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How to Survive in a Hospital and Fire a Doctor

June 10, 2015 By Alix Kates Shulman

This blog is one of a series that Alix Kates Shulman wrote for Psychology Today about her life after a shattering accident left her husband with a brain injury and dementia. She describes a roller coaster ride many caregivers will recognize, but these blogs are also a tender love story—the gist of it is captured in the title of her deeply moving memoir, To Love What Is (2008). 

Published by Psychology Today on November 21, 2008

After six weeks in a Maine ICU, my husband, Scott, who suffered traumatic brain injury (TBI) after falling from a sleeping loft, was flown to the NYU Langone Medical Center in New York City for rehab.

Rehab? On his first night there, he fell off a gurney, causing new brain clots.

(Second impact syndrome: "When a person sustains a second brain injury before the symptoms of the first have healed...the second impact is more likely to cause widespread damage...[including] rapid death.")

How could this happen? Explanations come in passive voice. He "was left" on a gurney awaiting a test and "was found" on the floor. The hospital concedes that it "erred" by leaving him unguarded and should have given him a red bracelet indicating "safety issues."

Yet not even a red bracelet or one-on-one care can insure his safety. One week later, I return from the cafeteria, where I'd gone while he slept, to find his bed empty. My stomach lurches; I rush to the nurse's station.

"Where's my husband?"

In the Swallowing Lab on three for testing--"but don't worry," says his nurse, "I sent an aide with orders not to leave him."

In a flash I'm on those stairs, taking them two at a time. I dash through a long hallway to the Swallowing Lab just as the lab assistant is leaving. Unaware that Scott can't follow instructions, she's left him unattended on a very high chair before the X-ray machine. Twenty minutes pass before anyone returns.

Why is there no safety warning on his chart?

Where is the aide who was instructed not to leave him?

When I find her in the visitor's room, she says she was ordered to wait there, and how could she, a mere aide, protest?

Now I'm a lioness stalking prey. I question everyone I see--lab assistant, receptionist, nurses, doctor. Not one was aware that Scott needed guarding.

Later, while I'm voicing a complaint about one doctor to another, I discover that I may discharge anyone I choose. Armed by this revelation, I begin to fire incompetents.

First the psychiatrist, who has declared Scott "depressed" after one minute's observation of him lying listlessly in bed and one question about his appetite.

When I ask how he can diagnose depression on the basis of a single question, he says, "It's not based on that alone. I can tell he's depressed by his facial expression."

For a TBI patient with a breathing tube in his windpipe, who cannot walk, who is down fifty pounds, and who doesn't know the month, the year, where he is or his own daughter's name, lack of appetite and his facial expression reveal his problem to be depression?

Fired.

A week later I take on the clueless psychologist, whose fast, mumbled speech and refusal to make eye contact with Scott make it impossible for him to understand her test instructions, leaving him frustrated and angry.

Fired.

Finally, I confront the nurse who sent him upstairs without adequate precautions, the same nurse who was in charge the night he fell from the gurney.

Fired.

I can hardly wait to get Scott home. 

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