The woman in Room 612 says she’s a witch. The things she stares at only she can see. She swears full voice. Throws whatever’s handy (blood pressure cuff, pillow, urine jug) at the nurses.
When security arrives, she swears some more, takes her meds and goes to sleep.
I met the witch during a brief stay at Tacoma General Hospital about a month and a half ago. I had excellent care. In a way that’s surprising. Hospitals are rough.
Around 11 o’clock my first night, a nurse — not an aide — wheeled me to testing. (Aides are scarce, apparently.) We moved fast because after 16 hours on shift, the nurse was due back at 8 a.m.
I like fast wheelchairs as much as the next guy, but fatigued nurses worry me a little.
My roommate was a man in his 80s, sharp enough to pivot among several conversations.
He explained to staff why he refused to eat (it hurt too much to digest the food). He told his wife how to sort recycling from trash (food always goes in the trash). And he deflected her more challenging questions (“Why don’t you want to live?”).
To secure daycare for her youngest, my day nurse wakes at 4:30 a.m. to get a spot in line. The daycare only takes 25 kids. Sometimes she wins a spot. If not, it’s off to her mother-in-law.
After work the nurse makes dinner and crams her older kid’s schoolwork so she can tutor until bedtime.
This is a good hospital. Clean. Sophisticated. Well-funded. The staff is excellent: continually learning, uniformly good-natured.
But based on my 36 hours inside, our healthcare system is in trouble.
The hospital is short-staffed through a combination of voluntary furloughs, unfilled vacancies and a surge in trauma patients. Area hospitals take turns handling the worst possible injuries, sending specialists and families all over Pierce County.
The variety of patient needs is staggering, from the witch in 612 – likely back on the street once she calms down – to my roommate, who toggles between tearful resignation and screams of pain.
At some point I expect my nurse will decide life’s too short. Or forget somebody’s meds. Or fall asleep at the wheel driving home.
At some point I expect a patient will go over the edge and do something bad. Worse than casting a spell. Something really bad.
It feels like we’re trashing what’s been an excellent system. Flawed? Sure, in so many ways: access for the poor; huge gaps between line staff pay and executive compensation; rising insurance premiums.
But the system I’ve counted on most of my life (yes, me, middle class white guy; I know), the place my babies were born, my elders treated? It’s been excellent. And it may not last much longer.
This is not a COVID problem. It’s structural. A highly specialized healthcare system is flooded with generalized problems like witches and old men who want to die.
Expensive diseases can be prevented but we don’t fund prevention. Boomers live longer and consume a disproportionate share of healthcare dollars. Machines are valued more than the people who run them.
Public policy and private investment veer away from each other or crash at high speed.
One way to achieve change is to heighten the contradictions, to allow conditions to become so bad they’re no longer tolerable. That’s a painful path.
Another is to bandage the worst problems until help arrives. That’s hardly strategic.
Surely public and private leaders can find a better way. The pressure’s building. And the woman in 612? She’s looking up spells.
Ken Miller is a longtime Tacoma resident and a former TNT reader columnist. Reach him at firstname.lastname@example.org