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How to Survive the ICU

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UCLA’s Ronald Reagan Medical Center

My recent stay at the Intensive care Unit (ICU) of UCLA’s Ronald Reagan Medical Center taught me some home truths about medical care in America today. If you are there because you show symptoms of one of the major diseases which could lead to death, you will likely be well cared for. I am talking about heart disease, cancer, Covid-19, preventable injury, stroke, respiratory disease, and so on.

But if your problem is of a more unusual nature, requiring a specialist to be on call that is not in the top ten leading causes of death, things can get a little dicey. The first time I showed up in an emergency room for an Addisonian Crisis was eighteen years ago in San Diego. I was admitted to the Tenet Hospital in that city and was assigned to a physician who insisted on testing me on bodily functions I no longer had. He repeatedly refused to talk to my endocrinologist in Los Angeles, Dr. Julia Sladek. Thereupon, Dr. Sladek urged me to check out of the hospital against the advice of Dr. X, who was not only incompetent, but willfully stubborn.

Even in Los Angeles, the first time I checked into the UCLA Medical Center with an Addisonian Crisis, I was kept there for several days being tested every which way by a team of cardiologists, oncologists, etc. until someone finally listened to me and called in an endocrinologist, who hailed from India. She knew at once what was happening, saw that I was over the crisis, and had me discharged from the hospital in record time.

Fortunately, that visit is now a matter of record and is consulted every time I am admitted to any UCLA hospital (there is also one in Santa Monica). I am no longer poked and prodded beyond my endurance for days while a series of well-meaning doctors who know little to nothing about panhypopituitarism (which is to say, complete lack of a pituitary gland).

In fact, I didn’t see an endocrinologist my last two visits. Thank God for those computer records!

Things We Take for Granted

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We Can’t Make Assumptions That Health Care Will Be There for Us

We walk into the kitchen, pick up a glass, and turn the tap on. What if nothing comes out? Or, worse, what if what comes out is polluted like the water in Flint, Michigan? What if we flush the toilet, and it just won’t go down because the sewer line is all backed up? What if the traffic signals just stop working? Or the telephone lines? Or the electricity?

Every day of our lives, we make casual assumptions that what has worked in the past will continue to work. I have this odd inkling that perhaps we are living at the start of a period in which things we assume will work, just won’t work.

I recently read an article on Salon.Com about how some 20% of rural hospitals are on the point of collapse. Given the money-grubbing nature of our healthcare system—especially on the part of pharmaceutical corporations and health insurers—I can see why there aren’t enough dollars in rural areas to motivate hospitals to remain in business.

This comes at a bad time, when the political divide between the urban areas on the coasts and what has come to be called “flyover country” has led to hard feelings. Much of Trump’s support is, I feel, based more on this urban/rural divide than any particular love for the orange-headed horror. Things can only get worse if Aunt Tillie dies trying to get to a distant hospital, but doesn’t make it.

Government can rectify this situation, but only if voters are willing to let government do the things that government does best. The nihilistic conservatism and Tea Party anarchy of the times makes this difficult.