Inpatient View


If it’s not bad enough to have a criminally insane person as President, and another one as Vice-President, in a country that has placed nuclear weapons at their fingertips, plus a Congress that wants that power and is itself beholden to another insane state, we have to have a trickle-down effect in every other state institution that is likely to decimate us. Politics is all about grandstanding and posturing, while the truth is shunned and oozes like melting fat from a broken refrigerator onto the kitchen floor. I refer to this bit of rancid news.

That link is to a Chicago Tribune article about MRSA spreading into the public housing slums from the prisons. It is rapidly becoming an epidemic that is neither friendly nor benign. It’s a killer. I have written about this menace before. It is a common everyday bacteria that was pushed to mutate inside hospitals by treating multiple infections in brain-dead patients at the same time that the NIH relaxed infection control procedures. With such enforced sloppiness, this superbug was bound to get away, and it did.

MRSA can be treated with Vancomycin, the last ditch in antibiotics, so you know what’s coming next: VRSA. Indeed, it came. This superbug is still confined to hospitals, as far as I know, but it will be on the street soon enough, because nothing has changed.

I was hospitalized for two days in January in a supposedly high-tech and cutting-edge hospital. Magnificent lobby, fast admission, a fine ER, with everything sparkling clean and private rooms, and the worst telemetry floor I’ve ever seen.

Let me explain that term. If a patient needs heart monitoring, but isn’t likely to die, he or she is wired to a small transmitter that sends the heart rhythm to a bank of monitors that is watched by somebody who presumably can interpret the signal. I worked on such a floor for a few years. The patient population is a mixed bag of medical and surgical, young and old, and terminally brain-dead. It’s cheaper than ICU, and riskier because of the patient mix, the lack of infection control, and the uneven levels of staff competence.

I arrived on the floor with two intravenous lines, both badly placed in my elbow joints. That’s a sure sign of rookie nurses. An RN duplicated the verbal history I had given in the ER, but was called away so often that she could not absorb it. The nurse’s aide would not listen when I told her that the automatic blood-pressure machine and oxygen saturation meter would not work on atrial fibrillation. (Same story in the ER and in the cardiac catheterization lab.) I was not encouraged. Then I saw the bathroom. During my forty-year career in hospitals I never saw such a filthy room.

The reason there is a world of difference between the front-end façade and the back-end operation lies at the feet of the mighty NIH. Their power over anything relating to medicine in America radiates in every direction and their method of operation differs little from the Pentagon: posture, strut, duck, and cover. Their subservient agency, the CDC, is in the news right now for hounding an individual who may or may not have TB. This is curious because they have singularly ignored worse cases of proven resistant TB. Why the sudden interest?

I don’t know, but it seems an awful lot like the White House beating the drums for war while losing two of them. The MRSA epidemic is real. The risk to the public is real. It is a losing battle that the NIH started by relaxing infection control procedures years ago, which they will never admit. So? Don’t look there! Look over here! See Bird Flu, SARS, TB. See the new wars we’ll win, not the old ones we’re losing.

Is it really so hard to cope with new street diseases? No. It’s a matter of management priorities that trickle down from the NIH, through the CDC, to The Joint Commission, the AHA, AMA, ANA, etc., to the individual hospital administrator who says, we’ve got to clean this place up — and I don’t mean the front lobby.

Well, I lucked out. Four months later there is no sign of infection. That’s better than my last encounter with hospitals as a patient in 2004. Sadly, luck has everything to do with it these days, just like surviving political insanity.