‘‘Screw-ups’’ 87
tions supposed to promote health may thus themselves induce risk. Nancy
and others saw these aspects of patienthood as in fact declining further.
The physical part of being a patient is going to get worse. The
dietary people said they used to have the food made upstate, and
even that is now too expensive. So they are just going to buy
prepackaged frozen dinners!
Other hospital employees may disappoint, too—not being available,
for example, to hook up the telephone or television at night when pa-
tients get admitted. The deficiencies Nancy saw included:
. . . having a phone, a TV, or any comforts, or things to do. There’s a
library: one lady, a volunteer, walks around with magazines and
candy. That’s it. Some transporters are unprofessional.
Nancy also complained, ‘‘There are no fresh flowers.’’ As a result, she
now routinely bought bouquets for the clinic she ran. Policymakers may
consider these concerns to be secondary to medical care, but the physi-
cians here argued otherwise. Aesthetics played far more of a role than
these doctors had anticipated, due to the symbolic meanings involved.
Frustration about the poor quality of the physical plant and of amenities
reinforced senses of helplessness and dependency.
Bureaucratic inefficiencies compounded these shortcomings in the
physical plant. Many of these doctors cited unwieldy management and
personnel structures. Difficulties began at the outset, during procedures
for admitting patients to the hospital. Nancy continued, ‘‘The method of
getting people into the hospital is barbaric—waiting for a bed in the ER for
hours.’’
These problems were so pervasive and deeply ingrained that not even
being a physician wholly eradicated them. Despite the fact that both
Walter and his wife had trained at the hospital, staff proved unrespon-
sive.
The surgeon arranged for me to be admitted directly—not through
the ER. But the admitting department couldn’t find any docu-
mentation. So, with intense pain and vomiting, I waited two hours
in the admitting office. My doctor did what he was supposed to,
and it didn’t make the mechanism of the hospital function.
Only Walter’s ability to ‘‘pull strings’’ helped. He ended up having a friend
run into the OR and grab a surgeon, who said his beeper wasn’t working.