Surgery at Baptist-Lutheran

Stephanie had been to the emergency room at St Luke's in Kansas City, where she'd been ignored, overcharged, and they'd missed an obvious diagnosis. But now, a few months later, she had a good job with health insurance, and a doctor she liked, who said Steph had gallstones and recommended surgery at Baptist-Lutheran Medical Center.

We were amused by the name of the place. Baptists and Lutherans are competitors for your Christian tithes, but they run a hospital together? "It's like drinking Pepsi-Coke," Steph said, "or eating beef-ham-chicken-shrimp stew."

We'd give Baptist-Lutheran a mixed review. First and most importantly, the surgery went well, and that's what really matters, right? They plucked out Stephanie's gallstones, and she was under anesthesia so it didn't hurt until she woke up. When she woke up, though, it hurt a lot.

This was Steph's first overnight stay in a hospital since we'd been a couple, and we soon noticed a big difference between hospitals "as seen on TV," and hospitals in real life. In TV hospitals, when you're in pain they give you pain meds; in real life the staff is very tight-fisted with pain meds, and it's determined by the clock, not by your pain. If a doctor has decided that you can have one pain-pill every four hours, your pain levels are irrelevant. You're not getting another pill until four hours have passed. So Steph was miserable for most of the day, after her surgery.

Here's another difference between TV hospitals and real life: On the night Steph checked in, I stayed past visiting hours, and to my surprise the nurse didn't shoo me away like you always see on TV. "Visiting hours are over; please leave."

Instead she asked if I wanted to spend the night. Stephanie perked up and said, "Oh, is that allowed? That would be wonderful! Doug — can you stay?"

"If it's allowed," I said, "I would love to stay the night." The nice nurse brought a folding cot into the room, and a blanket and a pillow, and Steph and I held hands as we slept.

That's probably not the best for everyone, and "visiting hours" presumably serve a worthwhile purpose, but being together was better for Stephanie and I. She wasn't alone in a cold, sterile, scary place, and for me, staying overnight in her hospital room was far, far preferable to going home alone with my worries.

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Fifteen or 17 years later, let's say thank you again, to the Baptist-Lutheran nurse who said I could stay overnight. It was tremendously helpful, and it set the precedent that lasted for the rest of Stephanie's life.

Sadly, as her health issues progressed and recurred, Steph was hospitalized many times through the years. My rough estimate is that she was admitted 25-30 times during our marriage, to half a dozen different hospitals, for a total of eight or nine months spent in hospital beds. And at Stephanie's request I was with her overnight, almost every night, every time she was hospitalized.

We could talk with each other when we were worried, or we could share on old movie on the TV in the room, or I could fetch water and ice, or run interference with the nurses and doctors. She wanted me there, so I was there. She appreciated it, and it's one of the things we did absolutely right.

There was one exception, though — one night at one hospital where they insisted that Steph needed to spend the night alone, and that I had to go home. And boy, did that turn out to be a disaster … but that's a different story. Let's get back to this story instead.

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Steph's experience at Baptist-Lutheran was pretty much the same as what we experienced at every other hospital. Some doctors and nurses cared; some didn't. Sometimes when she buzzed for a nurse, a nurse or a nurse's assistant came within a few minutes; just as often the response took 10-15 minutes, sometimes longer, and occasionally much longer.

It's an old joke that hospital food is bad, but it's also true. Hospital food can be seriously and intensely bland, and because Steph had a diagnosis of diabetes, every hospital automatically put her on an even-blander "diabetes diet" — except at Baptist-Lutheran. They put her on the regular menu, and didn't tell her. Her first meal, the night she checked in, she thought the food was so-so but the dessert was fabulous. With one bite she knew this wasn't a sugar-free, low-carb, diabetic-friendly apple pie.

She buzzed for a nurse, and explained that she was diabetic but they'd clearly brought her a super-sugary pie. The nurse looked through some paperwork and said that it wasn't a mistake. The doctors and dietician knew Stephanie was diabetic, but they planned to countermand the sugar with an increased dosage of her diabetes meds.

When the nurse left the room, Steph said to me, "Well, that's not the way they've taught me to handle sugars and meds at home, but it's a hospital so they must know what they're doing. I'm going to order a sugary dessert with every meal, and turn this hospital stay into a vacation from my diabetes."

She wasn't allowed breakfast the next morning because she was scheduled for surgery, and after the surgery she wasn't supposed to eat for a few more hours, so she was dang hungry by the time she could order a late lunch, with two desserts and a sugary soda. Again, the meal was bland but the desserts were excellent. She hadn't had a non-diet soda in years, and sugary treats were rare, so she was on a glucose high. And then for dinner, she ordered something very carbohydrate-laden, and again two desserts, and again a real soda. Breakfast the next morning was Fruit Loops, a cinnamon roll, full-fat yogurt, and full-strength orange juice.

"This is great," she said. "I'm eating like a person, instead of like a diabetic person."

Understand, please, that Steph wasn't being bratty or troublesome here. They were pricking her fingers to test her blood sugars before and after every meal, and supposedly keeping her glucose levels down with more and more of her diabetes meds, right? She was in a hospital, she wasn't on a restricted diet, they were monitoring and controlling her blood sugars, so why shouldn't she have a few days off from carb-counting and fake sweeteners?

After breakfast, Stephanie was eager to go home. A nurse came in at about 8AM, read us a recap of Steph's stay and a list of recommendations — no heavy lifting, come back for a follow-up visit in a few weeks, etc. We said thanks, took a copy of the paperwork, and Steph climbed out of bed and started packing our stuff.

"Oh, you can't leave yet," the nurse said. And then she explained that leaving the hospital is more complicated and time-consuming than entering the hospital. Basically, the patient gets a final pep talk from everyone — advice from the surgeon, from the hospital's day-to-day doctor, from the pharmacist, the dietician, advice about caring for the surgical wound, and a recap of everything from the nurse. Also, perhaps one or two more lecture sessions that I've forgotten.

We'd only had the recap from the nurse, but everything else on the check-list was still pending. Of course, all these things don't happen at the same time, and there are no "appointments" in a hospital, so all these people would be arriving one-by-one whenever any of them had a few minutes. "There's no predicting these things," we were told. "It might be half an hour, or it might take several hours."

So Steph waited in bed, and I waited in a chair, sighing and watching game shows or Sally Jesse Raphael or whatever was on TV. And we waited and waited, until the pharmacist knocked and meandered in at about 10:45.

That's when things grew strange, so let's add a disclaimer: Steph knew her medical stuff better than I did, of course, but she's gone and it's fifteen years later, so the details are hazy and might be wrong. What I remember clearly is that the pharmacist introduced himself, and read a recap of the meds Steph had been given in the hospital, and the meds she'd be taking at home. And it was wrong.

Steph knew her prescriptions forwards and backwards, and she spotted two mistakes — they'd listed the wrong dosage for the diabetes meds she was taking at home, and presumably because of that first mistake, they'd miscalculated and given her the wrong dosage of diabetes meds during her entire two-day stay at Baptist-Lutheran.

The pharmacist hadn't known about the mistakes until Steph told him the dosage was wrong, so we watched as the realization crawled across his face. To his credit, he promptly apologized and made no attempt to hide the mistake.

Still, Stephanie was angry, and so was I. What I remember most clearly was the instant feeling that all of Stephanie's sugary desserts and sodas hadn't been a vacation from diabetes after all, because she hadn't gotten the promised meds to countermand the sugar.

The pharmacist buzzed for a nurse, and someone pricked Steph's finger for another test of her blood-sugars, and quickly someone else appeared, and gave her a shot of insulin. More apologies were offered and accepted, and after the initial shock, Steph and I realized that a few days of sugary indulgences with reduced meds, while not a good idea, wouldn't do much lasting damage. She'd be back on a low-carb, low-sugar diet as soon as we left the hospital.

But to say the least, it was unsettling that a hospital had gotten Steph's prescription wrong. So we were cranky, and now extra impatient to get out of the hospital. Stephanie buzzed for a nurse, and buzzed again ten minutes later. When someone finally responded, Steph asked, "How much longer until I can go home?"

"There's no predicting these things," said the nurse or nurse's aide. "It might be half an hour, or it might take several hours." It wasn't word-for-word the same response we'd heard several hours earlier, but it was close. Obviously, this is a question they hear very frequently, so the answer is memorized.

"Well, what happens if I simply leave?" Steph asked.

"Oh, you shouldn't do that. The checkout procedure might seem slow, but it's important —"

Steph raised her hand and interrupted, but without raising her voice. "Am I required to stay? Am I allowed to leave the building?"

"We can't keep you against your will, but if you left, it would be Against Medical Advice." The way the staffer said "Against Medical Advice," it was clear that the words needed to be capitalized, and that this was in some way A Big Deal.

"With all due respect," Steph said, "I'm not getting anything out of hanging around the hospital all day. I've had my surgery. I've been briefed on the mistake you guys made with my meds. Unless there are other mistakes we need to know about, I'm not really feeling the Baptist-Lutheran love, so please tell everyone I said thanks but … I'm outta here."

It was obvious that the decision had been made, so I started packing up our stuff midway through Stephanie's speech. The employee we'd been talking with tried again to talk Steph into staying, but when it became clear that she was going home, Steph was plopped into a wheelchair and pushed down the hall, into the elevator, through the lobby, and out the front door, all while the staffer tried to talk Steph into staying.

I drove us home via the grocery store, where Steph stayed in the car with the radio playing, while I bought us a few sundries — including Diet Coke, definitely.

* * * * * * * * * *

After the surgery they had stitched up Stephanie's belly with "dissolving sutures," medical thread that's designed to fade away without needing to be snipped. That's what Steph was told, but the reality was something different. The stitches disappeared, yeah, but near as we could figure they disappeared inward, and they never really dissolved.

The surgical wound healed, and the scar on her belly largely faded away, and she never had the recurring abdominal pain again. And pieces of medical thread appeared at random near the surgical site, for several years. The sutures were still there, under her skin, and stiff like dental floss. Stephanie could sometimes feel the sutures poking up from under her gut-flesh, and short bits of medical thread grew out like whiskers on her belly, one at a time. For years.

Steph asked her doctor about it, and was told not to worry. "It's not a big deal; sometimes the dissolving sutures don't dissolve." The doctor's office seemed unconcerned, but offered to make an appointment if Steph wanted. Or, they said, you could just pluck out the sutures with tweezers, as they appear. For several years, Steph plucked sutures out of her belly with tweezers now and again.

"When doctors have to undergo surgery," Steph once mused, while she was tweezing her belly for the 20th or 30th time, "I'll bet they use dissolving surgical thread that actually dissolves. They use the good stuff — the stuff they didn't use on me."

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Update: Clicking a few keys on my computer, today I learned that Baptist-Lutheran Hospital ceased to exist, circa 2006. Wikipedia tells me it was sold to a giant health-care conglomerate, and the main building where Steph had her surgery has been turned into an old folks' home.