Personal path is best medicine

The Boston Herald

Beverly Beckham

Her baby was 12 hours old. Her husband had gone home to get his parents. Her parents were in the cafeteria. She was with a teenage cousin when a stranger in street clothes - he never introduced himself, never said "Good afternoon, I'm Dr. So-and-So," walked into her hospital room and over to the bassinet and began inspecting the baby.

"What are you doing?" the new mother - my daughter - asked.

Without looking up, without waiting for the husband to come back because this isn't news anyone should hear alone, the man said, "Your baby is evincing signs of Trisomy 21," which is the term for Down syndrome. He then continued with his examination.

So much for bedside manner.

This happened last June at Beth Israel Deaconess Medical Center, a well-respected facility. The doctor who didn't introduce himself is head of neonatal care.

This doctor missed a heart defect, too. He couldn't hear it, though less than 24 hours later a small-town pediatrician with an ordinary stethoscope did. Also at Beth Israel, two nurses took nearly an hour trying to figure out how to do an electrocardiogram, a simple procedure we now know takes five minutes. But we didn't know then. So we watched and we bit our lips and we worried as they kept putting electrodes in the wrong places.

Then there was the matter of jaundice. The chief of neonatology missed this, too. Discharged from Beth Israel on a Sunday, 2 1-2-day-old Lucy was admitted to Norwood Hospital the next morning.

We question everything. We question our government, our clergy, our neighbors, our friends, even our waiters ("Are you sure this is decaf?"). But we walk into a doctor's office and we leave our good sense behind. They must be right, we think. They're the experts.

Health insurers are about to give us online ratings of hospitals so that patients will be able to search out the best-rated facility for each illness. But there's a lot more to heath care than data.

"You better hope your mother dies because if she lives she'll be a vegetable," a surgeon told me 32 years ago. And I believed him and wept instead of telling him that for a smart man he had limited vision and an equally limited vocabulary.

Once we took my mother to Massachusetts General Hospital. We waited months for the appointment. My father and I helped her dress. We put her in a wheelchair. Lifted her into the car. Then we sat and waited in a hospital corridor.

When the specialist finally saw her, he said she should lose weight. He said "she" even though "she" was right there. He never addressed her. And you know what? I thanked him.

My mother eventually got a doctor who saw her and not just her disabilities, Deborah O'Keefe, an internist at Carney Hospital. But I bet in the online rankings, Carney won't come close to Mass. General.

Doctors remain our last sacred cows. We become silent in their presence. And we make excuses for them. "He's rude, but." We become like children again.

A friend's father is critically ill and his oncologist is abrupt and bristly. My friend tries to placate him. "I need him on our side."

Shouldn't he be on their side? Shouldn't there be some kind of chart that measures the human component of health care?

Statistics may tell us that Beth Israel has the best treatment for brain cancer. But what about the staff? Do they introduce themselves? Do they talk TO a patient and not ABOUT a patient. Do they listen? Are they careful with their words?

These are questions consumers of health care need answered. Which hospitals and doctors and nurses treat patients the best?

Patients should be surveyed and these results put online too