lot of the staff just don’t bother. Even around elderly patients.

If the staff of a reputable hospital is sending the message that masks don’t matter, there’s nothing to worry about, how can we expect anyone to care?

2

What a shitshow. How is that not malpractice?

3

Wow. That really sucks, on so many levels.

4

That it does. Any chance that when you “get him back in” for the test, it can be at a different facility?

5

No, I’ll go there. They already expect him, they know what it’s about. Another facility is going to want to have all the tests that were done done again, at their facility (and on their bill, of course).

Seems easier, I’ll just go back.

6

Talk. To. A. Lawyer.

I can’t tell you what to do about your dad, but I suspect if you take him back there you’ll lose control again. Clearly, they are doing things, or neglecting, a patient who is incapable of giving consent while completely ignoring said patient’s legal guardian who has power of attorney. That is unethical and I suspect all kinds of illegal.

7

AND: Document, Document, Document!

8

Thanks for the sympathy.

For those who say I should talk to a lawyer, and document everything, I have to point out that those days were somewhat worse than a typical NY hospital emergency room stay, but not so far out of the ordinary as to interest a lawyer.

I’ve been through it myself. And if you think my father’s experience was bad, try it without insurance. That’s what happened to me (around twenty years ago). I’d lost one job, found another, and in the couple of weeks in between, had a horrific accident, and was down that rabbit hole for weeks (and in debt for years).

9

I have to say this is the most horrifying part of your story.

I am so sorry you have had to endure this and continue to endure it. You are wonderful to care for your father as you are. Keep on being strong and come here and vent when you need to.

And it doubtless will do no good, but you might consider writing a letter to the hospital administrator. I had a not-as-bad-as-yours-but-pretty-awful experience with my mother in a hospital and I did that. It didn’t do any good, of course, but the act of writing it gave me a little sense of release: this was fucked up and now I will let it go since I can do nothing about it. Or something like that.

10

Here (Denmark) there is a Patient Complaint Board (patientklagenævn) which will check the story and reprimand and fine the hospital if warranted.
Isn’t there anything like it where you are?
It’s horrible what your father went through.

11

Hospitals here in NYC have something called a “patient advocate,” who is an employee of the hospital. I’ve spoken to them in the past. They’re pretty much useless. They’re like HR departments in large corporations – they hold themselves out as protectors of patients (or employees), but their primary function is to insulate the hospital (or the employer) from consequences in the form of lawsuits.

It is horrible what my father went through. It is not, however (as I said above) all that unusual.

And my father has financial resources in the form of excellent insurance (over and above Medicare) and has family nearby (me, and one of my siblings) who will always look out for him.

Imagine how it is for those old people without those resources.

In this country, we hate poor people and we don’t give a shit about old people.*

* Yes, I realize that old people do have family members who care about them. But as a matter of public policy, we don’t give a shit about old people.

12

For what it’s worth I’m sorry you are going through this.

If I had read this thread earlier I would have pulled out of the other “discussion” a lot earlier. Sorry to have given you grief in a difficult time.

13

I appreciate that, and thank you. But unnecessary – a, shall we say, strongly felt discussion was perfectly appropriate over there, and I wasn’t bringing any baggage into it. All is well.

14

Some old people have family members who care about them. Some old people don’t even have that.

15

Maybe write an email to someone higher up. Document everything and be specific. Not wearing masks is completely unacceptable.

Hospitals and dental offices are all about the money now. “Tell me what’s bothering you” - that question comes at the end. “What’s your insurance” comes first.

And pain killers and sedation is the solution to all their problems. I damn near had a hypertensive emergency as a result of the epinephrine at my last dental visit, despite my repeatedly telling them that I had high blood pressure.

Honestly, some docs really don’t know what the fuck they’re doing. And even if they do, they farm a lot of their actual work out to PAs.

But yeah, “Best healthcare in the world”

My ass.

16

This makes me very appreciative of the way my mothers nursing home handled her frequent crises that required hospitalization, and I’m sorry your father had to go through that.

You say your father has good insurance, which is a blessing, but I would suggest making sure he has the right good insurance - because I’m not sure you should be stuck paying for her transport out of pocket.

When my mom went into the nursing home, I had a lot of trouble arranging insured dental care and I couldn’t figure out why it was so hard. Then someone from her nursing facility told me they were struggling with her insurance and had me meet with someone from her insurance company to explain. It turns out that she needed a different policy, one specially designed for people living in residential nursing facilities. That policy covered visits from the visiting dentist service that the nursing home used and things like transport services to and from the hospital. It was very easy to switch, it wasn’t a better or more expensive policy, just different.

That said, I realize that the challenges of transport are very different in an urban area- my mother’s facility had a van and a transportation manager that was in charge of scheduling and transporting patients to outside appointments and to and from the hospital. I would get a call and give permission whenever she was moved, but aside from that, the nursing home preferred to handle it themselves. I found it odd that you were expected to handle this - I would’ve flipped if this happened to me.

I hope it gets better for you and your dad.

My moms last hospital admission was amazing in one respect. She had to have a surgery to clear a blood clot, the surgeon spoke with her, then called me.

The surgeon had me on the phone for twenty minutes, telling me what an amazing person my mother was and sharing some of the stories she had told him about her husband, about her work as a medical technologist.

After so many years of watching so many medical professionals treating my mom like a recalcitrant toddler, it was incredibly refreshing to find one that saw her as the person she used to be.

17

If they were actually pressuring you to sign a DNR, then every last individual in that place needs to have their license to practice medicine revoked.

18

Maybe.

The responses in this thread have been fantastic, and I want to thank everyone for the support.

But again, this is so much not out of the ordinary here. As I said above, it was a bit worse than usual, but not really all that much out of the ordinary.

And the DNR thing? At every step of the way on my father’s path for the last six years, at every facility, be it a hospital or a rehabilitative medicine facility, or the memory care residence where he now lives, the first thing they do is push for a DNR. In some cases, even before they start figuring out how they’re going to get paid and pushing for signatures on all kinds of stuff about that (including my personal guarantee at his memory care residence).

So I’m kind of used to it, and sure, everyone should be fired, but that’s what they do.

19

Is this push for a DNR a New York thing? My experience was not at the same hospital you were at with your Dad, but it was very similar. I was the health care proxy for an older relative with mild dementia. He would get confused at times, but was able to take care of himself. He ended up in the ER of a NYC hospital with a fever. This was almost 10 yrs ago, so no COVID restrictions. When I arrived there and presented the HCP form , I was immediately pressured to sign a DNR. When I protested a young, very young, doctor very dramatically began to give a demonstration like this…“so you would want us to craaaaccckkkk his ribs, and sternum, causing him pain and misery…” I immediately and in a loud stern voice said, stop it, stop it right this minute. You should be ashamed of yourself. I wish I could tell your mother what you are doing right now" (he was just slightly older than my grandchildren). He did stop, I got some strange stares for the rest of the day. My relative was admitted, in a room, treated for a urinary tract infection and went home.

20

They had to go through the sternum for that? Harsh!