My mother received her new set of dentures Tuesday — Not a major news event for an 87-year-old woman but the arrival of her new choppers comes almost four months to the day after Carilion Roanoke Memorial Hospital lost her previous dentures as the final blow to a week of monumental medical malpractice.
She fell and broke her hip on Aug. 1 and underwent surgery on that Sunday, beginning nine days of medical and bureaucratic nightmares at the hands of Roanoke’s largest hospital.
That it took four months to replace her teeth is a sad and sorry testament to what happens to victims of what is laughingly called health care in this nation.
Mom’s initial surgery went well. As it turns out, it was the only thing over the next several days that did. When I showed up to visit her on Monday following her surgery, nurses and doctors on the post-recovery ward were in a panic. They couldn’t find her because the hospital’s computer system ordered her moved to another floor without a doctor’s review or approval. It took three hours to track her down on another floor and move her back to the post-recovery floor where she belonged.
Then I talked with the hospital’s social services department about the post-surgical rehab she would need for a broken hip. The department promised to prepare a list of recommended facilities for me to pick up the next day.
On the following day, I dropped by the social services department to pick up the list only to find out it had been left in her room, on the table by her bed. Now, leaving a list of rehab facilities, most of them also nursing homes, next to an elderly woman who just had major surgery and a fear of nursing homes, is not what most would consider a good idea. Had she seen the list she would, understandably, gone into an immediate depression from a mistaken thought that we were shipping her off to a nursing home. That is something that will not happen with my mother as long as I’m her guardian and designated caregiver.
Fortunately, she had not noticed the list.
I went over the list, discussed them with my brother, who works in the medical profession, visited several, and we selected one we felt would give mom the care she needed to recover from the hip surgery and get her back to her apartment at her assisted living facility. The social services department promised to set up obtaining a room and promised to get back to us.
Two days later, I had heard nothing. I finally called the rehab facility and was told that, yes, they had a room reserved for the day my mother was ready for transport. So I called Memorial’s social services department.
“Oh,” the social services worker said. “Didn’t I call you back?”
“No,” I replied. “You did not.”
“Well, that happens. When do you expect your mother will be ready for transfer?”
“I thought that was something you would be telling me.”
“Well, the doctors don’t always tell us when they discharge a patient.”
“They don’t? Don’t you arrange the ambulance for transport?”
“Well how do you do this if you don’t know a patient is being discharged?”
“That’s a problem we have here sometimes.”
I went through a similar process back in May when she was a patient/victim at Carilion‘s Radford Hospital. As a general rule, I have little confidence in the health care facilities that hold a virtual monopoly in Roanoke and other parts of Southwestern Virginia.
On Friday, the doctor said he wanted to keep my mother through at least Monday because she still had some swelling in her legs. I agreed and let the rehab center know, figuring Memorial’s social services department probably wouldn’t remember to do it. They didn’t.
On Saturday, I visited my mother and she was looking forward to the move to rehab. I talked with the nurses and everything seemed on track to a re-evaluation on Monday for a possible move to rehab.
I left and was 30 minutes outside of Roanoke when Amy Dalton at the rehab center called to tell me that the “hospitalist” at Roanoke Memorial had called to say my mother would be moved later that day and that they needed to be ready to receive her.
Dalton tried to explain that their last instructions from me had been to expect a possible move on Monday and that their facility did not accept transfers on a Saturday afternoon because the pharmacy that served their facility did not make deliveries on Saturday afternoons.
According to Dalton, the Roanoke Memorial hospitalist’s attitude turned rude and she said that if the rehab center we had picked “couldn’t handle this” the hospital “would find someone who would.” The doctor then hung up.
Dalton, obviously upset, called me. I was even more upset when I called Roanoke Memorial and got the hospitalist on the phone.
“Mr. Thompson, I have good news,” said the hospitalist, who would not identify herself. “Your mother is ready for discharge. The rehab center you originally selected could not accept her today but I have found another one who can and we will transfer her there today.”
Holding my temper, something that is never easy for me to do, I told the doctor that sending my mother to another facility that I had not visited or selected was unacceptable. She turned hostile and said the decision was hers, not mine, because she was the hospitalist and her decision was final.
“Let me speak to your supervisor,” I said.
“I don’t have time to locate him,” she said.
“Make time,” I said. “I can be there in 30 minutes and you don’t want me to have to do that.”
I heard her slam the phone down and tell the nurse to “do something with this guy.” The nurse, who had worked with my mother for the previous weeek, got on the phone, apologized for what was happened and said she would get the medical director on the line ASAP. He was on the phone within 10 minutes.
I explained the situation, including the fact that the doctor who had cared for my mother for the previous week wanted her kept in the hospital until at least Monday because of swelling in the ankle on the leg with the broken hip. He promised to look at the situation and call me right back, which he did in about 15 minutes.
“My apologies sir,” he said. “Your mother will not be discharged and her doctor’s original orders stand.”
I thanked him and also asked him to keep the rude hospitalist from my mother.
“Another doctor is handling the situation,” he said.
I hung up, calmed down, and then headed back to the hospital because, frankly, I didn’t trust anything I was hearing from them by now. A new doctor was there when I arrived and he assured me that my mother would not be moved until at least Monday.
“I’m sorry this happened,” he said. “Unfortunately, it happens more than it should.”
I spent the rest of the day riding my motorcycle, my usual therapy to deal with the absurdities of the world.
On Sunday, I arrived at Memorial to find my mother crying.
“They took my teeth.”
“My teeth are gone.”
Sometime between the time I was there on Saturday and Sunday morning, her dentures disappeared from her room. The nurse on duty, a new one who had not been on duty at any time during my mother’s previous week, shrugged when I asked about the teeth.
“She keeps talking about missing teeth. Are you sure she had her dentures when she checked in?”
“Yes, I’m sure,” I said, my blood pressure rising. “I helped take them out after she ate lunch yesterday. She didn’t have them for dinner last night or breakfast this morning.”
She shrugged again. “I guess that explains why she didn’t each much breakfast this morning.”
Once again, I struggled to control my temper.
“Have you looked for them?”
“Well, I could check the linen service or food services. I’ll do that when I get a chance.”
“Do it now or I will,” I said.
About that time, the doctor arrived. When I told him about the missing dentures, his anger surfaced and dressed down the nurse and told her to get someone down to both food and linen services, find the missing dentures and also get her some soft food she could eat.
Unfortunately, the missing dentures were never turned up. Several doctors and nurses at the hospital told me that dentures and other personal items “go missing all the time around here.”
On Monday, the doctor found additional swelling in my mother’s ankle. An x-ray showed a blood clot that could have come loose if they had moved my mother on Saturday. Dislodged blood clots kill people and the hospitalist more interested in emptying a room than in the health of a patient could have killed my mother.
After two talks with the administrator’s office, the hospital agreed to pay for replacing her dentures.
Replacing her dentures should have happened sooner but my mother’s health did not allow her to visit a dentist’s office until three weeks ago and no dentist in Southwestern Virginia, it appears, makes house calls, even to a rehab center. Mom’s long-time dentist, Dr. Howard Cundiff of Floyd, showed little interest in helping even though he and my brother were classmates in school. That is something I will neither forget nor forgive.
Once she could be transported via a wheelchair, we found a new dentist who made her new dentures.
I promised my brother I wouldn’t write about the situation until our mother had new dentures in her mouth and the check from Roanoke Memorial cleared. Both happened this week. My mother’s hip is healed, rehab worked as best it could on an elderly patient and she is, for the most part, comfortable one again in her assisted living facility.
One of he the doctors who helped my mother during her nightmare at Roanoke Memorial told me he came to from a much larger hospital and thought he would be coming to a smaller facility where helping people would be a priority. He says he is returning soon to the larger facility because Roanoke Memorial “doesn’t give a damn about its patients. All it cares about is the bottom line.”
Roanoke Memorial is the centerpiece of the giant Carilion Medical Empire and it stands as a monument to bureaucratic incompetence, indifference to patient needs and the kinds of medical problems that makes medical care both overly-expensive and inefficient.
When I talked with the hospital administration about my mother’s nightmare week at their facility, the attitude was one of “well, these things happen.”
They shouldn’t. Not the almost daily list of screw ups that became a running Three Stooges Gag during her stay.
Roanoke Memorial is aptly named. It should be shut down but left standing as a memorial to corporate medical malpractice.