“Above all, do no harm,” is pretty much bullshit. Let me warn you.

You do not want to be a patient in a hospital. One, it means you’re sick enough to need to be in a hospital, which is pretty sick. Two, we’ll make you feel much worse until you feel much better. If you do get admitted, please just expect the following to happen. If you’re in a teaching hospital, with attendings and residents and medical students, more of this may happen. Be prepared in advance, so that you don’t get all crabby when I try to be happy-nice medical student and ask you some questions. (I realize you probably don’t mean to take it out on me, and that I’m always trying to put on my nice-happy face so that you won’t want to take it out on me, but you’re probably tired and frustrated and you’d take it out on Mother Teresa (may she rest in peace) if she were in my place, too.)

1. You will be poked and prodded, have your blood drawn–multiple times per day, from multiple arms and wrists.
2. You will tell your story to at least three people–not uncommonly 8 or more–and you will get annoyed, because we will ask you the exact same questions over and over again.
3. You will not get any sleep; people will constantly be bothering you with questions, physical exams, or lab draws.
4. You will be told lots of things, by lots of people, often things that use medical mumbo-jumbo. It will be confusing, probably–which test you’re getting, or what medicine you’re on. Many times people suck at explaining this stuff in normal terms, so please, please ask.
5. You may wet the bed, or defecate in your bed, and it may not be immediate that you get cleaned up.
6. You may be in a room with a noisy neighbor, or worse, a demented one that sits in a chair all day with her legs wide open and up in the air, making high-pitched shrieking noises all day.
7. You will probably smell, and when you do get washed up or get a sponge bath, it won’t be that fulfilling.
8. If you’re infected or contagious, people won’t want to touch you without gloves, and won’t enter a room with you without a mask. Necessary, but I’m sure isolating.
9. If someone decides you’re “an interesting case,” or you have something about your body that is different or rare or special, you may be made to feel like an object as a doctor teaches using you as an example.
10. Even if you’re not an interesting case, people may talk about your care with other team members like you’re not even there in the room, and many times, they will talk in medical code.

I’m not condoning this behavior or this system, but I’m saying often, it’s how it works. Many of the causes are medical–part of diagnosis or treatment–but others are political, legal, structural, academic, technologic and institutional in nature. We have a nursing shortage; we must teach future physicians; the law requires this; unions require that; paperwork must be done accordingly; technology is from the 1980s; there are limited resources available for health care. And on and on and on. If I could design the hospital system over again I would–and maybe I will when I’m older–but in 2006, this unfortunately may be your hospital experience.

Just more reason to stay healthy, eat well, exercise, and wash your hands, right?

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