Wednesday, March 28, 2012

Hospitalists - My birth as a racist at the age of 51

A week ago this topic would not have even caught my attention.  I might have had a minor poor opinion of Hospitalists but I couldn't have carried on more than about a one minute and 32 second conversation about it.

Now, after the week from hell in two hospitals, things are different.  The "hell" in the hospital was not caused by being sick.  Being sick in the hospital sucked and was painful and uncomfortable and scary. The "hell" came from dealing with the doctors who work as hospitalists in hospitalist groups.

As some of you may have picked up I became ill on 2/23.  A month later I am still sick.  But not acutely sick.  Not the sick that if you don't help me I won't be able to take another breath sick but the "hey dudes, something is really wrong with me, its not going away and I don't know how many more times I can go back and forth to the doctor and ER trying to figure it out" sick.

That was strike one:  You are not supposed to be in the hospital unless you are really sick with something that they can diagnose.  The hospital doesn't get paid for you being there by the day.  They get paid by the diagnosis and the more complex the diagnosis the more they get paid.

So I wasn't very sick but was taking up the bed that someone with a really "valuable" sickness could be lying in.  Or three or four more people as they rushed them through the bed.

So I have what appears to be some very basic viral or bacterial pulmonary issue.  Even if they can confirm an actual cause and make the diagnosis it isn't going to get them paid much money. 

What I needed, wanted and expected was that lab tests would be run and that I would be released to go home and get better with the help of the specialist(s) who work in the area of my illness generator.

What I got was a complete wall of stone, abusive, abrasive, caustic, demeaning and punishing behavior by most of the doctors involved. I was baffled as to what I was fighting against, what the resistance was that I kept running into, but I was determined to get them to do what I knew needed to be done.  So sick as I was I fought.  And I fought.  And I changed hospitals. And I fought some more.

Three of the four doctors I fought with were from India.  One was American. They were all men. The one doctor who finally helped was another American, a man and not even an Infectious Disease doctor.  But he was the one who ordered the Environmental Toxin screenings, who did the bronchoscopy to acquire the sample to do them with, approved a shower that I had been denied for three days and ordered a second dose of Diflucan to treat the yeast infection I had acquired from taking the antibiotics, which had been denied. He then recused himself from my case.

I was released with no diagnosis.  Lab reports are pending. I am still sick.  I do not know what the cause is. I do not know if I am getting better or if I should plan on getting worse first.  They are generically treating me for a bacterial infection that is biphasic but they are guessing.

I walked out of the second hospital with the label "Racist" stuck to the back of my shirt. I asked for the chaplain to come to visit me and they came back to tell me that he was Hispanic and wondered if that would be okay. I used the term "culturally similar" in requesting advocacy. It doesn't matter that I have good friends from Dallas who are from India. It doesn't matter that I've always worked really hard to relate to people who are different from me. After war was waged, Walt and I against three Indian hospitalists (and one American who works for the Indian Hospitalist group), battles were lost, souls were sold, but the battle was won. I got the tests.  I got them in a mostly timely manner.

I don't know if I'm kinda sick or on the way to being really, really sick.  A neighbor I know died last week of something that was similar to what I have. So I'm scared.  And I feel like crap. And I'm a racist. And I'm one tough, damned woman and no man from ANY country is going to walk into my hospital room and tell me I am having a panic attack when I am really sick and not expect to have to deal with me about it.  Hospitalists, or men or Indians or martians -  be forewarned.  And when I'm lying in that bed, as long as I am able to speak and think, I will demand a dialogue.  No - you are not going to unilaterally decide how to care for me.  You make me part of the team or you will have a fight on your hands.

I have attached a link to an article that describes how the "Hospitalist" model made its way into American hospitals.  As I suspected it had nothing to do with providing quality patient care. As I suspected it is all about making money.  What I didn't suspect was that Medicare restructuring was the impetus that drove the change. And so I walk away armed with yet more information about how Medicare, as administered by Congress (both Republican and Democrat) - not the Federal Government - drives the whole, crazy thing we call Medicine in this country. We don't need Medicare Reform.  We need to stop letting our legislature dictate how to practice medicine. They are not doctors. They are not acting on the best interests of the patient. No national healthcare reform is going to be successful until we remove Medicare/Congress as the governing force behind all things medical.

I strongly suggest you read this article if for no other reason than to prepare yourself for the agenda that the hospitalist and hospital have when you hit that bed.  Your social consciousness will come after you've experienced it.

Copyright 2012 - Chardale Irvine.  You may not publish or reprint this article without permission of Chardale Irvine.  Thank you.


  1. Char,

    I am sooo sorry you are feeling so sick. I am also so sorry for what you have been going through. Really sucks. You are right. There are some major problems going on out there!

    On a side note...happier... I love the way you write! It reminds me so much of your Father. So, if it helps you feel better -- even a bit, keep writing... cause you know, we are going to keep reading!

    Love you!


  2. Thank you Terra. I take it as a huge compliment that my writing reminds you of my Dad, Gary Dotson. I love how he writes and envy the way he worships the beauty of words. It has been so fun to see him venture out with his stories and accountings. I am having fun with the chardalescuriousjourney though this post wasn't much fun. I did feel relief when I published it and that's what it is all about ! Love you too

  3. Char,
    Just for kicks I clicked on the article and read about this growing movement of "hospitalists". If you ask me, it sounds like a pretty idealized way to deal with the changes imposed on the medical community by Congress and the insurance industry. Sounds good on paper, but your three Indian doctors didn't seem to read the part about having a dialogue with the patient. I hate that about most doctors, that sense of superiority they sometimes lord over their patients. I love that you are ballsey enough to stand up to them, and I hate that you ended up having to do it. I would have loved to hear your treatment described as "compassionate care". Unfortunately, caring service is the exception these days.
    Love to you,
    Your cuz Lynn

  4. Lynn, I so agree that these Indian doctors missed the part of their training that taught them how to have a dialogue with their patients. Since it happened in both hospitals I am guessing it must be a pretty serious cultural issue. I am doing more research - I suspect I'm not the only one who has had this struggle but it is such a delicate subject that no one dares research it or write about it. - Also, I realize the insurance lobby is quite powerful but what I'm finding is that most insurance coverage and payment uses Medicare as their contract basis. I wonder though how much influence that lobby is having on Medicare policy and funding.

  5. Update: the labwork confirmed Herpes Simplex in her lungs! It eventually went to her brain and was causing stroke like events. Char took her life on 2-20-2015 alone in parents empty house. Asshole doctors. Some days I want to go back and punch everyone of them in the throat