Long day’s journey into recovery.

Monday, October 9th, 2006

Hello from Michigan, where Sammy’s dad continues to mend in the hospital after open heart surgery that is daunting even when you aren’t almost 90 years of age.

Experiencing this process from the edge (I’ve only visited the hospital once or twice; Sam has done the heavy lifting of parent-in-hospital care) I’m struck by how providing information to the patient and his/her family about what’s happening now and what’s going to happen next seems firmly rooted in the last century. It may well be that there’s a tradition of a “need to know basis” that comes out of a similarly hidebound attitude about doctors as elevated priests of knowledge.

This approach has its advantages—if you screw up or change your mind, it’s easier when you don’t have to discuss it—but it also leaves patients confused…in a situation where they’re already befuddled about basic questions (“What day is it again?”) enhanced by the cocktail of drugs and anesthetics that they’ve been asked to down.

In the Intensive Care Unit, the monitor that Nick was hooked up to had streams of data—heart rate, blood pressure, and so on—in clear, colorful, antialiased type…it was one of the nicest displays I’ve seen since Dr. McCoy’s Enterprise bedside. But that readout was located behind the patient’s head—he couldn’t see it. He could, however, turn the TV set onto CNBC and get similar cascading streams of real-time data about Wall Street’s health.

I kept thinking that since they described the process of recovering from significant surgery as a progression, a curve to follow, there ought to be a large colorful real-time screen right in front of the patient that displayed that curve and the mileposts along it, nicely formatted and overlaid. Heart rate: 78 and steady. Next nurse visit coming in 04:12:01. Dinner tonight will be cottage cheese, deal with it. Last urination: 37 minutes ago. You slept 4 hours last night. If your hemo numbers drop below 211, expect to get some whole blood. Your daughter last visited you 45 minutes ago. If all goes well, you’ll be released in 2 days, 1 hour and 32 minutes.

Your son-in-law last cut the grass at your house 2 days ago. Your wife’s stress level: 17% and rising.

And perhaps to quote one of the Enterprise-D‘s descending bedside metrics: medical insurance remaining: 21%.

It’s always nice to know where you stand—even when you’re flat on your back.