Sunday, November 11, 2018

Sunday Long Read: Physicians, Heal Thyself

This week's Sunday Long Read comes to us from Peter DeMarco of the Boston Globe, who recounts the story of the death of his wife Laura two years ago, who drove herself to the hospital as she suffered an asthma attack, and died in a Massachusetts hospital emergency room waiting for somebody, anybody, to help her.

Some 10 minutes passed between the time Laura called 911 and the time she was found, in cardiac arrest following a devastating asthma attack. Those 10 minutes meant her life.

We didn’t know at first how many of those minutes she’d gone without oxygen to her brain, so for most of the seven days Laura spent in the intensive care unit at CHA Cambridge Hospital, where she was transferred, there was a glimmer of hope. If Laura had been conscious after making the 911 call for even three or four minutes, she had a chance to pull through.

Her doctors told us we could only wait, because her brain was swelled, preventing a clear CT scan. Each day, they would lift her eyelids and shine a light straight into her pupils, looking for movement. There was a small flicker early on, but little more.

Laura Levis, the love of my life, my wife, died September 22, 2016. She was 34. Her death certificate says she died the day before, of hypoxic brain injury, but that was just when Dr. Duncan Kuhn brought Laura’s father, my father, and me into a private waiting room in the intensive care unit. In a gesture of humility, Kuhn sat on the floor, looking up at us as he told us Laura wasn’t coming back.

Laura was still on a respirator, still breathing, her hands and body still warm, her hair still soft. Her organ donor surgery couldn’t be scheduled until the next day, which is the day I consider to be her last on this earth. She died minutes after I let go of her hand in the third-floor hallway of that hospital, after a team of doctors wheeled her through a set of double doors into an operating room, cutting into her beautiful body so that others could have life and sight from her gifts, including her heart.

This part of our story, I have shared before. I wrote a letter thanking the doctors and nurses who tried to save Laura’s life that The New York Times decided to publish. “Every single one of you,” I wrote to the medical staff, “treated Laura with such professionalism, and kindness, and dignity as she lay unconscious.” The letter was featured on NBC Nightly News,shared across Facebook, and republished on websites across the world. Less than three weeks after Laura’s death, millions were touched by her life.

But that was not the whole story. Far from it.

As any husband would, I blamed myself for not being with her when the attack struck, for not being able to help my wife in that moment. I asked God, Why? Why? Why?

I knew that one day I would have to find the spot where she collapsed. That I would lie down on that spot, to be with her spirit, to comfort her because she must have been so, so scared.

I have since learned where that spot is. But it did not turn out to be on a street leading to Somerville Hospital, or some obscure location.

Laura made it to the doorstep of the emergency room that day, on her own two feet, just as she said in her dying words. She stared through a plate-glass window into the emergency room waiting area — she could see the red-and-white emergency room sign inside — but she could not get in. To her dismay, the door was locked.

Her attack intensifying, she called 911, telling the operator she was right there but could not get in.

Help was just a few feet away, on the other side of that door.

But, incredibly, that help never came.

This is the story of how my wife’s life was wasted by the actions of people whose job it is to save lives. It is the story of how our entire emergency-response system can completely fail us, from the moment we dial 911 and the satellite GPS “ping” of the cellphone can get our location wrong by hundreds of feet. It is the story of how cracks and flaws not just at Somerville Hospital, but throughout our health care system — communication errors, overburdened staffs, lack of fail-safes — can snowball into someone’s unimaginable death.

And it is the story of how there will be no justice through our legal system for what happened to Laura, as public hospitals in Massachusetts, and throughout most of America, are largely protected by state laws against malpractice and negligence claims, leaving thousands who rely on such institutions little recourse when harmed or lied to.

Even when a 34-year-old woman is left to die outside an emergency room, destroying the lives of the people who loved her.

Everything that could have gone wrong, went wrong for Laura Lewis, and she died because of it.  If that sounds like a nightmare scenario for you, well, you're not alone.  It happens to thousands of people every year in this country, because emergency rooms are overloaded, because we make hospital ERs the primary care of tens of millions of Americans who literally can't get health care anywhere else.

Our health care system is broken, and one party wants it that way.

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