By: Dan Regan
The other day, Presidents’ Day to be precise, I had my hip replaced. Years of playing squash, a fast-moving and otherwise healthful racquet sport, had worn away the cartilage on one hip and had ground the joint down to nothing. The surgeon’s highly technical (sic.) diagnosis was that it was “beyond broken.”
Leading up to this common but still major surgery, I found myself with three overwhelming concerns: (1) my toenails; (2) a slight irritation at waist level, dry skin from Vermont’s cold winters exacerbated by a styrofoam flotation belt worn for exercise in a pool; and especially (3) whether home health, after the operation, would look askance at our small house, and at the clutter and occasional mess created by its three dogs and three cats. Anyone who has given birth may already be scoffing at these concerns. Whether they are merely peculiar, fairly usual, or an abject denial of what was to come, I am not sure.
I do know for sure that, soon to turn 73, I am extraordinarily fortunate. This was the first time I had ever been an in-patient at a hospital. By contrast, in a single year—2016 for instance—7% of the total US population experienced a hospital stay of at least one night duration. That’s over 35 million inpatient stays in one year.
These Americans—readers of this blog among them—are a hardy bunch. My hospital of choice (Copley) provided an exceptional quality of highly personalized care during my recent stay. The entire staff was just terrific.
Nevertheless, no matter how wonderful the ministrations of a healthcare team, a hospital is a humbling place. That’s because a hospital is an example of a « total institution »—that is, a place of work and residence where a large number of people are cut off from the wider community for a considerable time. Their new community has its own rhythm, rules, and procedures. For the healing and recovery process to play out properly, hospital patients must skillfully play their important roles; above all, they must make an effort to get better.
Of course, the promise of eventual recovery makes it all well worth it, but hospitalization is nevertheless far from easy: frequent patients have to be mighty tough. For one thing, a slight pall of anxiety overlays everything. Patient instructions, for instance, even for a planned-in-advance procedure such as mine, can end up seeming more complicated than assembling furniture from IKEA. Amidst the swirl of prescriptions, instructions, do’s and don’ts, it’s hard not to feel at least a little dense.
To be sure, lots of valuable lessons are learned in the process, including humility, gratitude and our common humanity. But they come at a price: a temporary loss of privacy, nakedness and exposure, the surgical assault upon one’s body, as well as a forced immersion into the private travails of strangers who are all too close.
No one looks forward to feeling these ways. Their antidote would seem to be minimizing hospitalizations. Accomplishing that will require, on the part of many of us, a greater focus on wellness. And even then, some hospital stays are the product of bad luck or non-preventable circumstances beyond our control. Certain microorganisms, genetic legacies, environmental factors or accidents can land us on our backs.
But there remain many hospital stays that result from individual lifestyle choices. My hope is that, to minimize the chances of being hospitalized, readers will take whatever steps they can toward their own wellness. Recent posts on this blog, for instance by Caleb Magoon and Michele Whitmore, provide some great and practical suggestions. Future posts will provide more, so stay tuned.
In addition, wouldn’t it be great if insurance providers increased their support for wellness? In Germany, for instance, certain blood pressure readings would yield an Rx for hydrotherapy and spa treatments. Try charging your insurer for those! Nor is there generally insurer support for membership in a gym or fitness center, despite the consensus among healthcare providers that more exercise would be beneficial for most people. Acupuncture, in spite of its lineage that dates back thousands of years, is rarely supported. Even therapeutic massage, the benefits of which are widely recognized, is not generally covered.
A greater investment in preventive and wellness measures would save a great deal of money now expended on curative, after-the-fact treatments. So I urge readers to take whatever steps they can, hopefully with—but even without—the support of their insurers. The hospital, even a great one, should be a last resort.
Dan Regan, a sociologist, is the former dean of academic affairs at Johnson State College and continues to work part-time for Northern Vermont University. He writes for a variety of publications about whatever interests him, including—recently—climate change, living with arthritis, the NFL players’ protests, and higher education.