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The Way it Was: Medicine has come a long way

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March 3, 2010

by John Straka

Now I know what it's like to have surgery in a huge health care complex, and it's different from when I had surgery before.

The ordeal begins with pre-op testing. They assign a time and location and it's up to the patient to find the right place. That involves maps, diagrams, dealing with traffic, parking and lots of walking. Small signs, long corridors and special elevators make it like a treasure hunt or geocaching.

When you find the right place, you check in and wait, along with a room full of other patients. You are told to change into a gown, or to drink a large amount of their "lemonade," and you wait some more. The actual x-ray, or whatever the test is, takes only a few minutes and then you have to hang around, find out where you go next and repeat the process for each test.

Some tests are not actual tests, but interviews. The patient is asked a whole lot of questions by someone from the anesthetic department or the surgery department. Some of the tests are on different days and the patient has to go through the whole process twice. There is lots of paperwork and lots of forms to fill out, instructions on what to eat and drink before surgery and what medications to take or not to take, as well as what parts of the body to wash, how to wash and when to wash.

Then comes the day. Report to the right place early and wait. Nothing to eat or drink, just wait. During surgery, your family is on pins and needles wondering what's going on hour after hour. They give family members an electronic device that relays such information as "40-percent complete," or "getting ready to finish." That helps calm nervous loved ones, but not much.

After surgery, there is time in "recovery" before the patient returns to a hospital bed. It makes for a very long day.

Hospital beds are almost as complicated as the space shuttle. They have two-way communication with the nurses' station, and can weigh the patient while he or she is in the bed. The beds vibrate and roll patents around to prevent blood clots and bed sores. The foot of the bed is adjustable to make the bed longer or shorter so a tall person has leg room and a short patient doesn't keep sliding down the hill of an elevated bed.

Some hospitals serve meals to all patients at regular meal times. Others serve meals when the patient phones in an order, just like in a restaurant.

About 70 years ago when my mother had a mastectomy, everything was different. She had no x-rays, no mammogram, no biopsy, blood tests, no EKG, no pre-op testing of any kind. Her physician/surgeon said she needed surgery, made phone call to the hospital and another surgeon to assist him and a day or two later she was admitted.

They gave her ether as an anesthetic and did the surgery. She was in the hospital for 12 weeks, in the same room, the same bed and with the same nurse every day except weekends. She lived 50 years after that. Modern hospitals do not use ether and that makes a big difference, because it made people sick with nausea and vomiting.

Hospitals used to be the place where you went when you got sick and you stayed there when you were well. Now they keep patients only long enough to do the procedure and send them elsewhere for recovery, rehab and nursing care.

Each hospital employee has a specific job. I suppose that's better than having each doctor do everything himself. Someday, that may lead to a machine that will do all the tests, a computer to analyze the results and make a diagnosis and a vending machine to dispense medication.

Providing transportation for pre-op testing for my friend was the first time I experienced how different modern surgery in a big complex of several buildings and many departments is when compared to the way things were when I was very young.

While pushing my patient/friend along a very long passageway, a lady appeared ahead of us. She asked if we could use some help, quickly parked her jacket on a window ledge and took over the task of pushing the wheelchair.

Anyone who does not believe in angels should have been there. I don't know who she was, where she came from or where she went, but she was there at just the right time and place.




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