ASNN

Car accident

Here's the short version: my blogging of favorite albums (and, in fact, all of my life) was interrupted by the fact that Nase (my wife, for those just joining us) was in a pretty bad car accident. It was a one-car accident (the car hit an electrical pole) and all involved are relatively okay. Nase is the only one who was really hurt, and she is still in the hospital being treated for multiple fractures in her left heel. She will require surgery, both now (of the fix-it sort) and possibly later (of the reconstructive sort), but all things considered, she is doing quite well.

Read on for the sordid details.

Around 3pm on Friday, Joe[*] (a friend of ours), Ilyana (our 5-year-old daughter), and Nase were driving from Tehachapi to Palmdale for a wedding rehearsal. It was rather windy, as is the norm for Antelope Valley and Tehachapi. Joe was driving our car since Nase was feeling too tired to drive. Everyone was singing hymns and feeling good.

Suddenly, the car lurched to the right-hand shoulder. (My guess is that the wind blew the car over, the right-hand side tires fell off the pavement and jerked the car to the right, and the tires lost traction on the soft shoulder.) The car fishtailed and struck an electical pole in the right-front of the car, spinning it around a couple of times before it came to a stop.

The car was a mess, Ilyana was scared, Joe was stunned, and Nase was severely injured. However, through her injuries, Nase directed Joe to remove the relatively uninjured Ilyana from the car, while she broke out the passenger-side window (we still aren't sure how) and climb out through the jammed door. The three of them staggered to safety a little ways from the car.

Over the course of the next few minutes, dozens of people stopped to offer their assistance to Nase, Joe, and Ilyana on this back road. (For reference, the road (90th Avenue in Rosamond, around Backus Rd.) is relatively well-travelled between Antelope Valley/LA and Tehachapi, but is still fairly "in-the-middle-of-nowhere".) Many of the people who stopped offered coats and blankets to Nase, who was disabled and bleeding quite profusely from her foot. One, presumably a school teacher, even gave Ilyana some books while they were waiting for the emergency response team.

The EMTs finally got there, and decided that Nase and Ilyana (who were both complaining of abdominal pains and other injuries) needed to be airlifted to the hospital. The cloud cover and wind were too great to fly them into Bakersfield (the largest nearby city), so they were taken to the Antelope Valley Hospital ER. Ilyana was quickly discharged, as was Joe (who had hitched a ride in the ambulance to AV), but Nase wasn't so lucky.

Unlike Ed, I didn't have any trouble convincing the doctors that we didn't have health insurance. The fact is, we don't have ANY health insurance (whereas Ed was trying to convince his wife's health insurance company that he no longer had insurance). None, zip, zilch, nada. Yes, this is one of those horror stories where you don't have health insurance and you need surgery, an extended hospital stay, or both. Yes, this sounds like the kind of thing that only happens to someone else. But I am here to say that this indeed happens.

AV Hospital didn't have an orthopaedic surgeon available on the weekend. So Nase needed to be transferred to a hospital where she could see an orthopaedic surgeon for her mangled foot. And because we had no insurance, our only real option was the trauma center at the USC/LA Country Hospital, which is also a school of medicine.

As a sidenote, I hate not having options. I feel trapped when only one option presents itself, and this was no exception: I didn't like the fact that because we had no insurance, my wife's injuries (which stemmed from an at-fault, one-car accident in which she was a passenger) would be treated at a public health care facility. But I realized that it was more important to see about getting her into a place where she at least stood a chance of being treated (as was the case at USC) than it was to deal with my own personal preferences of having choices. So we arranged to have her shipped, via ambulance, to USC near downtown Los Angeles.

Although she arrived in good shape, she soon began to experience the ambivalance with which public health care nurses and doctors treat their patients. Before she could get a bed, she had to go through the ER again, only at USC rather than AV. The staff at USC is used to dealing with gunshot wounds, knifings, and other severe traumas, so they were pretty unimpressed with Nase's condition. (This, of course, didn't affect the fact that she was in severe pain.) In the busy ER, she was pretty much ignored; she was given very little pain medication to deal with her shattered heel, and was frequently approached and pitied... but no assistance.

After four hellish hours in the ER, she was given a bed in an orthopaedic trauma ward early Saturday morning. The neglect just continued there. Nurses would generally come in about every 60-90 minutes to check on her, but would rarely respond to individual requests to speak with them. (And the times they did respond to our requests, many of the nurses had a bit of a language barrier with English. The Korean nurse assigned to Nase's shared room was adequate when it came to English, but her grasp of the language was by no means firm. Don't get me wrong: I have no problem with foreign nurses, but when they cannot communicate with their patients, it becomes a problem.) The rule was pretty much that we had to request to see the nurse about four or five times before she would actually come in. As for the doctor... forgetaboutit. Nase saw the doctor precisely once before Things Changed (keep reading), and that was a five-minute meeting to inspect her foot and help his interns/residents get some experience.

Because of the nature of her wound (it was actually an open fracture, exposing the bones in her foot), we were assured that her surgery (to sew up her foot) would take precendence over other surgeries. Of course, any major traumas would take precedence over her, but that was something we could accept and live with. What we couldn't accept was the fact that when the Demoral shots weren't working well enough, they decided to try Tylenol with codeine. (Why scale down the medicine when the more-powerful stuff isn't working?!?!)

When I told my dad how they were pretty much ignoring her, and giving her weak painkillers (when they were actually paying attention), he got pretty upset. He decided to drive down, to stay with Nase overnight, and to deal with the hospital staff as the situation arose. Upon arriving, the first thing he did was to call the nurse and grill her on what the Tylenol/codeine prescription was all about, since it was far too weak to actually do anything for Nase as the Demoral wore off. He made sure to speak to one of the residents and convince them that Nase needed treatment. Ten minutes after that, I received a call from him that Nase was in surgery. We were relieved...

...until we found out that they really didn't do anything. They *did* flush out her wound, pump her full of antibiotics, and sew her up... but they didn't actually address the fact that her heel was in many pieces. We found out that they would do that in a second surgery, but we also found out that that second surgery probably wouldn't happen until at least Tuesday. Here it is, late Monday night, and I can testify that their estimate seems to have been pretty close.

In the meantime, she was treated to the wonders of socialized medicine for the uninsured. After her surgery on Saturday night, she was moved from the ortho ward to a general ward. To her relief, the nurses in the general ward seemed better and a little more attentive. That was before they:

• Didn't tell her that her pain medication order had run out. Instead, they just stopped giving her pain meds and waited for her to complain.
  
• Stranded her in x-ray for 45 minutes, 20 of which she was crying before a doctor (not a nurse) offered to help her get back. In addition, she was in a wheelchair with all of the blood running to her foot... when we found out later that the doctor had insisted on bed rest, which meant she was NOT to get out of bed at all.
  
• Talked right outside her bed area (behind a curtain, which they apparently thought was soundproof) about how difficult Nase was, etc. etc. Oh yeah, they were speaking in Spanish, like she had NO idea what they were saying...
  
• Somehow worked a codeine allergy into her record, even though no one remembers how it got there. As a result, she was limited to her Demoral every 4 hours, when she could also have been getting additional pain meds in between Demoral shots.
  
• Moved her into a wet (with water and cleaner) bed.
  
• Refused to find her a wheelchair to allow her to go to the bathroom on her own. (This was before we knew that she had been prescribed bed rest. But that's not why the nurses refused to get her a wheelchair; it's because there was only one wheelchair for the entire 10th floor. Hey, they *did* offer a crutch (yes, ONE crutch... I guess they only have one of those as well).)
  
• Couldn't find her a pillow. Nope, not even one. Pillows are more scarce than wheelchairs or crutches on the 10th floor!

In a nutshell, this is a hospital from hell. I'd say they have poor bedside manner, but that assumes SOME bedside manner, and most of the nurses have precisely zero. Nase is miserable, I am miserable because I can't help her (short of getting in the faces of the nurses to get her help, which I have had to do on a number of occasions), and nothing seems to be moving. (Well, she has moved beds twice in two days, but nothing *productive* seems to be happening.)

Please don't think I'm mincing words. The nurses are worse than worthless. They are animals, apparently thriving on cruelty to those in the most need of their help. They feel no obligation, or even desire, to do their job even poorly. Rather, they sit around their little nurse's station in a little clique and bitch about life, the patients, whatever. They are worse than worthless because they give the air of actually caring, doing something, helping. And yet, they are imparting only desparation to the patients (Nase isn't the only one from whom I've sensed this) and encouraging resentment among the doctors (toward the nurses). That is worse than worthless: that is soulless.

Not all of the nurses have been this bad, but the good ones have been so few and far between that I think they must not actually be nurses, but simply human beings.

(For more reading on the miserable state of this hospital in general, see this article for example. It's important to note that once you actually get *seen* and your problems get *addressed*, the doctors are absolutely top-notch. It's just getting to that point that is difficult.)

One final note on the hospital issue: the second operation on Nase's foot is supposed to happen tomorrow. If it does not (say, because another trauma comes in that trumps her spot in the OR), she will be in a private hospital by Wednesday morning and under a different ortho surgeon's knife by sundown on Wednesday. The two insurance companies (ours (since it was our car) and Joe's (since he was driving) seem to be playing pretty nice together, and while they cannot preauthorize a procedure, they can tell a doctor what the limits are and what they plan to pay if a procedure is done. Hopefully, this will be enough for one of the eight private ortho surgeons we are contacting, and she will be in St. Joseph's in Burbank before tomorrow is over... IF the USC doctors end up unable to help her out.

Nase is okay, awaiting surgery, and in good spirits. The car is totalled, and we aren't sure what we're going to be able to do for a car, long-term. At least for now, we will have our choice of a couple of cars from family and friends to borrow, so that's good. I'm going tomorrow to the tow yard to collect our things from the car, and I'm a little excited to see what it looks like. Maybe I'll take pictures...

Anyhoo, keep us in your prayers. Right now, we are praying for a couple of things:

- A miracle, in which Nase's foot fuses together before the surgery in such a way that she has no chronic pain or stiffness, thus baffling the doctors. Yes, our God is that big.
- Peace for Nase about whatever happens, and comfort as she toughs it out at USC.
- The ability for Nase to get around well enough by Thursday to enjoy Thanksgiving with the rest of our family.
- Patience and self-control for those of us who are ready for God to get on the ball, who are ready to strangle the nurses, or both.

Watch here for updates (though I promise not all of them will be as long as this one :-).

[*] Name changed to protect his dignity^Widentity.

Posted by pcg at November 24, 2003 1:41 AM