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Undercover, MD


I had a baby. OK, that may not be entirely accurate: My wife, ever the stickler for details, likes to irritatingly point out that she had the baby and I just stood around, unearthing innovative means to get in the way while nervously asking inappropriate questions seemingly aimed only at annoying the hospital staff.

A baby was had, nonetheless.

And while that is remarkable, the really notable story is what happened during our hospital stay.

An Inauspicious Start

It’s hard to read a newspaper, view a television news program, or have a conversation in public without knowing the situation: The U.S. healthcare system is in shambles—nearly 50 million uninsured, 16% of GDP spent on healthcare, and a World Health Organization (WHO) overall ranking of 37th in the world based on multiple health indicators. And, of course, there’s the thorny data suggesting that as many as 98,000 patients die annually from hospital-induced medical errors.

As such, I was prepared and ever vigilant for this admission. This was my chance to see, from the patient’s perspective, this massive, impersonal, error-riddled, sputtering system. I would expose it for what it was, and take names.

We started our odyssey a bit early, as these things are wont to happen—two weeks early, in fact. A somewhat inauspicious start, some would say. Admittedly, that’s what my buddy grumbled as I called him 90 minutes before the first pitch of Game 4 of the National League Divisional Series to tell him he’d have to watch the Phillies play the Rockies without me.

I stalked the halls looking for a less-than-15-second hand wash or an HIPAA violation. Seeing none, I pondered my wife’s fate at the hands of this massive, impersonal, error-riddled healthcare machine. I just couldn’t surmise a scenario in which she’d get out of there alive.

The Death Trap Beckons

My wife went to check in while I parked the car. Well, sort of park the car. It turns out this unwelcoming beast known as “the hospital” actually employed valets to park my car. “Parking is the last thing you need to worry about right now,” the attendant said. I, however, saw through this ruse. Aaron—according to his nametag—is up to no good, or so I thought, counting the pennies in my ashtray.

After checking in, the first person my wife and I encountered was Jane, our nurse. She came in all bubbly, effusing that “things will go well and you’ll be with your new addition very soon.” All heart-warming encouragement and smiles aside, she actually appeared unaware of this death trap cavorting as a hospital—a jumbo jet’s worth of patients dying from medical errors every day is no laughing matter, missy. “I’ve got my eye on you,” I whispered conspiratorially to no one; a knowing smirk appeared as I took down her name.

Later, this Jane would interrupt my attempts to make my wife laugh through expertly executed 1980s dance moves. Jane implored her to just “let it out and cry for a few minutes—then you’ll feel better.” Somewhat embarrassingly, this automaton was so caught up in her own medical world that she misinterpreted my wife’s tears of laughter for tears of apprehension. Oh, how misguided these medical personnel can be. “Stick to the nursing and I’ll comfort my wife,” I thought to myself. My wife, meanwhile, was in the process of “letting it out,” after which she did indeed report feeling better. Oh, she’s good. If I didn’t know her so well, she would have led me to believe Nurse Jane’s advice was sage, caring, and spot-on. I wasn’t fooled; my wife’s a sucker for my dance moves.

Procedural Missteps: I’ll Be Outside

Next up: Steve, a second-year anesthesia resident intent on plunging a catheter into my wife’s spine for pain relief. Little did young Steve know that I was on to him and his attempts to give my wife Brown-Séquard syndrome. After all, procedures are a common source of hospital error. Under the guise of “informed consent,” he spouted the pros and cons of the procedure, all the while failing to mention the near certainty with which my wife would develop paralysis from a spinal hematoma.

Of course, I am no boob. I relentlessly exposed this neophyte with my knowing questions, finishing the undressing with a curt “there is no way you’re coming near my wife with that needle!” To which my wife, in her ever-tender way, ordered me to get the hell out of the room so she could get some (unprintable expletive) pain relief. See, this young doctor was getting to her as well.

Undeterred, I continued to prowl for medical errors. Knowing communication to be fertile ground for hospital slip-ups, I watched intently the handoff of care the day nurse, Jane, gave to the night nurse, Sarah. Surprisingly, Jane appeared to get it all right—at least that’s how it would appear to the untrained eye. She succinctly overviewed our history and course, documented the medications my wife received, gave the plan, and told her what to do if things didn’t follow that plan. Sarah repeated back the salient points as she reviewed the written chart and asked a few questions.

All good on the surface, but she spent so much time doting over my wife’s emotional needs that she failed to notice my discontent over the Rockies’ series-ending loss to the Phillies. I helpfully pointed out this blunder to her, at which time my wife rolled her eyes and asked, “Why can’t guys have babies?” Assuming my wife missed that class in medical school, I immediately began to overview basic reproductive physiology, at which point I was again asked to leave the room—this time by Nurse Sarah.

Waiting-Room Reflections

Not one to be satisfied with my victories, I stalked the halls looking for a less-than-15-second hand wash or an HIPAA violation. Seeing none, I pondered my wife’s fate at the hands of this massive, impersonal, error-riddled healthcare machine. I just couldn’t surmise a scenario in which she’d get out of there alive.

Just then, Susan, our obstetrician, came out to let me know that my daughter would soon be making her entrance. She informed me that it would be OK to film the procedure, if I liked. “But what about malpractice? Aren’t you worried about having this on film?” I asked. “Not a bit,” she replied. “What I’m worried about is your horsing around causing us both to miss this delivery.”

With that, we were back in the room, reunited in our common purpose. Moments later, I was the proud owner of a freshly minted baby girl.

Putting down the video camera, the state of the healthcare system finally came into focus. To be certain, we have our problems. But this wasn’t the massive, impersonal, sputtering system I was led to expect. Rather, I found it filled with caring, compassionate, highly skilled professionals with names like Aaron, Jane, Sarah, Steve, and Susan. Together, they had engineered a true miracle.

A miracle named Kaiya. TH

Dr. Glasheen is associate professor of medicine at the University of Colorado Denver, where he serves as director of the Hospital Medicine Program and the Hospitalist Training Program, and as associate program director of the Internal Medicine Residency Program.

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