a hospital is no place to be sick (delhi summer illness 5)

While i have given some account of my symptoms in earlier posts, it seems useful to give a quick recap to contextualize why i found the hospital space so difficult to navigate. And let’s be clear from the outset: i am an extremely privileged patient in Delhi. i am physically inclined to get good service in hospitals; i can read and, moreover, can read English, the language of most hospital signs (at the hospital chain i attend, most signs seem to be in English only except for the one about not doing pre-natal sex determination); and i have enough medical knowledge and confidence to ask my doctors questions. My navigation issues were not about lack of comprehension but rather poor design and poor service.

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Though i had been feeling grungy for a few days, the distinct symptoms set in on a Monday morning. My alarm went off and i woke up, ready to push myself into a sitting position in bed, only to discover that my wrists and elbows were not interested in supporting my weight. On later mornings, they didn’t want to bend from being locked down by my sides and i would have to spend many minutes consciously willing my shoulders and elbows to cooperate so that i could get my hands to my face to wipe the sleep out of my eyes with my thumbs, since the rest of my fingers were stuff and against the idea of balling into fists.

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But that first morning, having had my arms joints turn to jelly, i tried to push the sheets off of me, only to discover that my fingers were not interested in pinching the sheet to move it. No doubt this all looked a bit funny, a bit like the Wolf of Wall Street quaaludes scene, but it is worth noting that it was actually terrifying. it is worth noting this because it is something that not a single doctor acknowledged over the course of this illness. Doctors: i don’t care how many patients you have coming in each day complaining about the same symptom set — overnight loss of functionality is scary to each of those patients and deserves to be acknowledged as such.

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In any case, on the first morning, i finally did some worm maneuvers to at least get myself sitting up and ready to try standing. This is when i learned that my legs and feet weren’t faring much better. The arches of my feet felt like they couldn’t support my weight and the rest of my toe joints didn’t want to bend to facilitate walking. My knees had gone to rubber while my hips were like the Tin Man in Oz. It was a long, slow, fairly ignoble shuffle to the bathroom. Once reaching, i learned that my fingers weren’t going to support gripping a toothbrush, a water bottle, a hair brush — really anything at all. My thumbs would work for texting but not much else.

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Just like that, i became a 90-year-old woman (crankiness included).

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When i finally got back to bed, my only interest was trying to get joints to pop, which seemed to hold the elusive promise of some pain relief. Besides napping, i am not sure i did anything the first day besides bending and extending my right leg in hopes of a knee pop and doing the same with my left elbow, which stubbornly refused to cooperate.

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All of this is to say that i wasn’t in much of a shape to walk by the time i decided to get to the doctor the next day — forcing me to recognize explicitly just how much mobility is expected of patients in a hospital. To leave my flat, i navigated the marble stairs down, relying mostly on weight put on my forearms on the railings, since i had as little faith in my wrists as i had in my ankles to support me. My mostly faithful autowalla Pankaj drove mercifully slow and cursed out another driver that tried to rush him.

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At the hospital branch (of a larger corporate chain) nearest my house, there isn’t a real drop-off and pick-up space, since the hospital is sort of nestled on a residential ‘slip road’ that runs parallel to the main road. This creates traffic jams and issues. Nevertheless, Mr. Traffic Mover, don’t yell at sick people to get out of the car faster or to walk faster. Of course, not all people who go to a hospital/clinic are sick and not all of those who are sick have mobility issues — but let’s make some basic assumptions about the types of people who are arriving to a hospital and try to accommodate.

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Walking to get into the clinic is hardly the only walking that you will need to do — indeed, i wondered multiple times if the the architects of clinic and patient-flow systems had ever considered the fact that patients might be sick in their design.

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First you go to a counter to get a token in order to go somewhere else to sit and wait to pay for your consultation. Then you’ll pay for your consult (also, attendants/receptionists, if someone asks for help getting their credit card or cash out of their wallet, bloody help them. Again, you work in a hospital, where people need help).

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Then you’ll go off to find, first, the queue at the ‘sisters’‘ station (though it is a secular hospital, the nursing aides are referred to as sisters) to get your vitals taken (where you may have to wait), then probably walk somewhere else to wait for your consult and then walk to the consult room itself. None of these are short distances around a central waiting room; some of the trips involve changing levels.

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You may also get lost along the way, since there are at least two ‘sisters’‘ stations that look identical but are on opposite ends of a large open space. Since the receptionist could only muster enough energy to vaguely wave that you need to go somewhere behind her, you don’t know whether to turn right or left. The signs indicate that both directions are legitimate options. Sick people, in general, are trying to conserve steps and don’t particularly appreciate getting themselves to one station only to be told that they should have gone to the identical looking one that offers the identical reading of blood pressure and temperature — but is located on the opposite side. Give reasonable instructions, as though you are trying to minimize the effort the patient needs to make.

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If you are prescribed a blood or other test, you make your way back to (wait in line for) the front reception to pay in advance for the test, then go off to find the samples collection station. And if, say, you were only charged for some but not all of the tests prescribed to you, you will have to walk back to reception (where you will not receive an apology) to pay and then back to the sample collection station.

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Then you can make your way to the pharmacy and finally, attempt to leave, after spending several minutes cajoling the fellows standing outside at a podium to help you flag down an auto.

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Surely there is way to streamline some of this back and forth or at least make it incumbent on hospital staff, not the patient, to do the some of the running around. There are, so far as i could tell, plenty of staff idling about.

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At one particularly low moment, i found myself in the west block (separate building) trying to pick up two sets of lab results, one taken in the west block and one taken in the east on two prior trips to the doctor. At first the receptionist explained that by entering my mobile number and patient ID (which apply throughout the whole hospital system, at least in order to make an appointment online), she would only be able to print the results from the west block sample and that i could walk over to east block to have someone put the exact same information in a computer over there and print out the other set of results. This is the moment when i lost my cool. As it turned out, yes, one of the idle staff could go over on my behalf and claim the other set of results.

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The question is: why, as a pretty clearly unfunctional person, i had to ask for basic assistance. Seriously, it’s a hospital, people are sick, they need help, and not every patient has 10 family members with them. Design your floor plan and your services to accommodate that.

 

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4 thoughts on “a hospital is no place to be sick (delhi summer illness 5)

    • Well, it wasn’t fun — and i certainly find that i have a shorter fuse in India than elsewhere in the world and this was somewhat on display. i can’t imagine a situation in the US when i would, say, yell at a receptionist for not apologizing, nor am i particularly proud of having done so.

      But what is really important to reflect on is that i probably get treated better than most patients — my main disadvantage vis-a-vis other patients is not having family accompaniment. If the receptionist will barely give me the time of day or proper directions, then what will she do to patients she finds beneath her? If i can’t figure out the all-English signs to navigate the hospital, then what about all the patients who don’t read, at least not English? The hospital would rapidly go from frustrating to terrifying.

      As always, thanks for reading!

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  1. Meri says:

    I had a similar experience in Delhi more than a decade ago. The only way I made it through was a family member helped. And it is true in the U.S. as well (though to a lesser degree–most U.S. hospitals have workers who will at least recognize physical disability and try to accommodated it.). In most situations, sick people need healthy advocates to help navigate the system. It is really difficult to do on your own.

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    • Indeed! i wish that health advocacy was a more recognized function in India. Some aspects tend to be managed by the family but they are not necessarily more informed, just helping to make sure the patient gets attention.

      Like

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