Well, it’s been awhile, as they say. I’ve been away from the internet since March; although I do really wonder if we can ever fully get away. It wasn’t a happy vacation, mind you. The pandemic continues to loom large in my mind, and even though cases of covid19 have slowed (and nearly stopped) in my ICU doesn’t mean it hasn’t been busy. There is just as much normal heartbreak, death and disease to be found at my hospital as ever–if not more. And my colleagues are getting restless, wanting life to return to normal and travel the world again; they’re getting burnt out and in desperate need of whatever they call rest. The hospital is tallying it’s “losses” from last year and trying to squeeze the staffing and supplies to make up some deficit.
It has been a long few months of near hopelessness. What can be changed to make things better? What will normal look like? What is even the point?
But I’m back to try again, to think about this messy world I inhabit–on the edge of life and death, between the sick and the living. To make meaning out of this whole thing, healthcare, the pandemic, life, health, humanity. I’ll start again today in earnest.
I have gone back over a few “drafts” I’d saved while in hibernation and published them. I can’t claim quality. But, it is what it is. I’m sure I’ll be in this position again, so forgive me. And join me. Below are some links I’ve accumulated in the past week, and I knew that the urgency I felt when saving these links meant I was ready to start writing again…
Homelessness & Mental Illness Make a Deadly Combination
At about 8:20 a.m., 94-year-old Leo Hainzl, took what would be his last walk with his dog, Rip, to Glen Canyon. He crossed paths with a man who’d slept on the streets of the neighborhood for years and had often menaced passersby through a fog of mental illness. Police said Peter Rocha, now 54, attacked Hainzl with a stick, causing him to fall, hit his head and die within hours at a hospital.
Read more at SF Chronicle: “San Francisco’s Mental Healthcare System Fails Two Men”
Another instance when a homeless person, Rocha, who lived in Glen Canyon for reportedly more than a dozen years cannot be helped by police–because he can simply refuse medical care. And so he was left on the streets, where his mental illness deteriorated and left untreated led to the psychosis that caused him to kill someone. A very sad case.
Homelessness is a public health problem. Mental illness is a public health problem. If we don’t find systematic ways to treat these problems, we will never help the people suffering from these conditions.
Crisis Response Teams in SF: Are They Helping?
The crisis teams were created as part of Mental Health SF, a major initiative to reform the city’s care system, which is often understaffed and overwhelmed. But Mental Health SF has struggled to get off the ground during the pandemic.
Supervisor Hillary Ronen, one of the architects of Mental Health SF, said the crisis response teams look like “a promising program.” But to be successful, she said, the city must increase its long-term care options, from case managers to residential treatment programs.
According to city data, 9% of the street crisis teams’ encounters have ended in a 5150, an involuntary mental health hold for those who are a danger to themselves or others. Meanwhile, 18% were transported to a hospital and 18% to a program such as residential care or drug treatment.
The majority of the crises are resolved on scene, which means the person is left where found. But it is unclear what happens to people after the team leaves.
Read more at “S.F. finally has a new mental health team to respond to homeless people in distress. Is it helping?” on SF Chronicle
A Series of Mistakes That Should Never Be Made
Jeannette Shields, 70, broke her hip while she was at the Cumberland Infirmary in Carlisle, North West England, where she was being treated for gall stones, BBC News reported. While she was in the hospital she buzzed for help to go to the restroom, but went by herself when she got no answer, and she fell and broke her hip after she got dizzy, her husband, John Shields, told the broadcaster.
She then had surgery to fix her broken hip, and the hospital told her husband that the procedure had gone to plan but “unfortunately they dropped her off the operating [table] after the surgery.”
John Shields, 78, said: “She had a great big bump on the back of her head and she just deteriorated and then she just passed away, just died… I’m really shocked.”
Read more at Newsweek, “Woman Dies After Being ‘Dropped’ on Floor Following Surgery”
Is Medical Culture the Problem?
A plastic surgeon wants to go back to basics, the very culture that is built into medicine during training, to address our healthcare system’s problems:
“Many factors contribute to our nation’s soaring medical costs, flagging clinical quality and the rising dissatisfaction of both doctors and patients. The one problem we continually overlook with tragic consequences is the flawed culture of medicine.”
–Read more “Op-Ed: How doctor culture sinks U.S. healthcare” at LA Times