Tuesday, June 23, 2015

Hospital Time

Living on Tulsa Time.
Living on Tulsa Time.
Gonna set my watch back to it
'Cause you know that I've been through it.
Living on Tulsa Time.  --J.J. Cale

Lately, I've been living on hospital time.  We've all been there, right?  Someone we know is in the hospital and if we have care of them or just if we care for them, then we spend a lot of time in the hospital ourselves, getting used to its rhythms and idiosyncracies.

Things started out perfectly.  We had to be there at 10AM.  We did paperwork for the first hour.  At 11, it was "nurse time," as they got my father situated with his gown, his bed, his vital signs, and what I would do with his belongings.  Like clockwork, at 12 on the dot, another nurse came in and rolled him away for surgery prep, since the 1/2 hour surgery was at 1PM.  All of this went as predicted.

But then "hospital time" began the long unwinding on its clock.  Surgery scheduled for 1PM didn't happen until after 2:30; the doctor called to say the surgery had been successful and that he would be in a recovery room about 20 minutes later.  I don't know if that happened.  All I know is that sometime after 4:30, we saw my father in his ICU room.

And since patients have any number of issues and difficulties after a surgery, a variety of doctors come by and put in orders--orders for medications or procedures or tests.  When you are new to "hospital time," you think that those orders mean that those pills and tests are going to happen in the next half hour or hour.  You think this because, for example, if your loved one has high blood pressure and the pill will bring his blood pressure down, you think that this is a matter of some urgency.

That is when you are new; a veteran learns that nothing is a matter of urgency (with a few flatlining exceptions, of course).  Everything is a matter of when the person who is to bring it or do it, whatever it might be, can get here.  That's "hospital time."

Of course, having a loved one in a hospital means that your time is scheduled, too.  The visiting times to see my father in Neurosurgical ICU were 10-10:30AM, 4-4:30PM, and 8:30-9PM each day.  That can pretty much plan your day, if those were the actual times.  Like everything else in the hospital, the doors to visitation opened when the nurses were ready for us, not when the times were printed on the door.  Always at least 15 minutes later, often much more.

But no one is able to factor that in.  Decide for yourself that there's no point in arriving until 10:15 and then have that be the day they would have let you in on time?  With such a short window?  That's a major guilt sandwich waiting to be eaten right there.  But you also know in that back of your mind that they aren't going to make you leave at the printed time either.  That, too, is left to whim.  That, too, is "hospital time."

And so, each time I would visit my father, I would ask, "Hey, did they do that swallow test?"  "No," he would say.  "But that was ordered two days ago!"  And then he would have another choking incident that night.  Or, "Have they had you stand up yet?"  "No."  And I would ask the nurse, because that, too, was a long-standing order.  "I think they were really busy today," she would say, "Because they haven't made it up here yet."

There are two ways I use to understand "hospital time."  The first is a time about four years ago when we had some major renovations done on our house.  We hired the contractor; he hired the subcontractors.  The theory behind that, other than ease for working people like us, is that a contractor will be able to coordinate the work of all of specific people--painters, countertop guys, floor refinishers, electricians, etc--to happen in the order that it needs to happen.  Well, it didn't work for us or for anyone else I know.  Our hardwood floors, which should have been the last thing, were finished while any number of workmen were traipsing through our house in dirt-covered boots.  And parts of the floor had to be redone as the result.  Workers would knock on the door at 7:30AM to do a job we either didn't know was happening at all or weren't expecting for days.  Other workers who were making incredible progress on, say, cabinets, would suddenly disappear for a week.  That's what a hospital runs like.  Except that the house, in this case, is someone's body.

If a hospital were a restaurant, the dessert would come before the entree, the appetizer would arrive at 2AM, the chef would tell you what was on the menu, but then another chef would stop by your table and suggest a completely different cuisine.  That ketchup that you needed for your french fries?  Well, it's never coming at all, even though someone has gone to get it.  You might get served your salad three straight times before you ever get your main meal.  You might be force fed a menu choice you didn't even expect.  A hospital is the restaurant where someone else does all of the ordering for you, and, if you're not careful, you might not ever get to leave the table.

Which is not just a larger metaphor.  My father, who paintakingly poured over the menu choices and circled what he wanted and turned the sheet in dutifully to the nurses never once got the food that he ordered the entire time that he was in the hospital.  But it was always on time.

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