Under The Knife
November 11, 2016
by Sean Philpott-Jones, Chair, Bioethics Program of Clarkson University & Icahn School of Medicine at Mount Sinai
Under The Knife
I nearly died last month. This is not an exaggeration. What started out as a bad bout of influenza quickly developed into something more. After five days sick in bed, I was struck with stabbing abdominal pains, a fever that spiked over 105° F, and a severe case of sepsis. Had I not gotten myself to the emergency room, I might have ended up in a coma, or worse, as a result of the raging infection coursing through my blood stream.
I spent a total of 16 days in the hospital, including an overnight stay in the intensive care unit (ICU), as a team of doctors and specialists furiously tried to bring my infection under control. I’m now convalescing at home, 23 pounds lighter and with 6 holes in my chest and abdomen.
For someone who considers himself to be healthier than most men his age, this was a terrifying experience. For a bioethicist who reads, writes and teaches about clinical care, this was also a very humbling experience. Other than a couple of out-patient procedures to fix orthopedic problems, this was the first (and longest) time I have ever spent being treated for a severe medical issue. I learned a lot about what it means to be a patient, lessons that will undoubtedly influence my own research and writing about modern medical policies and practices. In particular, there are five lessons that I want to share.
Lesson 1: Modern medicine is an inexact science. Over the course of eight days I underwent eight X-rays, three ultrasounds, two CT, two hepatobiliary (HIDA) scans, an MRI, and a sigmoidoscopy. I also had dozens of blood tests. These test results were inconclusive and confusing, leading one surgical resident to admit to me that clinicians often just make their best guess as to what’s wrong, treating the symptoms and letting the body heal itself. In my case, it was only after they opened me up in the operating room that the doctors realized that I had peritonitis, peri-appendicitis, and several perforations of my small and large intestine. They still don’t know the cause of my illness.
Lesson 2: Modern medicine is very expensive. I have already received eight bills for my care, totaling nearly $30,000. Still looming are the charges for the operation, all of the medical tests, and the night in the ICU. My total bill is likely to be over $100,000. Thankfully, I have medical insurance and my total out-of-pocket costs are capped at $3,500, an amount I can afford. By contrast, there are many who live paycheck to paycheck for whom even a few thousand dollars would be a financial hardship, and that doesn’t include the 10% of Americans who are uninsured and would likely driven into bankruptcy if they had to deal with a $100,000 hospital bill.
Lesson 3: The looming “superbug” crisis is even more frightening than I thought. I have written in the past about one of the most deadly threats to human health since the bubonic plague: the coming epidemic of antibiotic-resistant bacteria. I’m even more worried now. It took the doctors 16 days, infusing me intravenously with some of the strongest antibiotics known, to bring my infection under control. As soon as bacteria resistant to those drugs emerge – a question of when rather than if – there will be nothing available to treat such severe infections in patients like myself. Unless we address this problem head on, in the coming years millions of patients will die as a result of untreatable infections.
Lesson 4: Nurses and medical technicians are the underappreciated heroes of modern medical practice. This is not to say that the doctors didn’t give me great care, but during my 16 days in the hospital I rarely saw them. They would pop into my room at random hours, check my vitals and palpate my abdomen, and then go out into the hall to issue new orders to the nursing staff. The nurses and medical technicians on the ward were the ones that provided the front line care that I needed. They treated my pain, drew my blood, gave me antibiotic infusions, managed my fever, bathed me, took me to the bathroom, sat with me, and provided me an unlimited supply of cold ginger ale to soothe my parched throat. They did so for me and all the other patients on the ward unflinchingly, despite the fact that many patients and family members (not me) often take out their anger, fear and pain by yelling at the nursing staff.
Lesson 5: Never underestimate the importance of friends and family in the treatment and recovery process. In some ways this is the most important lesson I learned. When I was at my lowest point – my abdomen distended, my legs swollen from the 15 liters of IV fluid pumped into me, and my pain controlled only by frequent injections of morphine – it was the visits from my friends and family that gave me the strength to soldier on. They didn’t need to talk (sometimes they didn’t, as I often was barely lucid from the painkillers). Rather, they sat with me and held my hand. Without them, particularly my husband, I’m not sure I would have survived. Remember that next time a friend, family member or even a distant acquaintance is in the hospital. Make sure you visit them, even if it is only for a few minutes. Your presence is the most powerful medicine there is.