Think you understand the patient experience? Read this doc’s scary story of an ER trip

Charlotte Yeh was an emergency physician for eight years, but it was not until she was hit by a car that she experienced the emergency room from the patient side. She was in Washington DC for a business trip and got hit as she was crossing an intersection. It was dark and rainy, and I […]

Charlotte Yeh was an emergency physician for eight years, but it was not until she was hit by a car that she experienced the emergency room from the patient side. She was in Washington DC for a business trip and got hit as she was crossing an intersection.

It was dark and rainy, and I was about a third of the way across the intersection when I heard a loud thump and felt a sharp pain squarely in my backside. It took me a few moments to realize I’d been hit by a car. Before I could make sense of the situation, I had flown through the air and landed on the street.

She ended up spending four days in the hospital. Her injuries required rehab and she walks with a cane almost three years later. You can read the full account of her experience on HealthAffairs.org or a shorter version at The Washington Post.

Here are the scariest parts of her time in the hospital as well as her redeeming experience in rehab.

The hallway felt safer than a private room.
There was no bed available when she got there, so she stayed in the hallway. She was later transferred to a room in the maternity ward, only to realize she wanted to be back in the hallway.

I took comfort in being left in the hallway. It meant that I was okay, that the hospital staff wasn’t so worried about me. As a patient, though, I felt alone. I was struck by the demeanor of some hospital staff who rushed by. It seemed as if they were deliberately avoiding eye contact with any of us poor souls waiting in the hallway, lest they be interrupted and asked for help.
[in the morning] … the staff learned that I was an emergency physician and moved me out of the hallway into a private room, assuming this is what I would want. The room was darkened so I could sleep, and the door was shut. Now, instead of feeling safe in the controlled chaos of the corridor, I felt abandoned, clutching my nurse call button, a lifeline to the world.

The staff tried to discharge her and she couldn’t even walk.
Later in the day, a trauma team decided Yeh could leave because she had been stable all night and no major injuries had turned up on the CT scans. She was still in pain and not sure if she could manage alone in a hotel room:

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“Nothing is broken; you can go home now,” said one of the team members. … The PT team attempted to stand me up, and I nearly crumpled to the floor. I couldn’t support my weight, let alone walk. They helped me back onto the stretcher and then left the room to brief the admitting team.

The resident returned. “There’s no medical reason to admit you,” he said, “but if you can’t walk, we’ll just have to.” The resident’s comment struck me as callous, as if addressing my basic need to function and recover after the accident had nothing to do with the care he and his colleagues were there to provide.

It took four days to get a complete examination.
Yeh’s knee and backside were hurting but no one had examined those parts of her body. She had to ask multiple times before her knee was examined. It wasn’t until she started to feel worse that she got a neurological exam.

“…nurses came in and out as I asked, over and over, it seemed, ‘Is anyone going to look at my knee?’ At the end of the day, an orthopedic consultant appeared.
That night, I began to experience numbness and tingling in my leg and my hip. Three times, doctors or nurses came through, and each time I explained my concerns but was not evaluated. It wasn’t until 24 hours later, during the night of my second day of hospitalization, that I had a neurological exam, which revealed contusion of both the sciatic and the gluteal nerves.

On my third day in the hospital, someone asked if the admitting trauma team had done a history and physical. It had not. They had not. A resident then performed a ‘tertiary’ exam—essentially, a repeat history and physical examination – although he and I both knew the prior exams had been incomplete. By my fourth day in the hospital, I was both medically and functionally stable, able to ambulate cautiously with assistance and a walker. I insisted on getting transferred to a rehabilitation facility near my home in Boston.

The care team in rehab got it right.
At the end of her experience, Yeh found the kind of personalized patient care she had expected in the rehab center:

I saw staff treating every patient with dignity and respect, and listening to what mattered to them. Each member of the rehabilitation team asked me what ‘my goal’ was. I told them it was to be able to go up and down the stairs in my house. No one ever asked me this during my acute hospitalization.

During my rehabilitation stay, I witnessed pure encouragement and compassion. Staff appreciated the patient’s current capacities, physical and emotional, and showed a sophisticated understanding of the gradations of care and recovery. Care becomes personal when dignity is established, regardless of the setting.

[Image from flickr user Leroy]