to "...communicate forget not..."

There has been many an evening when I have left work a bit late in order to finish off email correspondence with clients and/or contractors. I long ago realized that even a short break in communication can cause serious problems when a correspondent lacks the information to proceed in the right direction. Thus the saga of my past weekend.

It began simply enough on Wednesday, with a routine annual physical. My doctor noted some things on an ECG that he had not seen before, and asked me to wear a Holter monitor for 24 hours to record my heart rhythm during my normal daily activities. This I did, returning the monitor to the hospital about noon on Friday.

The day finished, I headed home, ate supper, and got ready to continue preparing the car for a quick trip north on Saturday. About 7:00 PM, I received a phone call from my doctor's partner in practice -- my doctor was apparently very much off-call that evening -- telling me that I needed to go directly to the emergency room at AGMC. I asked him why, since I was feeling quite well. He told me that the doctor who had read the Holter monitor was extremely concerned that my heart could stop and I could die at any moment.

Those who know me well know that I have maintained that very thing for quite some time. The human heart stops after every beat, and by the grace of God, it then takes another squeeze. That stop is the only rest it gets in a person's entire life. I find that miraculous, others find it terrifying.

During the phone call I was asked several times if I was having any symptoms, such as shortness of breath or chest pains. I replied that I was not. Apparently that was not believable, since the doctor who read the monitor was a highly regarded expert with much experience. That doctor did examine me 40 and 35 years ago, respectively, long prior to the valve replacement, and he had no knowledge of the subsequent treatment history. At the end of the call, I was informed that the Emergency Room at AGMC had been notified to expect me.

I was less than favorably impressed. I was feeling fine. Telling my Beloved Rib the essence of the call, I jumped in my car and drove off to the auto parts store to pick up some pieces I had ordered the day before. Jesse and I had plans to finish the wheel alignment job on the Sable, and I was set to take Grannie to visit Uncle Sam the next day.

As I was signing for the order, I received a call from Joonyah who asked how I was feeling and informed me that he was on his way over to take me to the ER. Then, as I was driving home, I got a call from Jesse, who asked me where I was. I told him that at that moment I was on the overpass at I-76. He asked what I was doing there; I sensed a bit of alarm in his voice and my perverted sense of humor almost drove me to say, "Getting ready to jump" but the more responsible part of me told him I was heading for home with the parts. He then said he would be at the house shortly.

I arrived home, and was finally persuaded that to ease everyone's mind, I should go to the ER. We went. They were expecting me. I asked if my doctor was aware I was there. They didn't know, but the verdict of the ER cardiologist (who had never seen me before) was that I was in a life-threatening situation. They booked me, gave me a gown, started an IV, and took me to my cell. They asked me about my symptoms, and seemed very unhappy when I said I didn't have any. Obviously, I was not being truthful; if the doctors said I should have symptoms, who was I to disagree?

Oh, and by the way, they had run my health insurance card, and the carrier said that I was not covered; that coverage had lapsed that very day. Now just the day before, at the office, we had been discussing health care premiums and the fact that my Medicare coverage was to become active Saturday, and I was told that the Medicare supplemental PPO coverage would not become active until January 1 and my premiums had already been paid through December 31 under the current plan. No matter; the insurance carrier said my status was inactive.

I was hooked to a monitor and put to bed. At least my Beloved Rib did not forsake me. She slept beside me on the hospital bed all night. In the morning, one of my cardiologist's partners came in to see me, looked at the record from the monitor, listened to my heart, and asked about my symptoms. No chest pain, no shortness of breath? Hmm. He had not been able to find my records in their files, but said that it was possible he had mis-spelled my name. Meanwhile, he did not think that the slow heart rate was very serious, but I had taken my meds just before the Friday night call, and they could account for the the slowness. Because he did not have my records, and was not MY cardiologist, he could not recommend my discharge.

Another doctor stopped by -- the partner of the doctor who had admitted me -- and asked why I was there. At that point, I told him I didn't know. He asked about my symptoms, and again, I got the feeling he did not believe that I was not in distress. He was in the room a total of less than 5 minutes, and said that he would have to wait until my cardiologist recommended my release.

Saturday was spent reading. Joonyah and crew showed up, wanting to know what was going to happen. I had no idea. So we wandered to the nurses' station and asked when my doctor would arrive. I was told that he normally did not make rounds at AGMC. I asked if my cardiologist would be coming in. Again, a negative; he did not make rounds on weekends, and when he did come in, it would only be in the nature of a consultation, since the ER cardiologist had the responsibility of finally signing off on my release, and the GP I had been assigned in the ER would have the responsibility of actually signing the release.

At about this point, I was beginning to have symptoms -- of great irritation. My Rib called my doctor's office, then dialed the emergency number from the recording she got, and explained that we needed to talk to my doctor. Shortly thereafter, his partner called my cell phone and, out of breath and sounding a little unhappy that we had disturbed his Saturday activities, said that indeed my doctor had been informed that I was in the hospital. I was resigned to my imprisonment.

Now up to this point I had been alone in my room. I was comfortable, and Friday night I had slept with just the bedsheet covering my feet. Late Saturday afternoon, the adjoining bed was given to a fellow who was recovering from complete cardiac arrest. His grandson, who had been a lifeguard and had providentially been present at the time, had started CPR immediately. A pacemaker was now installed, and he had been brought up from ICU. Wrapped in blankets, and clutching a pillow to his chest (his ribs had been cracked during CPR), he immediately complained that the room was too warm. His nurse complied, turning the thermostat down from 70° to 65°, and unleashing a cold draft from the ceiling vents. (Beloved Rib would later sneak over, while he was sleeping, and turn it back up to 68°.) Needless to say, I made use of both the sheet and the blanket the next two nights.

Sunday morning, my cardiologist's partner dropped in again, having looked at my file in their office, and basically opined that, in my case, someone might have over-reacted. He felt that my stay was probably a waste of time, seeing that I had a history of a slow heart rate, and I was scheduled for an appointment in their office in a few weeks anyway. Nevertheless, he was not MY cardiologist, and without a recommendation from MY cardiologist, who would not be in until Monday, the ER cardiologist would not sign off on my release. He did authorize putting me back on my blocker, but at a reduced dose.

My assigned GP again dropped by for an obligatory 3 or 4 minute chat, and again seemed very doubtful that I was not feeling any symptoms of distress, especially since my blocker had been withheld on Saturday and my heart rate and blood pressure were now quite high. I was pleasantly surprised by a visit from Art and Sarah Kaufman, who had been visiting one of his cousins in a room a few doors down from mine. I had not seen Art since he found Jesse his house, and we had a brief but very good chat. Mike and Suzi brought Grannie to visit, and Suzi left her tablet with me so I could go on-line (the hospital has an open wireless network for patient/visitor use).

My Beloved Rib had spent two nights sleeping beside me on a hospital bed. I sent her home Sunday night so she could get a better rest in a warm room. At 3:30 in the morning, the nurses came in to change my IV. I said it could wait, I was going home in a few hours. They said no, that it had to be replaced anyway, and they got it done, barely, on their second try. Ouch.

Monday morning was foggy, but I was eager to escape. My cardiologist showed up at about 8:30, said we would take up the discussion at my scheduled appointment, and wrote out the recommendation for my release. I joyfully called for my Beloved Rib to come get me. The hours dragged by. About 2:30, the assigned GP having failed to show up, we mentioned the fact to my nurse. She began calling around the hospital to find out what was delaying my release.

My assigned GP had gone home for the day, early, and had left a list of patients to be seen with another doctor, who eventually showed up in my room about 3:00 and said that he had not been informed that I was to go home, or he would have been in to see me in the morning. Nevertheless, he was empowered to sign my release, which he did, and by 3:30 I was on my way out the door.

A comedy of errors? Perhaps, but I keep reminding myself that God has a purpose in all things. I met some new people, I saw an old friend, I was kept from traveling. Having an abnormal patient in their care may have been a good training exercise for the nurses. Plus, I have had a lesson reinforced : the passage from Hebrews 13:16 (KJV) now has a special meaning for me.