Obamacare: A Bridge Too Far

Posted by PITHOCRATES - December 22nd, 2010

This part of the road…it’s the wide part

In the movie A Bridge Too Far, there is a humorous line following a bloody World War II battle.  This movie was about Operation Market Garden.  The plan was to use airborne troops to seize vital bridges over rivers that would take the Allies into Germany.  Once they secured the bridges, British 30 Corps was to advance up a narrow road to link up with the airborne troops.  Then, Bob’s your uncle, war is over.  And the good guys win.

But it wasn’t a very good plan.  And it was an extremely bold plan.  That required speed.  Two things not in Bernard Montgomery’s (British general who came up with the plan) repertoire.  His troops loved him.  Because he was very cautious.  Took his time.  And he liked to fall back and regroup.  Again, all the wrong attributes for such a bold plan.

The big problem with this plan was 30 Corps.  The airborne troops reached their objectives.  But 30 Corps just couldn’t link up fast enough.  In the movie, shortly after Michael Caine jumps off with 30 Corps, they run into a hail of German fire.  Being on a narrow road, there was little room for the British to maneuver their armor.  And armor that can’t maneuver has another name.  Targets.  They won this battle.  After taking some losses.  A subordinate vented to Lieutenant Colonel J.O.E. Vandeleur (Michael Caine), saying their superiors were asking the impossible of them, advancing up such a narrow road.  And Michael Caine replies, “This part of the road…it’s the wide part.”

Going Home from the Hospital

My father spent about a month in the hospital after suffering a bad heart attack.  He’s 86 and the damage done is irreversible.  Heart is only pumping at 15-20%.  His lungs suffered some damage.  Kidneys, too.  He’s pretty weak.  Has no stamina.  Can’t sit up for more than 10 minutes without hitting the wall and collapsing.  But he was in rehab the last two weeks.  Bitched and moaned more than he did rehab.  But he did enough.  Because they said he was good to go home.

We met with a social worker to discuss life after the hospital.  Well, that was the plan.  It was more of a dog and pony show to see what my father could do.  He came a long way, too.  He was cursing and bitching like his old self.  Calling his rehab torture.  Which it was to him.

The social worker made some small talk.  About different things we could do with dear old Dad.  Nursing home.  Go home with some in-home care.  Go home without the in-home care.  I guess I must have been napping during this part when we were standing in the corridor, because that wasn’t small talk.  That was our intensive discharge family interview.  And, according to the discharge nurse some 5 days later, we signed forms saying that we refused all in-home care.  I don’t remember discussing it.  But, like I said, I could have been napping while I was standing there.

With that ‘interview’ having been a week before his discharge, I had no idea what we would have to do for him at home.  Did he need a wheelchair?  Walker?  Bed commode?  Bed pan?  Home oxygen?  Respiratory equipment?  The day before the discharge we talked to a social worker who got a little snippety with me (it was documented that you had your interview).  A nurse and a therapist came in to talk to me eventually.  In about 45 minutes, they answered pretty much all of my questions.  These two gave a damn.

I asked again about home oxygen.  They tested his blood oxygen levels lying down, sitting up, standing and walking.  They said he didn’t need home oxygen.  Even though he was gasping for dear life during this testing.  So we talked with the nurse one last time.  Agreed to meet with him at 3 PM the following day.

The following day we got there about 2:45 PM.  Went through the medications.  Talked with his therapist again (a great lady).  About an hour or so later, we were ready.  We just needed to wait until his cardiologist could see him one last time.  Dad had to use the bathroom while waiting.  The doctor showed up about 10 minutes after he used the bathroom.  And heard him gasping for dear life.

So he checked him out a little and talked to the lung doctor.  They did a series of blood oxygen level tests.  All the while my father was cursing them for the torture they were putting him through.  This doctor spent the next 2 hours or so reversing the previous decision not to put him on home oxygen.  Then we waited another 2 hours for the hospital oxygen service to deliver a portable tank and to follow us home so he could set up a unit in the house.  The whole discharge process lasted about 6 hours (included the home oxygen set up). 

The Punch Line

I guess I was being a bit belligerent.  The frustration and exasperation got to me.  When we finally got Dad home, we got him into bed.  With the ordeal of the last 6 hours, I didn’t want to force him to walk to the bathroom to urinate before going to bed.  The hospital gave us a couple small urinal bottles he could use while in bed.  It was the least I could do for him.

Well, now here’s the funny part, as he handed me the filled bottle, I took a step or two towards the bathroom to pour the contents into the toilet.  And as I did I noticed a spray of urine falling behind me.  The urinal leaked.  Like a sieve.  Worse than a drivel glass.  Over the bed.  On the floor.  Everywhere.

Lesson?  Don’t be belligerent in the hospital when picking up family.

The Good Old Days of Health Care

This was not a pleasant experience.  Going to the hospital rarely is.  All I could think about was that this was the ‘wide part of the road’.  Before Obamacare takes over.  When they replace the touchy-feely kindness of health care workers with cold, disinterested bureaucrats.  As bad as things are today, under Obamacare, we’ll remember these as the good old days of health care.

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