Hospitals Yesterday

JOHN R. LION

June 28, 1993|By JOHN R. LION

The hospitals of yesterday had floors of linoleum and wood, and in the afternoon, nurses wheeled around trays of juices served from pitchers. Doctors sat at bedside and talked with patients. Visitors came freely, and brought flowers which sat in vases on nightstands. Large clocks without second hands languished on the walls of wards. After childbirth, a woman stayed a week to rest up. Intravenous fluids dripped from bottles, and the clanking of syringes dropped into curved metal pans could be heard on morning rounds when blood was drawn.

Glass syringes gave way to plastic, and an era of disposability came. Paper products displaced materials and people, and electronics came to stand vigil over those who were sick. New sounds of chirping and beeping began to fill hallways. Doctors walked more quickly. Nurses retreated behind glass partitions, sending in their stead assistants who punched in at 5 to go home.

In time, doctors shed white coats and wore suits, and name tags read CEO or VP. New sentinels appeared. Insurance checkers prowled hallways, and doctors made urgent and passionate phone calls not to colleagues or patients or their families, but to those who would pay the bill. ''Let me keep him one more day,'' they pleaded to unseen bureaucrats. ''What can you do for him that can't be done for him outside?'' the businessnurses challenged.

Hospitals now went from small print to large print, to billboards, to television to proclaim their services. Patients came, were operated upon, and left the same day. New words appeared: Ambusurgery, Urgicenters, same-day, next-day, care while you wait. Staff wore big round buttons boasting ''WE CARE,'' while downstairs in nerve-center admission offices, clerks faced computer screens and droned ''What kind of coverage do you have?''

Hospitals brimmed with machines that peered deep within those thrust beneath their rays, but the rays sped right past the souls of those they scanned. The skin became irrelevant, but stroking was discounted as a dataless intervention, prone to being misconstrued as perversion. Death, also, was not allowed. Patients with chemotherapy infusion pumps nibbled at Domino's delivered pizza as they watched television and waited for morning discharge. Thrust into still clammy hands was paperwork, documentation of services rendered and caution urged. Little was left to chance, except healing.

Now hospitals were cold corporations. Gone were havens from pain, the asylums from mental suffering. In place came fears. For patients came fears of prolongation of life and fears of becoming destitute from a simple weekend in the ICU, or the fears of coping at home after post-surgical expulsion. There were fears of having one's child kidnapped from a nursery and fears of being carjacked in the parking lot outside. For doctors came fears of litigation and fears of being stabbed while on duty in ER. Policemen replaced nurses at portals of entry. At some, pockets became routinely searched for weapons.

Goodbye to the hospitals I knew. The hospitals of today are scary places.

John R. Lion practices psychiatry in Baltimore.

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