The Nation's Pulse/Bedpan Hospitality
Haag, Ernest van den
BEDPAN HOSPITALITY by Ernest van den Haag Apart from Samuel Butler, long dead, nobody believes that hospitals ought to punish the sick-yet punish them they do. Comfort in a hospital, it seems, is...
...My bed was too narrow (a double bed was, for some reason, out of the question), and when I confessed to being over 65 the nurses insisted upon raising the bars along its sides, as if I belonged in a crib ("regulations, you know...
...Hasn't the time come to treat sick people as though human, adult, and entitled to whatever comfort their medical conditions and their purses permit?nd their purses permit...
...Hospitals were places for the poor only...
...Why must every patient suffer the discomfort of plastic sheathing when it's needed only occasionally...
...But then they can't afford to make customers uncomfortable, can they...
...Hospitals take advantage of this dependency to re-infantalize patients, because the staff finds it convenient to treat all patients as if they were children...
...They're deliberately made that way...
...Hospitals were charities (most, in fact, are still run on a non-profit basis...
...Why must every room be equipped, expensively, for the worst case (oxygen outlets, mechanized beds) when only a few patients, are likely to need the equipment...
...And there's a phone at every bed, each implacably set to jangle at top volume...
...It's the law," she explained...
...Even where nurses are cheerful and medical services superb, the hospital's punitive tradition survives -and demands discomfort, humiliation, and absurdity...
...It's fine that medical services should be equally good for everyone...
...This is a hospital.'' The biggest hotels manage to cater to the wishes of individual guests...
...But why must everything else be equal...
...Thus the admission policies of hospitals preclude competition...
...Why must patients suffering from broken ankles, or simply undergoing tests, be treated as though totally disabled and incompetent...
...Besides all varieties of discomfort and inconvenience, there are still other hospital traditions, at least one of which is scrupulously honored: The patient is not to be trusted...
...The truth is, they are incompatible not with medicine but with hospital traditions for which there is no longer any justification, if ever there was one...
...You are not a guest...
...The fear of being sued is supposed to explain all kinds of foolish regulations, universally applied...
...They squeak and have no rubber tires...
...And they must be swallowed in the presence of a nurse...
...Indeed, noise-unnecessary noise -seems to be part of hospital regr-men, at all hours, as if it were somehow snobbish or elitist to have quiet, to speak in low voices...
...We will make you well, they say, if you are willing to suffer...
...Hospitals offer room and board markedly inferior to what any hotel knows it must offer on pain of losing guests...
...The patient who wants comfort is suspected of not taking his illness ,seriously enough...
...My bathroom had no bathtub...
...And, of course, in the hospital there was nothing resembling room service: Meals had to be ordered a day in advance, and food was brought only at meal times...
...You go on a stretcher, like it or not...
...My room was smaller than any hotel room I've ever stayed in...
...But why shouldn't a patient in a hospital enjoy the comforts and conveniences of a good hotel (to the extent his condition permits), so long as he is willing to pay for them...
...For one thing, I couldn't close the...
...A just spent a few days in a hospital...
...Just getting an antihistamine, I was made to feel incompetent...
...The mattress and pillow were sheathed in plastic, which was hot, uncomfortable, and slippery: Shall I go on...
...Money didn't buy me privacy (even in a "private room") and it didn't buy me comfort, either...
...This is a hospital," the saying goes, "not a luxury hotel...
...Not without a doctor's permission...
...You can walk up to the X-ray room yourself...
...Needless to say, it doesn't help your dignity or morale to be pushed around like a cripple, or a piece of meat, when there is no need for it...
...And the deck is stacked anyway: If you want your personal physician to treat you, you have to use the hospital to which he is accredited, even if another one is medically no worse, and more comfortable for you...
...They feel guilty for being patients-and they feel dependent...
...door...
...Nobody seems to oil the wheels...
...As it is now, there is no effective competition among hospitals by means of patient comfort...
...Disease, through most of history, was thought a form of disgrace, deserving pity, perhaps, but not comfort...
...All patients are alike in the hospital's eyes: equally guilty of being patients...
...You are a patient...
...I doubt it will, until, at least, the non-medical aspects of hospitals are run on a profit-making basis by private firms, as hotels are...
...Hotels, by the way, with sanitary problems of their own from their frequently changing guests, manage to do without the plastic sheathing...
...Magazines are unavailable...
...The grateful patients did not expect comfort, and the patronizing spirit of charity has-not changed...
...Carts pass through the corridors all the time...
...A hospital feels not just responsible for your health, but, above all, financially liable...
...So: phone calls, extra personnel, special elevators-all for someone (me, in this case) who is as able to walk by himself as the aide pushing him...
...But then it does seem to make the hospital feel more in control...
...I couldn't control the air conditioning...
...Hospitals don't...
...Most patients accept this treatment without protest...
...I paid the extra charge and reserved a private room, except that it wasn't really private...
...And that's not the only difference...
...Never mind...
...The punitive tradition of hospitals dates from time immemorial...
...Now, aspirin may not be advisable in some cases...
...He should be dedicated to being sick and getting better, not thinking about trivial luxuries incompatible with the dignity of illness, let alone the sacred mission of medicine and the ministrations of its angels of mercy...
...I doubt that it helps the patients...
...There is only one reason...
...At night a nurse with a flashlight came by, not quite noiselessly, every half hour-I suppose to make sure that I was still alive...
...Medicines are doled out shorn of their individual packaging, powders of their envelopes...
...What prevents such a policy is not the law, or any medical need, or fancied difficulties about liability, but the punitively egalitarian ethos of the hospital...
...The hospital does not believe that any patient will act rationally without supervision...
...Why insist: You cannot have it unless we decide you can...
...But it would be simple for the hospital to protect itself against liability-allowing patients to sleep at night, for instance, or to move under their own power, or to take their own medicines-by having any competent patient who wants to do so (and perhaps his physician) fill out an appropriate form...
...And when they have nothing to shout about, they whistle or sing...
...Can't have patients running around by themselves, you know...
...Comfort in a hospital, it seems, is frivolous...
...Why then not tell me to consult the doctor before taking it...
...And even when I managed to stick some newspapers under it, nobody bothered to knock before barging in or close the door when leaving...
...Somehow, there remains the idea that comfort is inappropriate in principle, like champagne at a funeral...
...And why did the nurse's aide who took my temperature treat it as a state secret...
...Medicine was largely purgative and punitive...
...There is plenty of television, yes, but no radio (am I the only patient who likes to listen to music...
...The same rules for everybody, regardless of his medical or financial condition: "Where do you think you are...
...We know, I know...
...No snacks, no cup of coffee when you want it...
...Thinking that sleep was probably good for me, I protested, meekly, but to no avail...
...the well-to-do were taken care of at home...
...Nurses' aides, for instance, seem to enjoy shouting at one another across miles of corridor...
...I asked for aspirin...
Vol. 14 • December 1981 • No. 12
