Scared and Grateful

Cleveland_clinic_2_6 You know how the US health care system is allegedly dead?  Mangled beyond recognition?  Well — don’t you believe it.  There are places here where the true wonder of good health care is visible in abundance.  The best of them, in my opinion, is the Cleveland Clinic.  I need to tell you why.

When someone you love – and live with – is sick, it’s scary.  When they’ve been through open-heart surgery, a shattered shoulder repair and a lengthy illness, it’s very scary.  That’s where I am right now. Scared.

My husband’s heart surgery was in 2002.  Five years later, he began to feel sick.  Many of the symptoms were similar to those from his initial illness, congestive heart failure caused by a faulty aortic valve.  The fear: that his valve was again failing — that the repair had not held.  So we went one more time to Cleveland to the remarkable institution where he’d had the surgery, to find out what was wrong.

After many tests, all perfectly scheduled and wonderfully administered, we learned that his heart is in good shape – at least the part that had been repaired.  The trouble was that the arrhythmia – irregular heart beat — sometimes very fast — that had also been dealt with in the surgery, had returned.  Now he’ll take a medication that, at least initially, is like being kicked by a horse.  If medication can get his heart back into rhythm, he can avoid the thing that scares me most.  It’s a surgical procedure, far less invasive than heart surgery, but still with some risk.  And it’s not fair.  He’s had enough to deal with – and frankly – so have I.  But apparently, higher powers have declared that not altogether true and this is our next mission.  So we’re on it.

The thing I try to remember and I want to tell you though, is how blessed we are to have access to the best that health care can deliver – and how remarkably common-sense a lot of it is.  This hospital is declared number one in cardiology every year because it is excellent.  The staff standards are high — and the hospital is headed by one of its top surgeons ( who operated on my husband.)  His standards are demanding and every surgeon who is hired "from Hopkins or Harvard or anyone else" still is vetted in action by the Director.  In addition, the nurses are empowered to make decisions and raise issues with physicians, the morale is positive and energetic and there’s not a nasty or impatient person behind any desk or lab coat. 

All of these truths add up to a single truth: there’s no mystery.  To get good health care we need a nimble, well-educated, trained and motivated staff and leadership to keep it that way.  Of course the equipment and endowment matter too.  But somehow in the insurance mess, the malpractice mess, the escalating cost mess – all provoking defensive driving by doctors and hospitals, we’ve weakened quality control and management in service to these other issues.  It’s a tragedy — one made far more real to me by our experience with the best – something that used to be true of our health care system altogether and sure isn’t anymore. 

I’m desperately grateful for what we are able to do to keep Rick healthy but every time I walk into the Clinic I remember again what’s going on in so many other health care sites and seeing what could makes it all even more tragic. 

MIRACLE CENTRAL

I know it says “Miracle Central” up there but this is NOT about religion. At least not exactly. I’m at the Cleveland Clinic – one of the most amazing hospitals in the world — so my husband can have his yearly checkup. Why do we fly to Cleveland every year? Even the Rock and Roll Hall of Fame wouldn’t bring us more than once.

We’re here because at this hospital four years ago a doctor cut open his chest, and then his heart, and saved his life. It pretty much was a miracle. So we like them to get a look at him once a year — to make sure he’s ok. It’s harder for me to walk into the hotel here than it is for him, I think. He was in congestive heart failure and scared but kind of beyond reality the day we arrived, and then he stayed in the hospital while the boys and I stayed at the hotel. After the surgery he was on medications and then struggling to get his strength back. The small details of illness, and families hoping for the best, were lost on him. Two years ago, when we made an extra trip to go through the same surgery with a good friend and his family, we were so focused on the particulars of his situation that the human dramas beyond them faded well into the background.

But tonight, sitting in the “club lounge” of the hotel attached to the hospital, listening to people with cancer and heart disease and weird combinations of neurological and heart problems and their families – and watching them laugh and tease one another and struggle to be brave, I was just knocked out. First of all it’s a beautiful thing to see — we see it every year when we come here — the way families take care of one another and support each other — and the other families they meet over breakfast or coffee — through what is a truly terrifying experience. Until you see a loved one on a gurney, being wheeled down a long hall toward life-and-death surgery, as alone as he will ever be — as you stand with your kids trying to smile for him — you can’t imagine.

Secondly – it’s an outrage to see such magnificent health care and realize how few people get it. This hospital is run so brilliantly and with such pride; each staff member so competent, confident and gracious that you just want to hug all of them. It’s still possible to offer good health care in the US — and it’s as much about good management as it is about money. I wish you could see it. We should NOT be allowing the wonders of American health care to fade away without a fight. If you want to see what we’re losing, come to Cleveland. Don’t give up those miracles without a fight!