Doctor Breaks His Neck, Appreciates the Work of Nurses More

Seeing this comment this morning in my post about our culture of being overworked reminded me of this piece I read last night in the New York Review of Books by Arnold Relman, a physician with six decades of experience who fell and broke his neck and saw a new perspective on what it’s like to be critically ill and cared for under the U.S. medical system:

Conversations with my physicians were infrequent, brief, and hardly ever reported. What personal care hospitalized patients now get is mostly from nurses. In the MGH ICU the nursing care was superb; at Spaulding it was inconsistent. I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.

Even in the best of hospitals, with the best of medical and nursing care, the ICU can be a devastating psychological experience for patients — as it was for me. Totally helpless, deprived of control over one’s body, ICU patients desperately need the comforting presence of family and loved ones. I was fortunate to have that support, but some others in the MGH ICU were not. I can only hope they received extra attention from their nurses.

Thank you, nurse! He also discusses the costs involved in his care, which was covered by Harvard’s faculty plan, and poses this question about the amount of medical attention he received as a person in his 90s: “Given the limited life expectancy of someone my age, is it justified to spend hundreds of thousands of dollars to extend a nonagenarian’s life a little longer?”

Photo: British Red Cross