OVER many years I have been collecting anecdotal accounts of patients abused by carelessness and indifference in Baltimore area hospitals.
The problem in virtually every case was not basic medical competence. In fact, in every instance the essential mission of the hospital was accomplished -- the patient went home recovered or on the road to recovery.
The failure, rather, was in the ancillary procedures where thoughtlessness, carelessness, arrogance or a lack of humanity made a hospital stay a demoralizing and demeaning experience. After all, for the typical patient, admission to a hospital is at best fraught with anxiety; yet in countless small ways, the patient's anxiety seemed needlessly exacerbated.
The following are specific anecdotes of hospital indifference, ranging from 1968 to 1991. Since they occurred in a number of Baltimore-area institutions, I have elected not to mention the names of the hospitals on grounds that the situation needs improving in all of them.
1. A middle-aged woman patient, recovering from a major operation, has been without solid food for several days. Finally and suddenly, her appetite returns and she is hungry. An employee brings her dinner, sets it on the bedside table, just out of the patient's reach, and leaves. Since she cannot move to reach it because of the operation, she rings for the nurse. No one comes. After a half-hour, the same employee comes back. The food is cold. "I see you didn't want your dinner," she comments.
2. An elderly woman patient is hospitalized with a serious intestinal disorder. Lonely and confused, her one solace is the telephone on the bedside table, providing a link with her family. A nurse comes in for some kind of routine procedure, pushes the table aside and leaves. The phone rings and the patient listens helplessly, unable to reach it. This happens not once but three times in a week-long hospital stay.
3. A young man, the first night after a major operation, writhes in agony, unable to sleep throughout the night. Early in the morning complains and is given a muscle-relaxing medication that magically relieves the pain. "Why didn't you give me one of those last night?" he asks. "You didn't ask for one," says the nurse.
4. A woman in traction for a back ailment can't sleep because the weights attached to her feet clank against the metal foot of the bed every time she moves. She complains, but is told nothing can be done. A visitor comes in, notes that a simple pulley adjustment with two thumb screws puts the weights beyond the foot of the bed, and the clanking stops. She sleeps well, thanks not to the hospital staff but to a visitor.
5. A very elderly patient, a woman of keen intellect, has no loss of mental faculties but is somewhat deaf. Because she cannot hear well, the staff people apparently assume she is mentally incompetent and treat her like a child, going through all their procedures as if they were none of the patient's business.
6. At one point in this same patient's stay a doctor -- not her doctor -- comes into her room with a group of young men who are apparently students or interns. They turn her over, poke her and treat her like a laboratory animal, all the while joking with one another. When the patient finally protests, "Why are you doing this to me?" the answer is, "We're just having a look." This patient, when she finally is discharged, is angry, demoralized and takes weeks recovering emotionally from the ordeal.
All of these cases of mistreatment are doubly ironic because they are unnecessary. They reflect, it seems to me, a failure of hospital management. Managers must insist on that moment of thoughtfulness that can minimize or eliminate anxiety, misery and discomfort.
There is a strange twist to all this. Having collected these hospital horror stories for a long time, I was taken suddenly ill last year with a fever of 105 and conveyed to a hospital by ambulance. Knowing what other members of my family had endured, I was apprehensive. But I was treated with kindness, respect and continuous attention. Throughout the various procedures, nurses and doctors told me exactly what they were doing and why -- a boon to the morale of any patient.
I went home after four days feeling grateful not only for being cured, but to the entire staff from physicians to cleaning crews. ,, This only served to prove that a hospital stay doesn't have to be a stressful experience. Why doesn't this happen more often?
Gwinn Owens is the retired editor of this page.