IS OUR HEALTH CARE SYSTEM ON LIFE SUPPORT?

How long before you call 911 and hear elevator music interspersed with a robot voice saying: “Your call is very important to us. Please stay on the line and an operator will be with you shortly.”

That’s what we’re coming to. Some places are there already. Next time you have a medical emergency, you may not get the treatment you need. After waiting for your 911 call to be answered, you might wait a long time for an ambulance. A health care professional who worked in hospitals around the country for the past few years is telling me that our emergency rooms are so jammed, patients they used to be able to save are dying.

There aren’t enough nurses. There aren’t enough doctors There aren’t enough aides. There aren’t enough EMTs. It was a critical situation almost everywhere prior to onset of Covid. Writing three weeks ago in US News & World Report, ER physician Sharon Anoush Chekijian said: “Even before the pandemic, it felt like the emergency department was shouldering the lion's share of primary care: We'd provide treatment for hypertension, refill prescriptions when calls to the doctor's office went unanswered and manage chronically elevated blood sugar. Behavioral health patients with nowhere else to go would arrive one after the other by ambulance… Now COVID-19 has laid bare medicine's house of cards.”

Our ERs are teetering on the edge. The recent vaccination mandate from Maine Governor Janet Mills caused a surge of staff resignations, as have similar mandates across the country. According to the October 1st Lewiston Sun-Journal: “‘It has a huge impact on the existing labor shortage,’ said Dr. John Alexander. Central Maine Healthcare is the parent organization of Central Maine Medical Center (CMMC) in Lewiston, Bridgton Hospital and Rumford Hospital, as well as Maine Urgent Care and a primary care network. ‘In addition, to be honest, a lot of the people, a lot of frontline caregivers who have worked through this pandemic are tired,’ he said.”

I asked the health care professional who first alerted me to the problem why hospitals don’t just hire more staff. She said they’re just not out there and nursing schools aren’t graduating them fast enough either. Neither is there enough staff qualified to teach nursing students. Salaries at all levels are way too low. Hospital administrators. However, are paid well. Ten years ago the CMMC CEO was paid over $857,000 for fiscal 2011. What is it today? I wasn’t able to find data. My guess would be over a million per annum.

The Emergency Medical Treatment & Labor Act (EMTALA) passed in 1986 mandating that emergency rooms treat everyone who shows up. They must be screened, stabilized, then passed on to an appropriate hospital or they stay in the ER.

ER staff see patients suffering and dying every shift for lack of care. They see loved ones grieving too. CEOs do not see these things. They see spreadsheets of profit and loss. Kate Wells of Michigan Radio writes: “Inside the emergency department at Sparrow Hospital in Lansing, Michigan, staff members are struggling to care for patients showing up much sicker than they’ve ever seen.Tiffani Dusang, the ER’s nursing director, practically vibrates with pent-up anxiety, looking at patients lying on a long line of stretchers pushed up against the beige walls of the hospital hallways. “It’s hard to watch,” she said in a warm Texas twang. But there’s nothing she can do. The ER’s 72 rooms are already filled. “I always feel very, very bad when I walk down the hallway and see that people are in pain, or needing to sleep, or needing quiet. But they have to be in the hallway with, as you can see, 10 or 15 people walking by every minute,” Dusang said. …“I cannot tell you how many of them [the nurses] tell me they went home crying” after their shifts.” 

Dr. Chekijian in US News says: “The bottom line is this: The house of medicine in the U.S. is a house of cards that has already started its crashing descent into collapse.” 

I just turned seventy last spring and this is a disconcerting scenario for my demographic, the cohort most likely to need health care. Prone to chronic blood clots, I’ve spent many hours in emergency rooms over the past thirty years, the last few times on a stretcher in a hallway because the ER was overcrowded. I watched nurses scurrying about trying to tend to us all and hated to add to their stress by asking any more of them.

The last time I did that was three years ago. What will it be like the next time? I hate to think.

Shaking Things Up

My room circled in red

Every so often the Creator lets me be shaken up. It’s probably a sign that I’m getting too complacent, that He wants to remind me of my mortality, and that He sustains me in existence just has He does everything else. Not everybody who has read this far believes as I do, but it’s both an enriching and a sobering awareness. Here at Maine Medical Center where I’ve been staying for a few days there is lots of time to reflect. I’ve been taken out of my element and confined in another to ponder what I was doing before I came in and what I’ll do after I go back into the world outside.

It’s Monday morning and I won’t be getting out today. Maybe tomorrow. Maybe the day after that. I have little control and it’s blowing a gale out my third-floor window. There are few leaves left on the trees but some cling tenaciously while the branches are blown about violently. I’m right above the main entrance and I see the American and State of Maine flags on the pole out there are torn ragged and are tangled up with each other. Metaphoric? Perhaps the Creator has decided the whole region needs some shaking up.

Flag out my window

Five thousand people work here in this complex. Doctors, nurses, maintenance, and housekeeping staff keep it all running — mostly nurses. They’re very good here and it’s a kind of sisterhood. Because two of my daughters are nurses and they’ve been in here advising me, they connected with the sisters on the ward. Come to think of it, “sisters” is what nurses were called in England back in the day. So now I’m connected. I’m “family” as they put it. Nice.

Friends are watching the properties I’m responsible for in Lovell while this storm blows itself out. Messages and phone calls are coming in to my hospital bed and going out again. Down the hall, men in work clothes with hands accustomed to holding tools are on their cell phones instructing others to move generators around as they’re in here visiting family members.

I’ve always been busy, but thirty years ago I was even busier with a young family and all that goes with it. When my health problem flared up I’d be incapacitated for five or six weeks and discover again that the world could get along fine without me. It was humbling then and it still is. I’m not indispensable. I can be replaced. We all can. It happened five times in fifteen years and now I’m getting a reminder, but this time it’ll only be about a one week I think.

My mother turned 93 last month and five of her eight children helped her celebrate. All of us have taken care of her in one way or another for years whenever she’s needed it. We’re all glad to do it because she took care of us. Now my kids are pitching in for me when I need it. It’s a wonderful arrangement and it used to be the norm, but that’s changing. Visiting the Portland environs regularly the past five years, I’ve noticed far more people out and about with dogs instead of children. It’s a definite trend and a troubling one. Dogs are fine, but as substitutes for children?

Last May, France’s President Macron became the twelfth European Union leader who never had children. Others include Italy’s, Scotland’s, Germany’s, Luxembourg’s, Sweden’s, Holland’s, Latvia’s, Romania’s, Lithuania’s, and the EU President, Jean-Claude Juncker as well. I noticed the trend in my old profession. A fellow teacher leaned over at a contentious staff meeting and whispered: “Ever notice that the teachers who constantly profess to ‘care about the children’ the most never had any?” I looked around and realized he was right. It’s a definite trend and I don’t believe it’s a good thing.

No kids

Raising children can be expensive, time-consuming, heart-breaking, and tedious. It’s also rewarding, meaningful, heartening, fulfilling, wonderful, and sometimes you get grandchildren in the bargain. They’re terrific. All that experience changes us. Rising to the challenges of parenthood improves us and confers wisdom, and to completely deny ourselves is to diminish life. When parents and grandparents make plans, the needs of our offspring get major consideration that is personal as well as professional.

The Maker of us all knows this and I suspect it’s part of His protocol for those who would lead us. Some politicians may not be childless by choice and parenthood isn’t a necessary precondition for wisdom, but it’s a plentiful source of it.

As we rural folks go without electricity and all its amenities for however long during this latest shakeup, we will appreciate them when they come back. Then let us remain in that state of mind as long as we can.