Caring for More Than Surgery

By Ina Ames

I was a patient at a hospital in Boston after the head of vascular surgery infected me with an antibiotic resistant cellulitis.  I was admitted to the hospital 10 days after surgery.  I was admitted to the vascular surgery ward.  The first day, my surgeon was away.  On the second and third day, while my cellulitis grew and grew, he insisted that I would get better on vancomycin.  That did not happen.  All along one of my friends insisted that we get an infectious disease doctor and the entire staff on the vascular surgery ward insisted that wasn’t necessary and convinced my daughter to wait.  On the fourth day in hospital, my daughter demanded an infectious disease doctor.  She was told there was no one available.  My daughter then asked to be told where the infectious disease department was. She was informed there was no department.  (This, of course, was a blatant lie as I was under their care for the next 9 months.)  Finally, my daughter asked to speak to the patient advocate and was told none was available.  To her credit, my daughter told them that she was going to stand there – at the nurses’ desk – until they got her a patient advocate or had a policeman remove her physically.  I am told she just stood there staring at them until the patient advocate (who had been in the next room) came.  Within an hour, the infectious disease doctor was in my room.  Within another hour I had a protocol written which included several other antibiotics as well as the vancomycin, which was not sufficient for the type of antibiotic resistant cellulitis with that I had been infected.

I would like to tell you that this all ended up happily ever after.  I cannot.  It’s 7 ½ years later and I am just beginning to function well enough to start to take care of myself.   I lost my business because the recession hit about the time I became incapacitated.  I am currently 66 and living on Social Security and a small pension as I lost both my business and my savings trying to keep the business going when I couldn’t be there and keeping me covered by health insurance until I reached age 65.

My suggestion for cost of care is extremely simple.   In my world, it makes no sense whatsoever to have a patient who was almost killed by a surgeon then put under the care of that doctor.  My suggestion is that anyone who goes into the hospital with cellulitis be immediately treated by an infectious disease doctor.

I am the blessed one.  My friend’s friend had been at the hospital and treated by the doctor that infected him died.  I am alive and have lived long enough to enjoy my now five year old grandson.  My two children have banded together to provide me care for not only the multiple cellulitis infections I have but also every other virus and bacterial infection that I keep getting because my immune system is weak.  After 7 ½ years, I am beginning to be able to be out of bed most of the day once or twice a week.  My son gave up a successful career in California to move home to help take care of me (and has found a different successful career back home when I no longer needed his constant care a few years ago).  As I said, I am blessed.

So the question becomes, exactly what is my cost saving suggestion?  I suggest that if you have a patient with a specific disease, such as cellulitis, the patient be put in a ward for infectious diseases. My surgeon was the then head of Vascular Surgery at the Beth Israel Deaconess.  He was highly recommended.  However, being the head surgeon did not qualify him to treat my infectious disease.  His arrogance had him insist to my daughter that he was the one to treat me.  If hospital policy was that patients were treated not by the surgeon or doctor who had put them in the hospital, you would save a great deal of money and patients’ lives.

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Ina Ames was a contestant in the 2015 Costs of Care Essay Contest.