Joe was becoming more tired. Doing a little yard work would require an afternoon nap. It’s ok he thought, after all, he is getting up there. One day trying to pull a heavy bag of mulch, he developed a little pressure in his chest that went away quickly. He though he felt the same thing the next week carrying a box to the attack. Tuesday was much different because it woke him from his sleep. He was a little nauseated and sweaty. His wife called 911 and he was taken to the ER. They started a STEMI protocol and he was rushed to the catheterization laboratory for a stent. Now Joe is back in his room with his wife. They are waiting to hear what is going on. The Nurse Practitioner said he received a stent and could go home tomorrow good as new. But wait. How did that all happen and why?
Joe was already on a blood pressure medication and cholesterol medication. He was trying to loose a little weight. He was active around the house. The nurse said his numbers were good on the last blood work. Joe was receiving optimal care according to the guidelines from the American College of Physicians and the American College of Cardiology. Is that good enough? What is Joe’s prognosis? Good as new he was told. The chart said he should exercise and eat a heart healthy diet. He was instructed with those words.
Joe saw a physician briefly after the catheterization but he was pretty groggy and just remembers things are ok. His wife was told he received a stent and would need more medications. He was scheduled a follow up appointment and the prescriptions were emailed to his pharmacy.
Who knows Joe? Who knows his story? What does Joe do around the house, and can he go back to doing it ? Should he be doing more? What is good to eat? Does it matter? He is on medication. Do they go ok with his other medications?
Joes was treated in a system of what is assumed to be timely protocols. The hospital is happy because they met the door to cath lab time to get the stent delivered and discharge within the time period that is financially satisfactory for the insurance reimbursement. Electronic medical records make recording all the necessary procedures a snap with blurbs ready to cut and paste into the chart.
What did Joe learn about his condition? Is there anything he could do to change his future? How would one know? It is easier for Joe to assume it was his genes that his condition just happened out of the blue. It is easier just to fix his anatomy for the doctors and hospitals and move on to the next crisis. Is that ok? Maybe to some or many in fact. But not to me.
The status or the health of our bodies is directly related to our quality of life and longevity. But we are not robots. We are humans that flourish and thrive by interacting with others in a meaningful way. Our mental health and physical health are directly related. Being unwell leaves us particularly vulnerable. Taking time to sit and discuss the events leading to the health crisis, learning about the patients lifestyle is of utmost importance to adequate health improvement. People are unique with different wants, needs and desires. We are all deserve the time to convey these things, and we all deserve to have our questions answered and our disease process explained. Joe is at a crossroad. He can continue to be part of the factory of medicine and ride the conveyor belt of therapies. Or, he can choose to be educated and involved with people that actually care about his future. This cannot be done in the setting of corporate medicine. You get to choose.