Wednesday, December 12, 2012

Time spent at a hospital

A hospital, for regular people, is a place best avoided, second only to places like the police station, morgue and cremation ground in terms of places you would least like to visit, let alone frequent. It is grouped with such especially abhorrent places for some pretty obvious reasons. You visit a hospital either as a patient, or as a patient's minder. In the former case, you are probably going under the knife, or at least getting a whole bunch of invasive/non-invasive "tests" to figure out how much damage your body has to deal with. In the latter, your loved one is probably going under the knife or getting the aforesaid tests. There is a lot of anxiety, waiting, queuing up, monetary juggling, tears, running around and general helplessness involved in either case. But look beyond all of this, and you realize that the hospital is not just a place where doctors fix you up, rather, it is a huge community built up of people, processes and relationships. There are many categories of staff, the nursing staff, administration, catering, PA's to the main surgeons, the in-house surgeons, consultants, anesthesiologists  radiologists the list goes on. Each of these groups of people often have complicated relationships with the other groups, sometimes cooperative, downright confrontational at other times. From the perspective of an outsider, these complex relationships seem unfathomable at first, but to get anything done, one has to quickly read the situation and work within the invisible boundaries that govern them. I've managed to do this recently, and have been reasonably successful. That is to say, I managed to get through the hospital experience without any physical altercation. Yes, there were voices raised by me and against me. But reason prevailed, certain compromises on either side ensured these conflicts were quickly and comprehensively dealt with, to the satisfaction of everyone involved. Well, almost.

The first phase of hospitalization is always patient admission. Your doctor recommended hospitalization, you took the advice and got down to the hospital. Armed with reports printed on endless graph sheets, x-rays, your medical history, a picture of your favorite god(s) and accompanied by an entourage consisting of at least 3 relatives, a driver (if that's how you roll) and sometimes even the next door neighbor  you make your way to the Admissions desk, where one of your entourage, is given a form to fill, with details of your name, age, sex, marital status, next of kin, permanent address and a bunch of other details. You also put down any insurance coverage details if you had the foresight to get some such cover beforehand. If not, you tick the cash option, and pray you have enough liquidity for the expected expenses.

A small admission fee and some queuing up at the cashiers window later, you come away armed with a file. This file is basically a record of everything that you will go through during your time at the hospital. Armed with this file, your entourage makes its way to the ward allotment administration section, where some very nicely dressed young person will ask you to sit down, and choose from a brochure of available types of rooms. Shared, semi-shared, private, deluxe, super-deluxe, yes, these are the terms used to describe them. Each of these rooms can be booked by paying an initial deposit, ranging from a pittance to a small fortune, and each has a daily rent that sometimes exceeds what a very posh hotel would charge you. Of course you want to see what your money is going to get you, so pretty soon you find yourself on a walking tour of the wards, starting from the worst (read shared/semi-shared/private) to the best (deluxe, super-deluxe). Walking into the shared/semi-shared/private wards that are usually housed in the same part of the hospital on the same level, it is not uncommon to hear moaning occupants, others struggling along the corridors, dragging along IV drips-on-wheels, nurses that look a lot like jail wardens and a bunch of visitors that you would not associate with outside the hospital. Lets just say, it is a very persuasive argument to walk away from the "downtown" wards and make your way uptown where the people are nicer, roads are wider, traffic is lighter and the lawns are trimmed. So a quick ride in the elevator, and you guide takes you to this utopian ward, where the rooms are larger than your apartment, with coffee tables, lounge chairs, couches and spare beds. The televisions are flat screens, the nurses are, well, not as scary, and there is a general feeling of entering a place where you know convalescence and recovery will be encouraged. You have made up your mind, so what if it costs more than other available options, I'll take the Deluxe ward, thank you. You get a printout of a disclaimer that you sign and return to the snappily dressed person. You get a bunch of stickers with bar codes that identify your patient id, payment mode etc. You get a list of rules and regulations. You also get an Attender's pass and a Visitor's pass. You are informed about visiting hours. About the various telephone extensions in the hospital. And finally you are given directions to the Billing department, where you are expected to quite literally, show them the money.

A bit of a wait, some more queuing up, and a disbursement of funds later, you are now the proud lessee of a room, and you waste no time in getting settled. At this time, the ward nurse in charge of the current shift introduces herself and her team. You are shown a large whiteboard in the corridor that proudly proclaims the nurses and their shifts, the rooms occupants and even a thought for the day. The dietitian comes by, asks for your preferences, and sets up the menu for each day. If surgery is on the cards, preparatory tests commence, you provide bodily fluids and imbibe various medicines that come as brightly colored pills, flavored syrups and the much-hated intravenously delivered variety. I will not go into details like the easy-access gown, bedpans, catheters (ouch), sponge baths (which are most decidedly not enjoyable, unlike what we have been led to believe) and other items. You check out the TV programming, familiarize yourself with the channel numbers of those stations you usually tune into, make a few telephone calls to relatives/friends that could not accompany you into the hospital, and soon are left with nothing to do but stare at the ceiling, and note all the weird whirring/clicking/pinging noises that are ever-present in a hospital ward. More medicines are ingested, more hospital meals are delivered, more tests are done, and finally the HDIC, or Head-Doc-In-Charge of your case makes his rounds and walks into your, now-cozy-but-a-bit-chilly alcove. A few words of encouragement from him, some stern reminders to stay immobile as much as possible, a couple of words with the shift nurse and he's gone back to doing what HDIC's do, which is some pretty mysterious stuff I would think. You now know when the surgery is going to happen, what they are going to do to you, and how many more days post-op you will be residing in the said alcove. With a prayer on your mind, you make up your bucket list, make some calls to people you would rather not talk to, and generally gear yourself up for whatever you imagine comes next.

Post-Op, you are back in your room. Crossed the monumental breach in the time-space continuum that is surgery. Staring at the rest of your life to come. Well, staring at the ceiling to be honest, but in a much better frame of mind than before. Now is the time where you get a virtual stampede of visitors, and each bearing good wishes, temple prasadams, apples, oranges, bananas, horlicks, invitations to their houses, discussions about their experiences at hospitals until you are quite literally exhausted. Suddenly you miss staring at the ceiling. You miss those whirrs/clicks/pings that accompanied your solitude. You miss that silence, that blissful alone-ness. And then it is time to go home. To leave the hospital, get back to your life as you knew it. Clearance forms are filled, paperwork is completed, files are maintained, copies are made, money again changes hands, and you find yourself in the back of a car, heading out into the world again. You get home, only to find it just as you left it. You realize that, monumental though it may have been to you, your brief absence from your world was barely registered. It may have inconvenienced a few, scared some others, but was just a minor aberrance from the norm. Life, thankfully, does go on, and that itself, you realize  is all you ever wanted or needed.