the writing and photography of Neil Kramer

Month: April 2007 (Page 3 of 3)

Where’s ICU?

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Thank you for your emails and comments about Fanya, Sophia’s mother.  She is doing better, and was released from the hospital tonight.  

Fanya’s room was located in the Saperstein Critical Care Tower, which was opened last year after entrepreneur and philanthropist David Saperstein and his wife Suzanne made the largest donation to Cedars-Sinai in the Medical Center’s history.

“The Sapersteins have accepted a crucial role in the reinvention of our campus by providing us with the means to build a state-of-the-art critical care tower,” said [hospital President and CEO Thomas M. Priselac when he received the donation]. “The Suzanne and David Saperstein Critical Care Tower will combine the latest monitoring technology with staffing to provide the most fragile patients with the most sophisticated care available.”

The Saperstein Critical Care Tower is clearly important for Los Angeles.

Annual hospital admissions countywide are up 20 percent in the past 10 years and seven hospitals have closed since 2003, according to a new report funded by The California Endowment.  West L.A. hospitals have been hard pressed to keep pace with demand, particularly institutions like Cedars that draw patients from a wider area. Population growth, on top of an aging demographic more likely to become seriously ill, have only exacerbated the situation, said  Dr. Paul Silka, [medical chief of staff], noting that Cedars often has long waiting lists to schedule elective surgery.

While Cedars-Sinai Medical Center clearly has top-notch doctors and medical equipment, I was not impressed with the human aspect of the patient care.   For example, why did no one come out to tell us how the surgery went?  Why did no one tell us that Fanya was taken back to ICU half an hour earlier?  Why were nurses laughing loudly with each other all night, waking up the patients in INTENSIVE CARE?   Or why was Fanya not fed for fourteen hours?  Even though the doctor gave the order to give her food, the nurse forgot to inform the nutrition department.  It took Sophia three and a half hours of fighting with everyone to get Fanya some food after her angioplasty.  Is this the bad effect of “Grey’s Anatomy,” where the personal lives of the staff are more important than those of the sick people?  Like in many other big-city hospitals, the basic concerns of the patient and his family seem to be of secondary consideration.   

Nothing symbolizes this better than the Saperstein Critical Care Tower itself.  As you can see from the above photo, the $110 million dollar facility may be “state-of-the-art,” but someone forgot to put up a sign telling patients and their families which building it is and WHERE THE ENTRANCE IS LOCATED.

What’s Up, Cedars-Sinai?

It’s been hectic.   My mother came to town.  We prepared for the first seder. I fought a cold.  My mother cooked a wonderful brisket, matzoh ball soup, kugel, etc.  We went over to the home of Fanya and Vartan, Sophia’s mother and step-father.   After the meal, Fanya had pains in her heart.   It was hurting her so much, that we called 911.   An ambulance came and she he was brought to the Cedars-Sinai Medical Center’s emergency room.  We sat in the waiting room for hours.  Tomorrow, Fanya is going to get an angioplasty on her heart and liver.   Wish her good luck!

Now for some bitching about the hospital:

Cedars-Sinai is a world-famous hospital.  Its proximity to Beverly Hills has made it famous as the “hospital for the stars.”  This is where Hollywood celebrities have their babies.   Frank Sinatra died at Cedars-Sinai.  Movie producers have their names on hospital wings.  So, why do Sophia’s parents always get poor service at Cedars-Sinai Hospital?  

Because of the language barrier.   

They are an older couple who can only speak Russian.  Now, I’m all for immigrants learning English, but after a certain age, it is just too difficult a task.  Sophia often works in court as an interpreter, where every defendant who needs it is guaranteed BY LAW to have a language interpreter, and from what I understand, it is the same with every hospital patient.   Cedars-Sinai says that they have interpreters on staff.  So, why are so rarely used?

I was sitting in Fanya’s ICU hospital room this morning.  Sophia left to get some paperwork for her mom.  I noticed that the reading on the EKG monitor was at zero.  I told this to the nurse, a grouchy woman who looked like she came from another country herself. 

“Don’t move your right arm!” she told Fanya.  “It makes the monitor shut off.”

“She doesn’t understand what you are saying,” I said.  “She doesn’t speak English.”

“NO ARM UP!” the nurse yelled at Fanya, lying there with tubes stuck inside her arms, as if that was going to solve the problem.

“Don’t you have a Russian interpreter on call or on the phone?” I asked.

“She’s not here now.  Don’t you know Russian?”

“No, and I don’t think it is my job to be translating for the hospital.  When will there be a interpreter?”

“Let me go see.”

She left and I never saw her again.

The entire day has been one mistake after another.   Fanya is a slight woman.  She had lost 25 pounds in the last 6 months.  She was put on a restricted calorie diet!  The staff didn’t bring Fanya any food until 3:30 PM because they “thought” there was an order not to give her food.  Then she never got dinner.  After Sophia spoke to 5 people, they eventually brought her, a diabetic, four juices and Melba toast with cheese, at 10 PM. They gave her pills for diabetes with orange juice!   This is just poor medicine, but had Fanya been able to communicate – she would have been able to point their mistakes out, before they made her drink sugary juice with a pill to lower her blood sugar!  It is scary enough to be in a hospital.  It must be terrifying for a patient to be there and not understand the language of the staff, and Sophia can’t be there 24 hours a day.    Sophia told the nurses they can call her anytime to help with the Russian, but no one ever called.  God help the person who has to go into the hospital without having a family or friends to speak up for her!

When Fanya first came to the hospital, a male nurse was trying to figure out what was wrong with another Russian patient, a disheveled elderly man who was sobbing.   The nurse was poking the man in different places on his shoulder trying to figure out what pained him.

“Baleet?  Baleet?” the male nurse asked, using the only Russian word he knew, meaning “pain.”

Eventually, Sophia asked if she could help.   She spoke to the guy in Russian and learned that he wasn’t in physical pain, but emotional pain.  His grandson had just died, so he drank himself into a stupor, and his family didn’t know what to do with him, so they drove him at the hospital.  With three Russian families in the emergency room, wouldn’t it make sense to have an interpreter readily available?

Cedars-Sinai built a a major new building last year.  It cost millions of dollars.  The medical center has the best equipment, which must cost a fortune.   But would it really cost that much more to have a few more interpreters?   The hospital doesn’t need to have an interpreter for every language on duty 24/7, but Cedars-Sinai is smack in the middle of the major Russian and Persian communities of West Hollywood and Beverly Hills.  Many of these are elderly people who don’t speak the English, and they end up getting less than mediocre medical care in a supposedly top-notch hospital.  There are Spanish interpreters in most city hospitals.  There are Korean-speaking interpreters in mid-city hospitals.   Why is Cedars-Sinai so stingy with their interpreters?  Have a donor put his name on the interpreters’ uniforms if it would help get more money!

I know Cedars-Sinai would rather be known as the “hospital of the stars” and promote all the A-list actors who go there after drug rehab.    I understand that UCLA Medical Center is stealing some of the “celebrity cache” from Cedars since it is located in the less immigrant friendly, more upscale Westside (oh no, Britney had her baby there!).  The truth is Cedars-Sinai is now more of a “city hospital,” which means catering to the immigrant community.  Sure, it must be an annoyance for the busy, overworked staff to deal with foreign-speaking patients (unless, of course, the patient is a member of some Royal family),  but shouldn’t effective communication be an essential part of medical care?

Update:  Fanya is doing better.  More complaining about Cedars.

Letter from Iran

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Today is Passover.   It’s one of my favorite holidays, because of the food and the re-telling of the dramatic story of the Israelites leaving Egypt.   Who cares how true it is!  I perfectly understand weaving a tale filled with half-truths and exaggerations.  Maybe the Israelites just crossed a little river, but who’s going to see that movie OR join that religion?  Let’s make it the entire RED SEA!  And let’s give it some action, with the Pharoah and the Egyptians at their heels, racing to capture them.

Sadly, the Middle East is still a place of conflict and hatred.   Arabs hate Israelis.   Sunnis hate Shiites.   Our troops are fighting in Iraq.   Iran is creating nuclear weapons. 

I hate to sound Pollyannish, but I think we’re all basically the same at heart.  If you’re a man — I don’t care if you are from Toledo or Timbuktu — you have the same SEVEN BASIC worries as every other man.

1)  Can I get a date to the prom?

2)  Will my wife still look good in twenty-five years or will she look like her mother?

3)  Is there any safe way to make my penis even bigger?

4)  Is this the clitoris and should I ask her to make sure?

5)  Why do I make such a small salary?

6)  Why do the assholes from college always become the most successful ones?

7)  Boxers of briefs?

We think we are different culturally, mostly out of pride or nationalism, but it isn’t true.  We are all the same.  And every once in a while there is a brave hero who acknowledges that.

One of these heroes is Hedieh.    Hedieh lives in Iran.  He wrote me this email from Iran.  Af first I thought it was spam, but it is actually from Iran —

Hi,
    
I have no idea how inconvenient this might be to write you an e-mail, but I thought it might be interesting for you to know that someone reads your blog from IRAN.
    
I was once browsing through weblogs trying to find one who talks about life, women, family, tough times, a bit of politics,…. And I came across your blog.  I started reading, and before I know it, I had been scrolling down for hours. Anyhow, just wanted to let you know that I truly enjoy your writing, your ideas and your style.
    
Oh, and you are funny, really.
    
Thanx
Cheers
Hedieh

Cheers to you Hedieh.   I knew it!  Deep down in their hearts, all men enjoy corny sex jokes!   In fact, wasn’t it the great Persian love poets of the Safavid era who combined both mysticism and erotic passion? 

Can blogging create world peace?  Hedieh, please tell you friends about some of the other blogs on my blogroll.  Read them carefully.    A bunch or weirdos, right?   Neurotic.  Horny.  Confused.  But dangerous?  War-monging?   Nah.   The just want to eat hummus, have orgasms, and watch sports on big-screen TVs, just like you do!   Why can’t we all get along?

May peace come about through blogging!  Happy Passover!

(update — this post makes less sense now that I learned that Hedieh is a woman!)

Thanks for the mention about “The Secret,” Star Tribune of Minneapolis-St.Paul.   I love Minneapolis, home to such wonderful people as Voix de Michele, Not Faint Hearted, and Mary Tyler Moore.

A Year Ago on Citizen of the Month:  Double Entendres and Croissants

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