Books on Health: Surviving the Healing

February 17, 2004

"The sooner patients can be removed from the depressing
influence of general hospital life," Dr. Charles Mayo
observed in 1916, "the more rapid their convalescence."

Indeed, hospitals are essential, but too often they are
bastions of bureaucracy, neglect and sometimes outright
ineptitude. One often cited statistic from a 1999 Harvard
study puts the hazards of a hospital stay in chilling
perspective: hospitals kill nearly 100,000 people a year
because of human error, faulty techniques, malfunctioning
equipment, wanton carelessness, oversights or assaults.

"Many more leave the hospital worse off than when they went
in," writes Mr. Sharon in his book, one of these three that
outlines the pitfalls of a hospital stay and how to make
the best of it.

Mr. Sharon, a registered nurse and legal consultant, offers
what he calls "insider tips for avoiding hospital
mistakes," information that includes ways to prevent
mishaps in intensive care units, play the "emergency room
waiting game," communicate with staff to get better service
and deal with managed care when you're told that "your
request for treatment has been denied."

Much of his advice depends on the patient's asking
questions and being observant and insistent. In the I.C.U.,
for example, he advises asking the nurse what each wire and
tube is for, checking for swelling and redness from the
insertion of intravenous lines, and seeing to it that, in
the case of a transfusion, the nurse matches the serial
numbers and the blood type between the transfusion ticket
and the label on the blood product unit - in the presence
of a second nurse.

"Pay attention to how many patients your nurse is assigned
to," he writes. "If there are three or more, lodge a
complaint with the health administration and follow up with
the health department if you do not get a satisfactory

Dr. Sherer is an anesthesiologist, and a chapter in his
book addresses what to expect and ask for in his specialty.


The team should know, for example, if you use more than one
pillow at night (people who need to be propped up may
experience breathing difficulties because of "the
unfamiliar distribution of weight on your diaphragm");
where major dental work has been done to avoid damage to
crowns and implants; and whether you are right- or
left-handed so an IV can be placed in the opposite arm to
allow you to write, eat and drink more easily.

Dr. Sherer also suggests avoiding elective surgery in July
because of "the July syndrome." Then, those doctors who
have finished training are replaced by "fresh faces." If
you find yourself in a hospital in July, he writes, "and
see a young person hovering over you nervously with a
needle, you are hereby warned that you, too, could be in
for the pincushion treatment."

Dr. Sacco, a medical director at Bronx-Lebanon Hospital
Center in New York, offers a comprehensive analysis of a
hospital's workings and of ways to deal with the ones that
affect patient care. He also provides a detailed primer on
diseases; qualifications of various professionals; and
information on tests, medicines and equipment from Foley
catheters to nasogastric tubes; and end-of-life care.

He advises patients to ask doctors on rounds to wake them
so questions can be asked, and to question if they really
need an IV instead of antibiotics or other medications by
mouth, or a transfusion. As to whether someone needs to be
in a hospital, Dr. Sacco says patients have a variety of
choices. "More and more," he writes, "conditions once felt
to require in-hospital care are now being managed at home
or in subacute settings such as nursing homes or rehab
centers." Doctors admit people for many reasons, he says,
"not all of which have to do with the need to be in the