Advocacy 101

​My daughter, Sarah, is ashen with pain. Her CT scan shows a large kidney stone.
 
In the ER’s waiting room, we sit and wait. They’ve given her something to dull the pain.
 
My paramedic son has a photo from his Wilderness Medicine course – a teenager sits on a lawn, blood on her face. Some of his students portray hurt patients, smeared with fake blood, for others to assess and treat.
 
I wonder if, bloody, we wouldn’t wait so long. I must sense that Sarah will be all right – my humor wouldn’t kick in if I were afraid. Later, a nurse says that chest pains and being unable to breathe are the only fast tracks into the ER. That’s fair.
 
At last, they bring Sarah into the ER, put her in a bed, and hook her up to monitors. I stay with her. Things can go wrong fast.
 
I ask for an extra blanket to keep her warm; make a cushion of our jackets to better position the IV in her arm; find a nurse to bring a pillow. When Sarah’s monitor beeps, I see that the green numbers show that her blood pressure is way low. I find a nurse. He says lying on her side may have queered the reading, moves Sarah to her back, and rechecks her blood pressure. It is fine.
 
The hospital is full – we must wait for a bed before Sarah can have the “procedure,” having a stent placed into her ureter. Lithotripsy will break her kidney stone into tiny bits that can pass out of Sarah’s body, but they won’t do lithotripsy until they treat her infection.  Meanwhile, a stent, “a tubular support … to relieve … an obstruction,” will let her kidney do its job.
 
I check at the nurses’ station every half hour, making sure they haven’t forgotten Sarah.
 
I leave to go to the bathroom. Of course, that’s when the technician arrives to transport Sarah from the ER to her hospital room. He disconnects Sarah’s BP, heartbeat, and oxygen monitors, and hooks her IV bag to a mobile pole. I jog behind the gurney.
 
Sarah isn’t allowed to eat before the general anesthesia they will give her for the procedure. She is hungry and uncomfortable, but not in great pain. In a curtained pre-op cubicle, a nurse quizzes Sarah – name, date of birth, weight, do you smoke, drink, do drugs, have metal in your body, any chronic conditions, what is your medical issue, your level of pain, any previous surgeries and medical procedures, any reactions to anesthesia) – all questions other nurses have already asked her.
 
The anesthesiologist comes and asks the same questions. When I remind her of a long ago procedure she forgot, Sarah tells the anesthesiologist, but the anesthesiologist pays no attention. Sarah tells her again, and again the doctor gives no sign of hearing. I repeat Sarah’s information, louder. No response. Sarah asks the anesthesiologist if she has heard us. The doctor looks up, annoyed, but finally notes the information on her checklist.
 
The urologist, Dr. Anderson, comes into Sarah’s cubicle. He explains about placing the stent, and says he’ll let me know when she is in Recovery. They wheel Sarah off.
 
I've been at the hospital all day, and it's dark out. In the waiting room, I buy a bag of popcorn from the vending machine. I see an urn of coffee and a water dispenser, both free, but no cups. I pace and wait.
 
Dr. Anderson comes in. Everything went well. Sarah is in Recovery.

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​Six days later, I take Sarah to the hospital in the early morning dark. I stay with her until they wheel her away to the operating room.

​Sooner than I expect, Dr. Anderson comes to the waiting room. The kidney stone has been broken into tiny pieces. Now they can easily pass out of Sarah’s body.
 
We are home by noon.

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Sometimes, nothing going wrong means a job well done.