Dad
The emergency was a broken pelvis. That's what the chart
said, and that's what we braced for — my father, at the end of his eighties,
lying in a hospital bed while we learned words like conservative management
and recalibrated what recovery means at his age.
But the pelvis was never the war. The war was his heels.
Somewhere in that hospitalization, while he lay where he was
placed, pressure sores opened on the backs of both heels. I've done the honest
math on this many times. His circulation was poor; prevention was genuinely
hard; I can't exactly call it negligence and I won't. But I can say this: the
injury that nearly took his legs didn't happen to him. It happened around
him, inside the system that was caring for him, while everyone did what the
system does.
When the sores got infected, my sister sat with him in a
big-city emergency room for ten hours. Ten hours, at eighty-nine, his wounds
left uncovered, in a hallway on an IV drip of anti-biotics, my sister standing
next to him the whole time, to catch anything that needed to be heard, my dad
can’t hear well. At the end of the waiting, the options were presented like a
menu with two items: amputate both legs, or go home. My Dad said hell with that
and went home.
After all the confusion of whether he had an infection or
not, we realized the only way he would get immediate care for his wounds was at
a hospital. But we weren’t going back to
that ER, no way. I took him to a smaller
town's ER trying to engineer a direct transfer to a hospital bed — anywhere —
so that he would never have to sit in that first waiting room again. That's
what the hoops actually are. Not paperwork. Not inconvenience. The hoops are a
family hand-building a parallel healthcare system out of daughters, because the
official one offered a saw or a door. We wanted actual tests and second
opinions.
They did the tests, and still made the same determination. My
dad, more informed now, chose home.
Home meant six weeks of IV antibiotics and a dressing change
every single day, and it meant that the actual apparatus of his care became us.
Daughters with gauze and gloves. A visiting wound nurse practitioner who
rescheduled three times and disappeared for weeks on leave while the infection
was still live. A sister running scheduling and phones like a dispatcher. When
he started hallucinating, it was family, watching closely, who connected it to
one of the antibiotics building up in his aging kidneys — a hunch the doctors
later confirmed, and the drug was changed.
Here is the part I keep turning over. My father has the
health insurance of a retired teacher. It followed him through six years of
vascular disease, through procedures and wounds and this whole long siege, and
it held. It is a kind of coverage many of my generation can see but not touch —
a fossil from an era when a working life earned you a floor to stand on.
Me? After being dropped from coverage, after running the
marketplace math and finding it simply didn't work, an envelope arrived
approving us for a program nobody had mentioned when we were dropped — a
deductible that resets every month, coverage that only wakes up in catastrophe.
And my honest reaction, the one I'm almost ashamed of, was relief. Not relief
that I'm cared for. Relief that ruin is capped. That if something happens, I
won't go bankrupt. That is where the bar is now: we are grateful when the worst
is merely survivable.
In both generations the care exists. It just isn't
offered. It has to be excavated — by the sharp-eyed, by the stubborn, by
families with enough hands and enough stamina to keep digging while the person
they love lies waiting.
He's off the IV now, but still on antibiotics. The wounds
aren't leaking; the professionals are doing the dressings again; my hands get a
rest. He is, for now, steady. I don't mistake for now for a destination
— I've learned the difference between the map and the territory the hard way
this year. But steady is real. We fought for steady. We followed him through,
and almost three months now we're still following. I am so grateful for my
sisters, and can’t even imagine how exhausted a singular caregiver could be. Or just the patient alone, is unimaginable.
That's the whole story, really. Not a policy argument,
though you may hear one anyway. Just this: a man's heels, a ten-hour wait, a
two-item menu, and a family that declined to order.