Hospitals are not always places for the sick

When I was in labor with my second baby I selected to go with no pain medicine. My midwife directed me to walk the halls, the treatment employee was appalled and kept telling me to get back to my room, there was this back-and-forth.

Fortunately I was distracted enough the situation was irritating but luckily I wasn't in the hospital for an extended stay. It is difficult to figure out that balance between getting notice and receiving unnoticed for asking for that attention.


A quick journey to the other country is nerve-racking enough. But a prolonged hospital stay? Nobody likes the sound of that. Sickness to the side, we fear a lengthy stay for the reason that hospitals are not, we wish, of our usual world. There are the sicknesses to be caught there. And you can find the medicine mistakes, like the much-publicized heparin overeat given to Dennis.

But there are other realities that tap into our underlying insecurities about losing control. As someone who has worked in hospitals and who has had both parents hospitalized for lengthy stays, I speak from experience when I say that the hospital is another dimension. The flip side is that many lives are saved thanks to a hospital stay. When a person is healed-or cured-we are grateful there was a place to go, and specialists to intervene, and we call it a miracle.

Here's another. If you don't open your mouth the staff won't know your needs. But if you open your mouth too much you fear the risk of alienating the staff that is there to save your life. We feel at once royally annoyed yet oddly impotent. (Remember what happened in the Seinfeld episode when Elaine gets on the wrong side of one doctor, and the office "makes a chart" on her. Subsequently, her "difficult reputation" follows her around New York from doctor to doctor as she tries to get help for an itchy rash.)

Seinfeld episodes aside, the reality is clear. "The only person that connects the entire care team is the patient, but often the patient is the one who feels most out of control," Dr. Alpesh Amin, professor and executive director of the Hospitalist Program and Chairman, Department of Medicine, at University of California, Irvine, says. As such, whenever you can look for a doctor who understands who is most important (you). Go ahead, ask how they view the doctor-patient relationship. There is no place for ego in medicine.

In fact, Dr. Amin makes very clear that the single most important thing is that a doctor must understand that the patient should drive the practice. "I'm one person who knows science," Dr. Amin explains, about a physician's knowledge of the medical aspects of the case. "I need to know more about the other points of view of the care team and the patient and family," he says. By this he is referring to any number of issues that may include: what the patient wants, spiritual, religious, ethical values, medical history, family history...the list goes on. "Only then can we come together to help the patient make the best decision."

It's a good reminder, and it helps that it comes from the top doc at UCI. Still, the hospital can be a scary place. So, how can we feel more in control while we're in an environment that makes us feel out of control? Here's a few thoughts to keep in mind:

If you are not satisfied with the care of your physician or other healthcare professional, try to speak to that person. If that does not work.

Ask to speak to a social worker. Clinical social workers are specialists in providing counseling and in facilitating better communication between physician and patient and the patient's family.

Often, patients do not request a social worker because they believe that social workers only provide meal vouchers and bus passes (some hospital personnel, I'm sorry to say, are under this misconception as well). This is not the case.

The vast majority of clinical social workers have masters degrees and are licensed in their respective state, and have advanced training in psychotherapy and crisis management.

Do not hesitate to request a visit with a member of the hospital's spiritual care team.

Times of crisis can throw us into a mode of questioning ourselves and our lives, which is but one of the reasons hospitals have chaplains on staff.

If there is a trouble that doesn't improve, find the Ombudsman. An ombudsman is a people who investigates and mediates patients' troubles and complaints in relation to a hospital's services.  It gives a great snapshot of suggestions from the Joint Commission on Accreditation of Healthcare Organizations, a nonprofit organization that evaluates hospital care about how to deal with concerns in the hospital.

For me, I think the challenge is working with support staff who tell you cannot get an appointment for three weeks (by which point, that mysterious lump or cough will have either gone or changed into something much more serious) or create other roadblocks. And don't get me started on insurance companies! Once I actually get seen by my doctor, things tend to run much more smoothly.