I grew up in the days of our American pediatrician Benjamin Spock who was the first pediatrician who studied psychoanalysis to comprehend needs of children and family dynamics. He penned Baby and Child Care, a best-seller book. His concepts of child-rearing influenced generations of parents as it did for me raising 3 children without my mom advise. She died beforehand. Before that it was Our Bodies Ourselves an organization that has been active in the feminist health movement since 1969. They educated and advocated for health and reproductive justice for women, girls, and gender-expansive people. Striving to advance the rights of women, girls, and gender-expansive people to health and bodies ourselves. So yes they never talked about the realities of healthcare just answered questions. So I never really understood health care realistically. I was filled with crap for care for myself and others.

So when you call 911. They rush over with fire engines, ambulance and all flashing lights so the neighborhood knows you have an issue. The neighbors peep out of the curtain to see who is dying. EMTs come in run some vitals, determine which ED you are to go to, carry you out of the house. The ride is bumpy, loud, and fast. You get to the ED, a nurse triages you. You are definitely suppose to there but you wait hours for a doctor to tell you what the nurse already knew but now she/he orders the services you require.

I started my career in healthcare quite by accident. I worked at middlesex community hospital in the social services department. without experience or degree. My most influential patient was Charlie, he was an alcoholic, homeless, veteran, dad. I was trying to fix his situation (cause you got to fix people right?) and I spent tons of energy trying. I got him housing and contacted his long lost daughter. I ran to the unit as soon as I got into work on a Wednesday. I found out he jumped out a window on the unlocked unit and died. My heart was broken. So I quit and went to corporate america where people made money. No emotions ever involved. But I did miss giving myself to the passion of people who were doing good work making others lives tolerable.

I couldn’t stay away so I went to work for a nursing home chain. Looking for some balance. Nope lost on me. So with a few bucks in my pocket I went to California, I took a leave of absence and left Massachusetts. I later found a job at a psych hospital. They serviced a ton of entitled movie stars. But still went broke. I was the one who had to tell over 350 staff the hospital was closing. Because the CEO already left and I was his number 2 he was obviously smarter than I. It was a full staff meeting over lunch. Nothing fancy but still lunch? This was the beginning of my executive career in healthcare. I thrived on adrenaline and hope, so it was still my passion. That day I activated my professional shield thou. It would protect me from emotionally charged decisions. So I counted heads on the pillow, occupancy rates, and tried to keep the “mission” in sight but every day it got harder and harder.

At this point I need to tell you that my time with Charlie was always on my mind, it was a feeling I lived with and felt a failure at. I tried to keep in mind the mantra of Charlie when making decisions. I think it was only apparent to me:

Charlie would chant his mantra:: God grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference.

I was a healthcare executive for my whole adult life and we used to put surveillance cameras in the ED we used it mostly for training. But the things we heard and saw were embarrassing to staff and me. I made tough decisions about staffing ratios in accordance to acuity, equipment needs, and so on. It was always my assumption that staff worked at their highest level of training. Boy was I wrong. Here were nurses, bringing me to MRIs, taking admission information like a pro, emptying bed pans…freakin doing the job of aides/orderlies. Doctors waiting in the wings and occasionally jumping in, asking to squeeze his hand, what day is it, smile, my kids were there by now making decisions about tubes, drugs, while the nurses changing my flimsy johnny gowns often, the scratchy sheets, Horrible pillows, blankets without offering warmth and the kids looking away. But I was the lucky one. My son dealt with all the financial stuff my middle daughter took care of moving my leg or arm which was all twisted up snd clubbed. and my youngest in nursing school judged and took care of the medical/medication issues. The kids gave me comfort that they could take a part in this rather than just be horrified by the whole ordeal. In the past I got sick once a year with a cold. Those few sick days were my crash days. A day I would spend in bed and just collapse under the weight of my need for rest. So I had never been sick that the kids knew of. I had cancer once but they were never told. It was just another day at work for them for those days of doctors appointments and treatments. I didn’t actually think of my judgement calls from the corner office until I experienced rehab hospital 2 weeks after being discharged. In extremely humiliating positions I realized that my assumptions were so wrong. Supplies were low, blankets were flimsy, food was horrible (I ate a lot of jello), staffing was so wrong and training needed so much work. If you take someone to the bathroom it’s not a good idea to leave her there for 30 minutes. If they have left neglect don’t think it’s a good idea to put the call bell on my left. Just sayin. I was moved from ICU to rehab directly via ambulance. Where I really never knew what my reality was as they put the TV on my left, deserts on my left, a picture on my walker saying where is your hand? Wtf what were they doing. I have left neglect so my brain does not acknowledge my left side of my body. From temple to toe I am dead. My eyesight is 20/20 but I see nothing from my left eye, my hearing is fine but I can’t hear out of my left ear, but why with hours of therapist time did they never explain what was wrong with me. They gave me injections in my stomach of what I don’t know. It was exhausting.

I always relied on nurse managers to prepare the budgets in draft, then we cut them until their faces were red with frustration. Expecting them to fight for their success but medical staff don’t think that way. They are too worried about loosing staff and don’t fight. They also don’t ever see room for improvement vs throwing money at problems.

Recently the news discussed Tenant’s Union negotiations with the nurses Union in Worchester. I sat at that table on many occasions. In Ny, NJ, CA, etc. I want to say this on behalf of administrative support. I would listen to the arguing back and forth on the issues that nurses felt very passionate about. But what they did not know is that there were numerous calls before and after these tabled conversations in which the Union laid out there agendas which was not always aligned with the nurses issues. There were many calm conversations most of which supported the Union financially not the nurses. It’s important to keep the communication with administrative staff close and not always trust the middleman.

I need to say something thou. Healthcare workers always complain that their work is not complemented enough by management. So I just want to remind people that there is never actually never any recognition for management for the stuff they do every day and night. Many sleepless nights for all healthcare employees and patients. Trying to make things happen without a dime in their pocket. Grants, employee satisfaction and turn over, Bad Debt, equipment, insurance, public relations, DPH, laws, changes in environment, etc.

Today I would be a better hospital executive but when I went back to work my boss told me “ I was not the person they hired”. Department heads were sent to me to say NO by the CEO who had no balls. But post stroke I would say sit let’s figure out how we can make this work. I was actually fired for the first time in my life. Go figure.

These days I walk thru hospitals and clinics often. I always pick up things off the floor, talk to providers, and all staff asking the questions that I should of asked when I had control over their environments. I am too late and too soft these days to help but I do understand better.

It is a shame that my experience as a patient is not valued by the system today I really have grown to be the administrator I should of been and was early in my career.