Thursday, May 24, 2007

My Definition of Insanity Just Keeps Growing

So I had a cute little la la la things are getting better and it's sunny and yay! kind of post in my mind for today.

I saw my dad last night. In fact, there were five of us visiting. It was kind of a little party in his room. He had a little bit of sparkle. It felt better.

Then I got to work and got a call from my brother. He had a long talk with the psychiatrist last night. Who said he anticipates discharging him early next week.

Now, my dad had gotten comfortable at this hospital. We decided to let him stay where he is for now, because, after consulting with a variety of medical professionals, we determined that as long as he's doing well and likes his doctor, we shouldn't disrupt him.

Don't get me wrong - we're still on the hopeful list at Hopkins. Although as I've said, it's a long process.

My brother had been hounding the psychiatrist for days, and finally the psychiatrist called my brother back. They had a very frank conversation. My brother said they both put on the punching gloves and had at it, no holds barred.

Yes, the psychiatrist admitted, although he will not say this on record, the issue is money. Yes, what my brother has heard from others is correct. There is immense pressure - like, the kind of pressure that prevents one from keeping one's job at the hospital - to discharge people in 10 days or less. It all comes down to insurance. Money.

And the doctor's problem, as far as I can determine, is that while he doesn't believe my dad is ready to leave, he cannot say "I believe he is in imminent danger." Which I understand to be the magic phrase for insurance companies. Meaning, he will try to harm himself immediately upon release.

I don't necessarily believe it would be immediate. That is, depending on your definition of immediate. The third suicide attempt, it took 48 hours for him to wind up back at that hospital.

So in lieu of working on work today, I spent a good portion of the day editing a letter my brother wrote - at the recommendation of the psychiatrist with whom he had the boxing match - to the chair of psychiatry at the hospital. The guy said to write a letter. Take it to the chair, ask for a review.

So of course we wanted to have the most effective letter possible. I feel lucky to have amazing friends who also happen to be amazing lawyers, and you can be certain that I consulted them.

But goddammit. Here's what I don't get. See, my dad is on a locked floor. A floor where they check your bags to make sure you don't bring anything sharp. And then take away your bag if it is big and plastic.

All flowers we've put in plastic bottles. The razor you check with the nurses, and they stand there and watch the patients shave and then take it away again. And I meant it - you can't even bring a fucking plastic bag onto the floor. They make you leave those things at the desk when you check in.

So, you take someone that you feel is in enough danger that he can't have access to glass or belts or even plastic bags, and you say, sure, now that he's eating through his mouth rather than through a tube, sure, in a couple days, he'll be fine.

Because money, money is what is important. And it takes time, which is money, to hassle with insurance. There will be extra forms after 10 days. There will be a struggle. And it's just not worth it.

Is this not insanity?


  1. It *is* insane. And I'm so sorry that you have to deal with this. Your father is lucky to have such devoted people.

    I'll keep you in my thoughts!

  2. *hugs*

    It's sad when money comes before a person's life and well being.

  3. VVK - Thank you. Hug back.

    Dagny - Ah, thanks. You've been thinking of us for far too long, but I really appreciate it!

    Iwontbelost - Thanks for the hug. It truly is sad, even though I do understand how the world works.

  4. Sadly, the current state of the insurance/medical care system seems to have added a disclaimer to the hippocratic oath:

    Promise to do no harm is contingent on satisfaction of the necessary financial and administrative concerns of hospital management and the appropriate underwriting organizations.

    It's a joke, but unfortunately it's not remotely funny.

    Good vibes, good thoughts coming your way.

  5. It's all kind of horrifying. You have these doctors you're supposed to trust, but ultimately, they don't get to decide; the insurance companies do.


Tell me about it.