on the importance of assertiveness

First off, thanks to everyone who has expressed concern about my brother. Here's the story.

Day one: Monday 6 AM he goes to the E.R. because he had been diagnosed with pneumonia a week before, but is now coughing up blood. They run some tests and say, well it looks like your pneumonia is gone, but you're in congestive heart failure. Apparently he had approx. 20 pounds of fluid around his heart and lungs. I go in to visit him at 8 PM, and he's still sitting in the E.R. On a gurney. Peeing into disposable urinals. And a doctor hadn't been in to see him for nearly nine hours.

I take it upon myself to start harrassing the hospital staff. I have to harrass the nurse twice before she comes in. Then, finally after I was there for two hours, a doctor came in. I start grilling her about him coughing up blood. I'm not dumb. I know that coughing up blood is one of the first signs of TB. She doesn't think that it's an issue. She looked at his chart, poked at him a little, and left. Frustrating.

Day two: Still sitting on a gurney in the E.R. Tiny room. No television, no telephone, still not allowed to leave the room to use the toilet. Around noon, they tell him that he finally has been assigned a room, they're just getting it ready for him. Then another doctor comes in and he has to give his entire history again. This doctor hears "coughing up blood" and decides that now (after 36 hours in the E.R.) that my brother should be tested for TB before he is moved. So, he is taken off the list for a room, and put on a new list for a negative pressure room (of which there are only four rooms in the entire hospital) just in case he has TB.

Day three: Yup. Still sitting on a gurney in the E.R. but in a new fancy isolated room. I show up at 9:30 AM, and a doctor hasn't seen my brother since 8 PM the night before. I crack my knuckles and go into attack mode. I tell the nurses that we need to see the doctor. Then I call the patient advocacy office. I do this in rotation for a couple hours before a charge nurse finally comes in and says the TB precaution has been removed so he's back on the list for a regular room, but that the doctor assigned to see my brother "is too busy to come see him" and another doctor will be on after 2 PM that will come check on him. I flip my shit just a little and call the patient advocacy office again and give the girl on the other end a very calm ass ripping. A few minutes later, his nurse comes in, they have a room for him and he should be transferred some time that evening.

I don't know if my constant harrassment had anything to do with them finally taking care of him, but I'd like to think that maybe it did. Apparently, since my brother hadn't chosen a primary care physician on his insurance plan, there wasn't anyone to push his labs through and get things done. What a pile of horse shit.

Day four: I go to visit my brother in his brand-spanking new hospital room. He was transferred about an hour after I left the E.R. the day before. Since arriving at the new hospital, he had an ultrasound of his heart, saw five different doctors, nurses checked on him all the time, he had a flat screen television and access to a telephone. It was like being released from prison and checking into the Ritz-Carlton.

So, they think he probably got a viral infection in his heart, exacerbated by the pneumonia and other health issues (weight and smoking) which basically made his heart start to fail. When they did the ultrasound, it was pumping at only about 20% efficiency, and the entire heart was enlarged. They have him on all sorts of meds to try to get the heart strong again.

Day five: A pulmonologist looked at his CAT scan because there were some abnormalities in the lung. There's some fluid in his left lung and some swelling in his lymph nodes, so now they are deciding whether to do a biopsy to rule out lymphoma or sarcoidosis.


I swear, this is like an episode of House. But without the grumpy (yet strangely attractive) gimpy doc.