Hospitals Are Terrible

by Belle Waring on February 23, 2017

Being in a multi-bed room overnight, or being in the OR, or even sometimes when the chemotherapy room is crowded over-full and they are putting people in cheap plastic chairs before hooking them up to clear bags of poison–this is the worst. And the worst thing about being in the hospital overnight is that you can’t sleep. I understand intellectually that your doctors need to know what your blood pressure is. I mean, sort of. What if you don’t have any heart problems? Why always with the blood pressure? But between your IV bag running out and beeping and the irrational fear that air bubbles will get inside you and kill you, and the checking of the temperature and blood pressure every four hours, and the breakfast you actively don’t want being slammed down at 6:30, and the cleaning staff, well, you don’t sleep. No knitting up the raveled sleeve of care for you! And this is true even in a private room! This article in the NYT explores a very obvious point, namely that multi-bed wards are a terrible idea all the time. I felt vindicated to read that the decrease in hospital-borne infections outweighs the cost of constructing a hospital with individual rooms.

As a doctor, I’m struck daily by how much better hospitals could be designed. Hospitals are among the most expensive facilities to build, with complex infrastructures, technologies, regulations and safety codes. But evidence suggests we’ve been building them all wrong — and that the deficiencies aren’t simply unaesthetic or inconvenient. All those design flaws may be killing us.

It’s no secret that hospital-acquired infections are an enormous contributor to illness and death, affecting up to 30 percent of intensive care unit patients. But housing patients together very likely exacerbates the problem. Research suggests that private rooms can reduce the risk of both airborne infections and those transmitted by touching contaminated surfaces. One study reported that transitioning from shared to private rooms decreased bacterial infections by half and reduced how long patients were hospitalized by 10 percent. Other work suggests that the increased cost of single-occupancy rooms is more than offset by the money saved because of fewer infections. Installing easier-to-clean surfaces, well-positioned sinks and high-quality air filters can further reduce infection rates.

The whole thing is worth a read. Perhaps unsurprisingly, having a window out of which you can look at trees or nature has a huge impact on recovery time. I personally have always wanted to get the Magic Mountain treatment in which I am bundled in specially folded blankets and put out on a lounger to enjoy a view of the Alps.

The author doesn’t discuss bad fluorescents, though the commenters do. New compact bulbs can mimic the warmer light of incandesents reasonably well now, and that is another terrible hospital thing that could be fixed. I feel I should note two things here. One, the staff at hospitals is almost uniformly composed of kind helpful people who are working very hard. Nurses are great. The sub-nurses who are supposed to be just emptying bedpans or whatever are delightful. But let’s be honest: the actual doctors are the least friendly. Sorry actual doctors. I know you are busy. (But so are the ladies emptying the bedpans, probably?) Two, I am not in the hospital or accompanying anyone to same at the moment and this is just a general complaint so don’t worry about me; more importantly my migraine treatment worked. Since I made it to the first week (at which the Botox takes full effect) I have used my migraine meds only once. John was disappointed that I can have a headache at all but he doesn’t know that not having a real migraine every day after having had that happen for months oh God is a fairy wonderland (I don’t know why I’m not being more sparkly and cheerful all the time; I’m sorry, beloved family. I have terrible jet lag still). I asked my neurologist if there were any side effects and he said, “you’ll be running back here every twelve weeks begging me to do it again, but other than that, no.” OMG Dr. Fineman you are right. Thanks for the Tinkerbell-clapping, everyone! Now tell me of your experiences with flimsy curtains separating you from people with dementia shouting all night. The airing of grievances can be therapeutic; anyway it’s better than reading articles about politics amirite?

Bastiat anticipates climate science denialism

by John Quiggin on February 23, 2017

I’m working on the environmental policy chapter of my book-in-progress, Economics in Two Lessons, which is a reply to Hazlitt’s Economics in One Lesson, which in turn is a repackaging of Bastiat’s What Is Seen and What Is Not Seen. Hazlitt was aware of the difficulties posed for laissez-faire by pollution, and chose to avoid the issue. But, on Googling Bastiat + pollution, I came across a remarkable package in which Bastiat anticipates the climate change debate and takes the denialist side in advancee.

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