A huge blister appeared on the back of my dad's left heel the day after I brought him home from his recent hospital stay.
It popped the same day and became a nasty oozing wound that grew bigger overnight. I took him to an urgent care clinic, and the doctor peered at it from afar and prescribed some antibiotic cream. He had the nurse dress it and sent us on our way.
The next day, we had an appointment with Dad's primary care doctor as a follow-up to being released from the hospital.
Again, this doctor glanced at the wound from a distance. He prescribed an oral antibiotic.
Despite these interventions and my regular changing of the dressing, the wound slowly spread. Dad has extremely poor circulation in his legs, so I was really worried about it becoming a serious infection.
Luckily, the next week Dad had an appointment with his podiatrist to follow up on some toe ulcers. The doctor's assistant immediately took pictures of the afflicted heel. Then the doctor pulled up a chair, took my dad's foot in his hands, studied the wound, measured the wound, and started calling out descriptors to his assistant to take note of. He said it was a pressure wound from lying in the same position too long in the hospital. The podiatrist expressed his frustration with hospitals not putting protective heel cups on elderly patients.
I realized then that this wound could have been easily prevented.
He then whipped out some clippers/scissors and began aggressively cutting away the dead flesh, maintaining a running commentary for our education and pausing every so often to make eye contact with each of us. He explained that if the dead flesh were not removed, the bacteria inside it would continue to eat away at the good flesh.
How my heart leapt inside my chest with gratitude and affection for this doctor! He was everything I imagined a doctor should be, right down to his well-polished cowboy boots.
The next day, the wound was noticeably improved in appearance and had shrunk in size. I felt terrible that I had not thought to bring Dad to the podiatrist in the first place. The other two doctor visits were a waste of time and money.
This whole episode was a major surprise to me, because I thought caring for wounds was one of the most basic things a medical doctor should be able to do. But it also highlighted something that I had been noticing for a while--that many doctors do not lay a hand on their patients anymore. There is a fascination with remote monitoring also, as if electronic monitoring equals care. I remember lying isolated in recovery after having a c-section for my son. I was exhausted, emotionally drained, and alone. Then an automatic blood pressure monitor clamped down on my arm, and it made me start to cry. I needed human touch. Human caring. A consoling word. I was not comforted by the thought that a nurse at some remote location was looking at a screen with my blood pressure results.
This love of remote monitoring is being translated into the consumer market for senior care with the development of "medical pods" that you can put in your backyard for your elderly relatives. I applaud those people who are looking for an alternative to nursing homes, but it seems this alternative exchanges one kind of neglect for another. Certainly it depends on how the individual family makes use of it; I'm sure some families who use them provide lots of hands-on attention and loving interaction to the resident family member. But some of the marketing is clearly geared to those who think that providing a safe space with video monitoring and built-in pill dispensers, separate from the rest of the family, is the ideal, as if regular human interaction is not important. I read about this one family that spent $125,000 installing a pod on their property. I thought to myself, "Gee, you could have added on a mother-in-law suite to your house for less than that!" The article had a picture of an adult granddaughter sitting down at a monitor in the main house, watching her grandma in her backyard pod. It gave me the creeps!
Having granny as a part of everyday life in her rocking chair by the family hearth is the stuff of fairy tales, I guess.