Author: Allan Lohaus, M.D.
The following review was contributed by: Sue Vogan: To read more of Sue's reviews Click Here
When I chose this book to review, I just assumed that it would be another physician whining about not getting enough attention or complaining about the five-minute wait for an x-ray. I fully expected the physician's dry version of how bad the hospital food was, how slow the call-button response time had been, or worse, how really bad the healthcare turned out to be. I was in for a surprise.
Dr. Allan Lohaus, gynecologist-obstetrician, now patient, writes a detailed description of his days spent on the other side of the gurney -- he is suffering from an intestinal perforation with complications.
It's November, someone is preparing for surgery, and the site, room 147. The patient is "dressed in a hospital gown, called a johnny." He is no longer visiting the familiar room, where he has spoken with patients as their physician before. He is now occupying the room, where other medical personnel will be speaking with him, 'patient Dr. Allan Lohaus', his hospital bracelet declares. A nurse misses the vein, she says, "I'll try again." The patient responds, "No, let's let Dr. Ellis start it in the OR." He claims to hate and fear needles, despite his years of medical training. The same nurse asks him to "slide over onto the gurney" that will transport him to OR. He wonders if he "can perform this delicate act wearing no underwear." His wife, Martha takes his hand, they exchange goodbyes and a kiss. It's show time.
Surgery is over and Dr. Lohaus finds himself mentally doing his "own postop evaluation." He reasons that he is stable. He rings for pain medication, cannot recall if he has slept, but he hurts and feels anxious. He is bewildered, "I can't remember what has happened. I am confused. But I know Martha is with me." Day three after surgery will find the doctor-patient's mind "doing funny things." He attributes this to sleep-deprivation from pain and "poor pain management." He finds he has "wandered into the ER, bleeding from the IV site and yelling, "I need help! The nursing care stinks! Get me out of here!" He wonders "how he got there unobserved."
"The medications seem to intensify the delirium. Blood tests show a critically low level of calcium, 6.9. 'That can't be correct. I'd be dead,'" he says to the nurse. Retesting shows that it was a laboratory error. Things only get worse.
The staff is in over their heads and suggest the patient be transferred. But, there's a glitch! No bed is available at the Boston hospital. The patient has connections and calls "a gynecologic-onocologist at Brigham to see of he will release one of his beds." Finally, some action. The ride is confusing for the patient -- never sure if he is drowning, alive or being rescued. The pain has intensified. He asks a nurse for medication, is told that the intern and resident "will order it after they evaluate," and he asks himself many question, how many liters of oxygen is he getting, when will the doctors come, how soon will the fever be controlled, and when will his mind clear. That evening, "Dr. Brooks enters." The patient evaluates him -- tall, about the same age as the patient, glasses, friendly and confident look, "snappy, striped tie," and the result, "he is a doctor's doctor." The patient thinks, "help me," save my life." The story continues with as many ups and downs as a toddler just learning to walk and as many snags as a sweater worn in an overgrown blackberry patch.
Day one-hundred twelve finds the patient home, but there's pain with the j-tube feeding. A call is made and "Dr. Brooks advises discontinuing the tube feedings and using Tylenol rectal suppositories for the pain." He wants a call if the pain worsens and an update in the morning. "Putting on the glove, I expertly insert the medicine. Waiting for relief, I rest and reflect that, for me, this past December could have been called "Rectal Suppository Month." The patient imagines he films an educational piece on the subject. It's hilarious! And, he wonders what background music should be heard in his imaginary film. He chooses Mozart because "he was bawdy."
The patient is back in the hospital -- "in performing the surgery, a large vein in your abdomen was nicked and you bled. A vascular surgeon was called in to close it," Martha explains. He has had four units of blood and needs one more. "I must receive the blood or I'll die. I know that I could die from either the AIDS or hepatitis viruses that may be in the blood transfusion. As a surgeon, I used to tell my patients they had one in three-thousand chance of contracting hepatitis or one in thirty-thousand chance of getting AIDS from transfusion. I would give them these statistics without concerns for their fears. I'll be sensitive to those fears if I practice again."
"How much water will I get?" the patient asks the resident. Turns out, it will be "two tablespoons every three hours. The resident rises from the end of the patient's bed and disappears. The doctor-patient recalls when he, too, "sat on the foot of my patient's beds." He remembers Dodie. He plans to send her home the next day, checks her incision, and then, he drops the news -- the tissue report showed that the tumor in her ovary was not completely normal, but, it wasn't cancer, but a grade-zero tumor. "If it were cancer it would be called a grade I, II, or III." Dr. Lohaus recommends a consultation with a specialist. Now, looking back, he wonders, "how much did that reassure her?"
Day one-hundred thirty-two, the patient is eating again and finds himself "sitting on the toilet." He waits. How long should he sit? How can he know how long he will have to wait? Then, he hears a splash. "Bombs away!" he announces. "Then, standing, I look down at the stool of a seven year old. I am proud of my work and return to bed."
After more than one-hundred fifty days, the doctor-patient seems to be transformed. He has walked in the slippers of a patient, contemplated and worried from his hospital bed, asked the endless questions, and ultimately placed his life in the hands of others. Dr. Lohaus truly knows now what it is to be on the other side of the gurney. In the end, he is alive and grateful. From there, he realizes he has his health, the passion of youth to "help others, to love, and to be loved." Forever, because of his experience, he will be a better physician. "The illness is over."
A must read for patients, interns, nurses, and physicians. This book can only make you better -- it's just what the doctor should order.