A hospital visit

Lying in a hospital bed for most of a week wasn’t exactly how I meant to spend the end of my Fourth of July holiday. But it did give me yet another up-close look at a key component of America’s healthcare system.

It was my third hospital stay in the last two years, and all three have produced the same important impression: The people staffing our healthcare institutions and organizations tend to be a cut above the people trying to design and run them as a business.

So you don’t miss my point, let me put it bluntly. The janitor who just left my room has a whole lot more of my respect than do the top-level supervisors who last year totally botched my discharge and who this morning seem to be doing the same thing all over again.

My point here is not to describe the details of my physical condition. Instead I want to suggest several broad patterns that I suspect have come to govern our healthcare system.

That system is heavily populated, for example, with young people. That would not be surprising if it were true only of the orderlies and other service personnel who make a hospital community run smoothly. But as I’ve been shuttled from department to department, from one specialty to another, I’m struck with the youthful demeanor of those handing down key directives. “Stop kidding yourself,” someone will say. “They’re not younger, Joel. Remember that you’re getting older.” We’ll see. I’m starting right now to find some well-documented, authoritative statistics. But it’s not all bad. The younger these folks are, the longer they’ll be around!

A second factor tending to shape our current healthcare system is the geographic diversity of its personnel. These doctors, nurses, and dozens of specialists of virtually every kind and level come from all over the world. My admitting physician was Dr. Muhammad Shahid. Indeed, the staffing for the Asheville hospital where I camped out for the better part of a week included “traveling doctors,” “traveling nurses,” and so on—medical personnel of every description whose home base might be Orlando, Fla.; San Antonio, Texas; Portland, Ore.; or even Quito, Ecuador; Hong Kong; or Addis Ababa, Ethiopia. These were mobile specialists responding to short-term calls to fill personnel shortages anywhere around the country. It’s a phenomenon in more and more locations.

Yet another issue tending to reshape healthcare centers is the expanding takeover of many such facilities by private for-profit entities. I do not suggest for a moment that the takeover last year of our local non-profit hospital by a multibillion-dollar, out-of-state corporation is responsible for all the woes I heard from a number of employees. COVID-19 has certainly had its effect.

On the other hand, it’s a little too easy to blame everything these days on COVID-19. And it wasn’t a stretch for me to see clearly the decline in service and care that once made this hospital proud. At least once or twice a day, I heard soured staffers express frustration over limits that didn’t used to be there.

A fourth change is even more nuanced and subtle, and I can’t help thinking it’s related to the first three. It used to be relatively easy (and even natural) within a hospital like the one I’ve been in to give thanks in open prayer, to have staffers join in such expression, or for them openly to wear crosses or other symbols of their faith. I saw little or none of that in last week’s visit.

Might that be partly because such expression is far less typical for younger people? And less typical yet for folks like the Muslim nurse who gave us excellent care but made a point of holding us as Christians at a short distance? And just as typical for employees of corporations in America that boast of their nonsectarian secularism?

My thoughts on all this are still tentative. You may have experience that helps me reach some sound ­conclusions.