So, How Did You Meet Your Primary Care Physician?
By Howard W. Gabriel III, Ph.D.
For sometime I experienced shortness of breath. It developed gradually over time, but eventually I realized it was not going away. I finally went to the primary care physician with my wife. She thought it was minor; I knew it wasn’t.
Oh, I am getting ahead of this story! Let me introduce myself. I recently achieved my 59th birthday. My recent work experience has included 16 years teaching. Earlier careers were in medical education, medical research, public health research, health administration, writing, and some counseling. My formal education includes an interdisciplinary Ph.D. in health sciences with allied study areas in psychology and management.
The aforementioned summary of my background may seem like that of a rather smart individual. Please keep in mind that smart people do some very stupid things throughout their lives. Edgar Bergen was a great ventriloquist. He often asked one of his dummies, Mortimer Snerd, “Mortimer, how can you be so stupid?” Dear reader, please call me Mortimer.
So my wife and I sat together waiting for the primary care physician that she had known and used for more than twenty years. I had not seen a doctor since leaving my health career behind, more than 25 years ago. Thus my wife was glad that her “Mortimer” was finally going to see the doctor.
After a brief examination and some questions, the doctor ordered an EKG. When he got the results, he looked very pale. I vividly recall his concern. “You should be dead; I can’t believe you are alive!” I was in no way offended by his frankness. Later, I learned that I probably would have died within a week or two. Henry David Thoreau once said that he was born in the “nick of time.” As it turns out, I had gone to the doctor in the “nick of time.”
I was sent to an emergency ward of a nearby hospital and then on to a room in the intensive care unit. Here I met my cardiologist and spent a few days for several tests. The cardiologist concluded that I would probably need some kind of heart procedure and maybe surgery. I was transferred via ambulance to another hospital.
It was at this second hospital that the professionals decided I needed major by-pass heart surgery to survive. The surgery was scheduled for the morning of a day that was one week after I had walked into the primary care physician’s office. The surgeon stressed that without the surgery I’d be lucky to make another week. In that I was relatively young, he thought I’d do fine. Yet, there was a chance I’d die during the surgery or experience complications afterwards.
It was a time for great spiritual need. I am not sure of all the reasons why, but I remained a calm, cooperative, humorous type of patient. I don’t consider myself a zealous Christian. Rather, I am an everyday common sinner who has always felt more comfortable in the back half of the church during services. The countless hours leading to surgery found me at peace. The power of prayer cannot be described with human words from any language. As a lifetime Roman Catholic, I know and said the Lord’s Prayer and Hail Mary’s over and over again. I never cried once while in the hospitals. No, I’ve never been or tried to be a “macho” type of person. Since being released from the hospital I have often burst out crying, especially when alone.
Anyhow, my children took time off from their careers to visit me. My wife would eventually take two months off from her job. There were several chaplains who visited me before and after the surgery. They provided me with so much comfort and encouragement. I felt up beat when they left. My favorite Chaplin was Baptist. We shared thoughts, stories and humor. Friends and pastors from my wife’s church (yes, she is Baptist) visited repeatedly. More than a hundred get well cards came to my attention. There were individual prayers and even networks of prayers for me. Looking back, I wonder if I got “just enough.” The Lord knows how many I needed.
When I was a mere youngster, my father told me a story. I guess I was upset about not getting something. Anyhow, Dad said that there was once a man who complained about his shoes until he met someone without any feet. I recalled this story when I encountered a young person without any legs. He was being transported along the hallways and we passed going in opposite directions. The next day I encountered a female without any limbs. I said to myself, “Okay Lord, I get the message.”
My surgery was in the morning. After they put me to sleep I only remember one thing. A voice from afar said, “Howard, you must cooperate, your life is at stake.” I assume the voice was from a member of the surgical team.
I woke up 17 hours after the open heart surgery was concluded. It had lasted ten hours! I had a four bypass and some other procedures done. During my hospital stay I had a total of ten blood transfusions and two plasma transfusions. Thank you dearly all those who donate blood!
My stay in the hospital lasted 35 days! It was not exactly a Catholic retreat. There were IV hook-ups, oxygen tubing, surgery tubes and staples in my body. They used my left arm and right leg to ‘borrow’ for my new arteries. These two limbs looked like a truck had rolled over them.
Each hour consisted of visits by one health professional or another. Someone would come to monitor my vitals. Another person would provide me with lots of pills. Another person would give me treatments for my breathing and lungs. I was often being transported for certain tests like nuclear scans and x-rays. Let’s not forget all those who took my blood for constant lab monitoring. Then there were the sugar tests that made pin cushions of all my fingers. My entire body was shaved. I had several days of fluid intake restriction and fasting. One time my daughter called and I couldn’t speak to her. I had four individuals working on me at the same time. Each of them was doing something different to my body.
I have always appreciated a good night’s sleep. During my hospital stay two or three hours sleep was a good night’s sleep. The vast majority of evenings were interrupted constantly by people doing something to me. Most evenings had workers enter my room at all hours for various medicines, procedures or treatments. In the morning someone always asked me if I got a good night’s sleep. Pretty funny, huh! If you are thinking about naps during the day, I had only a few good ones. There were too many constant interruptions by professionals trying to get me well.
After the surgery and a few weeks literally tied to the hospital bed, I became helpless and very weak. I didn’t have much of a voice. My signature looked like a two year old’s effort. I couldn’t get out or back into bed without one or two people helping. At times I felt like a tethered animal that couldn’t get loose.
One time I was left in the bathroom to do my business. I had the door closed. I heard a voice call my name. I replied that I was busy and would be out in a minute, but suddenly the door opened and a young female doctor entered. She told me to go ahead and continue what I was doing. She wanted to check my lungs and heart. I was thinking of asking her to help me with the toilet paper. After a few minutes she left before I could say anything. I never saw her again.
During my hospital stay I was transferred to many rooms and to different nursing units. Sometimes my condition deteriorated and I had to go back to the prior unit. It was like taking two steps forward and then three steps backwards.
No matter what room I was in I always wanted my door open. This way I could watch people walk by. My favorite people were heart patients like myself. Whether with a walker or without, these people were heroes to me because they were trying to recover. I saw individuals who were young, old, tall, short, male, female, obese or slim. Heart diseases can strike anyone at any time!
Also among my heroes were the nurses and all the other hospital staff. Between 150 and 200 individuals served my medical, physical, and psychological needs. They often work 12 hour shifts. Each of them, without exception, seemed to care about me as if I was special. They were usually running from one patient to another. During my stay a number of nurses collapsed from exhaustion. We have an epidemic societal problem when it comes to adequate nursing staff levels. The nurses working are often overworked beyond description. The irony is that they are busy saving lives and getting people well. No one seems to care. The word around the hospital was that administration planned more nursing cuts. Some people would consider this staffing direction as penny wise and pound foolish.
Eventually I thought I was ready to go home. My doctor and wife did not agree, but finally relented. It worked a few days and then I returned to the hospital for a final week. This time I was ready to go home. On the last day I watched the outside from my room’s windows. I kept thinking of what Emily Dickenson meant when she wrote, “The mere sense of living is joy enough.”
Suddenly I saw a very obese, young woman smoking a cigarette as she got into her car. My primary care doctor had told me that our society is being subject to much suffering and premature death due to the unknown. I wondered when that young lady’s unknown moment would arrive.
For those of you interested in experiencing something like what I have survived, a chart has been developed. Howard’s Stupid Health Plan (HSHP) specifies the major requirements and potential consequences. I have written my sad account with high hopes that it will help spare others from the great unknown. The choice is often yours.
Now I continue with my rehabilitation efforts. I am never interested in going to bed at night. This is because I am so excited to arise to the dawn of a new day.
Howard’s Stupid Health Plan (HSHP)
A. HSHP Requirements:
1. Do not visit or utilize the services of a primary care physician for several
years.
2. Ignore factors in your life associated with heart disease such as:
a. cigarette smoking,
b. obesity,
c. high blood pressure,
d. high blood cholesterol,
e. excessive job and personal stress,
f. poor diet,
g. lack of exercise,
h. use of illegal narcotics,
i. family history (genetics),
j. gender.
B. Following the HSHP for a number of years may lead to many of the following:
1. Long stay(s) in hospital,
2. Subject to countless tests, medical procedures and treatments,
3. Sleepless nights and days,
4. Tethered to your bed by several hook-ups,
5. Major heart surgery,
6. Numerous blood and plasma transfusions,
7. Becoming helpless with no sense of modesty,
8. Long road to recovery and rehabilitation with several limitations to life activities.
9. Take some pills for the rest of your life,
10. Frequent doctor visits,
11. Complications associated with surgery,
12. Premature death!
