Being a patient of corporate Persons

Every time a new part of my body goes bad—or some previous grievant goes bad in a new way—I get a new kind of doctor. I don’t get rid of the old ones. I like the old ones. I just add a new member to my team. [1] It’s a pretty big team by now.

Every member of this team is guided by a question that I admire, especially now. The question is, “What treatment, if any, would bring Dale the most relief (best protection) all things being considered?” They are knowledgeable men and women, but they are not above taking a risk now and then. Not a one of them is the kind that would wake a patient out of a sound sleep at 3:00 a.m. to “take vital signs.” They would say, “He looks OK to me. Let’s check him after breakfast.”

A week and a day ago, Bette and I flew toward Philadelphia. I didn’t make it. For whatever reasons—the debate continues—I passed out on my Southwest flight and they off-loaded me into an ambulance in Chicago. I left MacNeal Hospital—the one closest to Midway Airport— about 24 hours later with a “note from the teacher” kind of note in my pocket and a hope that Southwest Airlines would not send me back to the principal’s office.

I may write more about the physical events (probably not), but today’s account has to do with liability. Any one of “my doctors” is willing to take a chance on me; to call a given reading “good enough” (blood pressure) or “Yes, but yours just runs high (prostate specific antigen); watchful waiting is probably the best course.” None of the questions they routinely ask is, “How can I be sure that I have a good case if I am sued.”

nurses 4I was told that Southwest Airlines has a policy that when they break out the oxygen for a passenger, that passenger goes into the hospital at the first opportunity. [3] I spent a substantial part of the flight lying in the aisle, making things really difficult for the food and drink cart. I had passed out, sitting in my seat, and was drenched with a cold sweat and had a very low pulse. I’m not saying they shouldn’t have been concerned.

But by the time we got to the hospital, I was feeling pretty good—not, I was told, looking nurse 2all that good—and I was ready to go on to Philadelphia. Not so fast. Southwest was committed to getting me to the hospital. MacNeal Hospital is committed to finding out what part of my equipment was at fault. There was no evidence by the time they got hold of me that there was anything wrong with my body, but they wanted to be sure. So the blood tests, the heart monitoring, the carotid artery scan, the EKGs, and an echocardiogram too, had I not had one just before the trip.

Everything looks good. So I feel comfortable going on and there is still a flight that will get Bette and me to Philadelphia. But the doctor was not comfortable with my judgment and the best she could do for me was a note—a form, actually—saying that I had left the hospital “against medical advice.” I would have been fine with that, but I was told that Southwest Airlines would not let me back on one of their flights unless a doctor gave me a note and this doctor wasn’t going to. Yet.

So now I’m in Chicago. A very prudent doctor is not moved by my account of having been through this many times before and will not allow me to fly on to Philadelphia. In point of fact, the discussion and the testing went on, concurrently, until there were no more Southwest Airlines flights that day, which is when I gave up.

nurse 1So now I am in the hospital. It is a huge and complex social organism run by people who have no sense of the larger picture of things and who are not permitted to use their judgment even if they did have that larger picture. The nurses ask you the questions they are supposed to ask. They don’t care that the previous nurse and the one before that asked the same questions and struggled in the same way over electrocardiogenic syncope. They are no more free to skip a question than the cashier at Chipotle was free to skip the question about whether I was old enough to drink alcohol. I was 75 at the time, but she was on camera and had to ask. [4] It’s a matter of not being liable.  This book cover has in mind that nurses, as well as doctors, are people.  My idea is that nurses, if they are only corporate agents, are not permitted to be very “people-like.”

Every doctor and every nurse did what she had to do and that included the classic awakenings at midnight and 3:00 a.m. to take “vital signs.” I was asked about the surgery I had on my left shoulder in 1962, on my knee ca. 1986, on my prostate at about the same time, and on my cardiac catheter ablations last year and ten years before. I was afraid they were going to start tracking down the colonoscopies.

The airline and the hospital are corporations, therefore, by the current definition, “persons” in some sense. But the really cool part about personhood, the part that has to do with agency and discernment and, where necessary, risk taking, is not a part of corporate personhood. So Southwest had no choice but to offload me, having given me oxygen. The hospital had no choice but to hold me against my will—no “free to fly” note, remember—until they had ruled out things no well informed doctor would have ruled in.

nurses 3The collusion between the Southwest Person and the MacNeal Person kept me in Chicago all evening.  The picture is of a Yukon Person.  I got “lunch” at 9:00 p.m. I tried to explain that some of the symptoms they were worried about would clear up instantly if I could just get some food. I got a room and a roommate by 9:30 after eight hours in the emergency room, monitored by machines, but otherwise mostly unattended, but the roommate was still watching hockey at 10:30 p.m. I thought he was a hockey fan, but it turns out he didn’t know how to turn the TV off. Go Blackhawks! I gave orientations to wave after wave of nurses—some very nice, some not so much—and negotiated my freedom from a compassionate doctor who wrote and legibly signed a note that said, “Dale Hess is safe to fly on 6/4/2015.” [5]

So we didn’t actually get to Philadelphia, apart from the airport, but my daughter picked us up and we spent some truly wonderful days with her and my son-in-law and my grandsons in Princeton, where they could shoot the next version of The Truman Show if they wanted to. It is beautiful and, in the days after graduation, it was peaceful.

[1] This is not “my team” in the sense that I am calling the plays or doing the scoring. This is the team that I have assembled to keep me playing the game.
[2] I asked a nurse recently if she would return those vital signs to me when she was done with them. She stared at me over the tops of her glasses, shrugged, and went on to the next bed.
[3] I was also told that the pilot decided to go on to Chicago and not to divert the flight to Boise, Idaho. Thank you, captain.
[4] She did face away from the camera and roll her eyes and I appreciated that.
[5] She had a really clear signature. I wan’t sure she was real doctor, based on the signature, but by that time I would have taken a note from the busboy.

About hessd

Here is all you need to know to follow this blog. I am an old man and I love to think about why we say the things we do. I've taught at the elementary, secondary, collegiate, and doctoral levels. I don't think one is easier than another. They are hard in different ways. I have taught political science for a long time and have practiced politics in and around the Oregon Legislature. I don't think one is easier than another. They are hard in different ways. You'll be seeing a lot about my favorite topics here. There will be religious reflections (I'm a Christian) and political reflections (I'm a Democrat) and a good deal of whimsy. I'm a dilettante.
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