Thursday, July 1. Will the efficiency of a highest-rated New York hospital be seriously affected by the general paralysis of the Bicentennial Independence Day? This afternoon I enter Lenox Hill for “hernia repair” with increasing qualms, not about a possibly unfavorable answer to this question but about the limits of newspaper assignments and whether this one is going too far. I am not an “action reporter,” after all, and the surgery is postponable.
Seventy-five other patients are sworn in at the same hour, a process no doubt slowed by actuarial complexities resulting from the malpractice crisis. In fact the patient leaves “Admissions” with the feeling that his identification bracelet manacles him to a “no-fault” system in which a fatal mistake, such as the transfusion of incompatible blood, becomes a “therapeutic accident.” One of the new non-liability contracts which must be signed states that “the charges incurred represent the fair and reasonable values of the services rendered.” But how, one might ask, can this be known in advance?
Certainly my cramped room is not worth the “charge incurred,” with its shower but no tub, towel rack but only paper towels: blotting the entire body is one of the more peculiar experiences of the assignment. Worse still, the centrally controlled air-conditioning, set at 55°, is not modifiable by the thermostat, and the frigid drafts from a vent along one rim of the ceiling are reminiscent of those next to the window seats in some airplanes. Also, the bed seems to be extremely narrow, especially when the railings are up, though no one can manage these without an amount of trial and error, just as no staff member can immediately find the right cranks for raising and lowering the head and feet, each move invariably beginning in the wrong direction; the secret of the “knee break” segment remains undiscovered, and that part of the bed uncomfortably elevated, throughout my stay.
I am requested to exchange my clothes for the open-back, knee-length, immodest hospital gown, and to “prepare for tests.” But first comes a detailed inventory of personal effects, which includes a question whether my teeth are part of me or detachable—rip-offs of dentures reportedly being on the increase. Then follows the taking of blood pressure, pulse, temperature, and of specimens for the laboratory. The electronic digital thermometer registers, to two decimals, until a “beep” signals that the correct degree has been determined. But whereas the machine is faster and more accurate than mercury in glass, it also produces more anxiety, the patient realizing that the longer the interval before the noise, the higher the fever.
Technology has not changed the method of ascertaining pulse, which is still done by human fingers on radial arteries. In my case, the nurse looks alarmed and asks if my beat is normally only forty-eight. No, I say, and suggest hopefully that this evidently failing rate may be due to “vagus inhibition.” Continuing to grasp at this straw, I mention the thermodynamics calculation by which the heart …