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Doctor Breaks Neck, Sees Reality of Hospital Care

Arnold Relman was in pretty good shape for a 90-year-old—until the day he fell down the stairs and fractured three vertebrae in his neck, he writes in the New York Review of Books.

He was rushed to Massachusetts General, where a crack medical team saved his life by performing an emergency tracheotomy (he couldn't breathe with a hemorrhage pressing on his windpipe) and restarting his heart three times.

When he came to—plugged into machines, unable to speak or breath well—he began 11 days at the hospital's top-notch intensive care unit and a month at the so-so Spaulding Rehabilitation Hospital.

Through a haze of pain, sleepless nights, and his family's comforting presence, Relman, a senior Harvard physician, witnessed "the current state of medical care in the US":

  • Anonymous doctors come and go, giving cursory exams and walking off to fiddle on computers—when you really need a primary physician to take charge, preferably your own.

    The US has a growing lack of primary care physicians, which makes hospitalization fragmented and scary for patients.

  • What personal care you get comes mostly from nurses.

    "I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled."

  • Health care is—surprise, surprise—expensive.

    The two hospitals charged his Harvard-faculty insurer $478,000, much of which wasn't itemized. The insurer balked and paid only $332,000.

Now he's back home with his wife, walking gingerly on a cane but feeling better—and living up to a note he scrawled his wife in the hospital: "I intend to hang around for a while longer, to love and bother you." (And he's not alone: People are recovering even from broken-neck paralysis, an expert tells the Union Leader, and the Guardian reports on a top world swimmer who continued to thrive after breaking her neck).

Click for Relman's full article.

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