Not disordered machinery


When we think of hospitals we think of a sterile environment. It is assumed that it is a place where your health and well being will improve. That each of your senses can be assaulted in all manner of ways and that because of this, rather than in spite of it, you will get better.

My 30-something year old brother-in-law died in hospital six years ago to the day. He died alone, confused and incontinent. Separated from his beloved daughters and in isolation. The lymphoma that riddled his body was undetected as immunosuppressive drugs stood sentinel over his new kidneys. Everything that could be done was done. He was a young man and the oncologist was determined that he would receive aggressive chemotherapy until she decided that he was beyond her help. We could only watch as he lost his dignity for the slim chance that he might walk out of the place alive. In reterospect it was hard for everyone. He was not ready to die and nor were the medical team prepared to call time. He might have beaten the pathology but it is the journey and not the destination that was the worst aspect of the experience.

Medicine has advanced so much in the last few decades. We now have many life saving drugs or procedures that can be deployed in what were previously hopeless cases. But what hasn’t changed much is the experience of being hospitalised. In the world of blogs and social media we can read the accounts of patients without having to experience them for ourselves:

A man in his fifties who was admitted to hospital with autoimmune haemolytic anaemia, a complication of chronic lymphocytic leukaemia (CLL), first went into a general cancer ward as the haematology unit was full. The ward was depressingly full of very ill old men some of whom died while he was there…..Living in isolation for long periods could be difficult for people who were not used to being alone. Some had felt lonely, frustrated, hemmed in or bored…..Some people found their room pleasant, peaceful and well equipped with television, phone, hi-fi and ensuite bathroom. Neil said his was better than some hotel rooms. Jim said the showers were awesome. Others found their room depressing and had problems with temperature regulation or hygiene. Some people personalised their room with possessions from home. Gilly arranged hers with kitchen, study and reading areas. Brian was disappointed to have no internet connection so he got a modem that would connect his computer via his mobile phone. Some hospitals restricted what people could bring in from home.

As new hospitals are built de novo or to replace aging and outdated institutions we have an opportunity to build new ones that facilitate the innate healing powers of the human body. Healing is ‘the result of intention, personal wholeness, relationships, healthy lifestyle, collaborative medical care, healing organizations, and healing spaces’ (The Samueli Institute). The optimal healing environment addresses issues such as: ‘Connection to nature, options and choices, positive diversions, access to social support, reduced environmental stressor, private and  adaptable rooms, less noise, better wayfinding, lounges and waiting rooms with a purpose’ (Terri Zborowsky and Jo Kreitzer). None of this requires a Nobel laureat to spend a lifetime ‘proving the case’. What it does call for is the determination to ensure that hospitals are a place where it is joy to be born, a refuge when you are ill and somewhere to die in dignity when there is no other option. Humans are not disordered machinery to be parked on a ramp in public place while technicians attend to their under belly. If they are treated as such when they are ill their chances of recovery are diminished. Rest in peace Johnny.

Picture by CJ Sorg

2 thoughts on “Not disordered machinery”

  1. My Uncle’s story is too similar to Johnny’s . My mum sat outside her brother’s hospital room for 12 hours waiting to be allowed to see him but was repeatedly told to wait. Sadly he passed away on his own while she sat outside. Now her story. Mum has been in hospital for almost 7 weeks. She has a T12 fracture adding to her inoperable cancer. My sister and I visit her every day. This is a women who has spent her life watching over and caring for others. Here are my comments to add to Moyez’s – Mum has been moved 7 time within 3 health care facilities. Try that with a broken back and a tumour wrapped around your ribs. Regardless of whether the facilities are old, new, modern or antiquated – I cannot fathom the decisions made around cost cutting within of our heath care system. I walked in one day to find a toilet roll sitting on Mum’s bedside table. I asked why it was there. Apparently she had used her one box of tissues supplied per person per hospital stay so was provided with a ‘green seal’ toilet roll (think shiny one side, harsh the other). My heart cried for her. Is this not the direst of indignities! Needless to say we now supply everyone in her ward with tissues.

  2. Thanks Alex. It seems relatively straightforward to improve outcomes in healthcare in all sorts of little ways. However a million dollars will be invested in research this week, rather than buying a dollar box of tissues extra per patient. As a junior doctor I remember having to manually evacuate an old mans bowel while the patient in the next bed, only a flimsy curtain pull away was talking to his visitors. The man died only a couple of days later. Where was the dignity in what he experienced on his last days on this earth?

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