The Health Care Fortress

by Robert Schnell

(Disclaimer: The following post contains profanity, gallows humor, and graphic illustrations. No warm fuzzy today. Intensive Care Nursing is not a profession for the delicate and squeamish. Bedside professionalism always. Not the case in the break room or the local watering hole after work. You have been warned.)

How about the powerful, multi-billion dollar health care business? It is one of America’s money making sacred cows cloaked in altruism, sacrifice, respectability, knowledge, compassion, confidentiality, and concern. That is the message spread via high dollar advertising and propaganda anyway but remember Corporate Medicine squeezes maximum profit out of patient suffering, misfortune, injury, disease, medical travails and we can’t seem to get enough of it.

I was once informed by a career military relative that another relative had a rare and fatal disorder newly diagnosed. I read this via email after a particularly tough night in the ICU. My professional guard was down and replied emotionally via email admitting sadness and tears at this news. Three decades in the ICU I have seen the pain, suffering, and final end of many unfortunate patients. The rare disorder identified is particularly lethal and a painful way to go. My military relative replied, “Some people pray … some people send positive thoughts. That is what I ask for, either prayer or positive thoughts … whatever people are comfortable with. Empathy is okay … for a short time, sustained for too long becomes sympathetic and that presents as weakness. We cannot afford or allow that chink in our armor…. there is no room for tears right now.”

The relative survived this event and lived many years longer until ultimately deciding to become noncompliant with prescribed medications and therapeutic regimen. It is questionable if the original diagnosis I was told was actually the case. When I can’t assess a patient I have to rely on others with lesser expertise.

Many lessons learned here. 1) Don’t listen to lay person 2000 miles away. 2)Talk to medical staff directly. We speak the same language. 3) When talking to military people weaponize empathy, and compassion. Talk their language but also understand they are under stress, hurting and doing their best to “keep their shit together”. You can even say “keep your shit together” to them. They eat that macho facade up! OOOH-RAH!

For years I searched for the right words to describe what I do in the ICU. After that email the words came to me. My search was over.

(For 38 years I towed the corporate line but never weaponized health care like some nurse administrators, who left the bedside, did. It was nice to retire and take off the armor worn to fight those administrators so proper care could be provided. And to all you nonmedical people out there, when you tell a senior veteran ICU nurse a lethal diagnosis, chances are good we have seen and dealt with it. Automatically a mental nightmare is visualized and if our core has not turned to stone it still evokes strong emotion and that is never a weakness. It is our strength and guides the care given. You would want nothing less.)

By the end of my career we were getting so many “Article 15s” they became the rule instead of the exception.

Published by undergroundcartoonist

Underground Cartoonist is a former ICU nurse that has worked at numerous civilian, military, and veteran Intensive Care Units across the country for better than three decades but has been sketching, drawing, and cartooning since he first picked up a crayon in kindergarten. Dabbled with political cartooning, writing, and general illustrations but the bread and butter came from health care. Recently left professional nursing to concentrate on camping, hiking, nature, the outdoors, trees, trails, and peace of mind. Love a campfire; rather watch it than TV. Avoid bureaucracy, career ladders, ladder climbers, and hero worship at all cost. Evenings spent with a good book, reading until the book smacks my nose when I doze off. Generally up at sun rise, listen to the mourning doves, put the coffee on, and play it by ear the rest of the day.

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