Hospitalized

Experiencing medical care from the other side

Dear Readers,

I spent last week in the hospital with pneumonia. The episode capped four weeks of progressively worsening respiratory illness that probably started as a viral infection. A few visits to urgent care suggested flu or covid was unlikely, and they provided some empiric treatment that was unhelpful at best (antibiotics early in disease course) to potentially harmful (a steroid pack right before I decompensated). Even though I make a decent living and have health insurance, I hesitated to go to the ER over worries about the costs. When I started spiking 103 fevers and could barely move, I knew it was time to take it seriously. I kept thinking, “I don’t want to be Jim Henson,” who tragically died of pneumonia at 53 because he blew off similar symptoms until it was too late.

Unfortunately, I was admitted out of state while working on a locum block in Auburn, rather than at home in Tampa. My wife Lenore flew up to be with me and my friend Pete stopped by to bring me food and supplies from my AirBNB. Out of town family and friends continuously checked in on me with calls and texts.

It was a humbling experience going from someone used to treating sick animals to being vulnerable in the care of strangers myself. For the first few days, I was bed bound with a violent cough and unrelenting fevers despite several different IV antibiotics. I could barely eat anything. Nurses and aides had to help with basic tasks and hygiene. Everyone in the hospital becomes a human pin cushion as they repeatedly draw blood for the lab and place IV catheters to deliver fluids and medications; I still have bruises from a few of the sticks.

Last week taught me several lessons. First, you always have to advocate for yourself in the hospital. At one point, they claimed no one could find the four bottles of blood painstakingly collected from two different arms for cultures. I insisted we collected them already and would not consent to draw them again; lo and behold, they found and ran the originals. Second, it gave me an appreciation for how precious these samples that end up on my desk as a pathologist are—it is all too easy to be flippant about demanding clinicians just recollect that blood or tissue when you don’t see the patient who will suffer in front of you.

Finally, I got a critical object lesson in the importance of being careful with language in my diagnostic reports. My CT scan readout included the following line: “Consider fungal and nontuberculous mycobacterial organisms.” This was likely included as a CYA—to be fair, it is uncommon for an otherwise healthy 38-year-old to have pneumonia, and the only history the ER provided was “cough”—but it freaked out my doctors and triggered an expanded search for atypical organisms, including a bronchoscopy and a ton of ancillary cultures, antigen tests, and PCRs.

I was discharged late Thursday. We recovered at the AirBNB that evening and drove back home on Friday. While I’m feeling better, I’m still weak and have a lingering cough. I lost ten pounds in the course of that week, almost 6% of my body weight, much of it probably muscle I’d worked hard to build over the last 12 months. Taking a short walk around the house with our dogs winds me. From my reading, patients can be tired for a month or more after pneumonia, and it can take 6-8 weeks for signs of the infection to clear up on imaging. I am trying to balance rest with pushing myself so I can improve my lung capacity.

Reflecting on this episode, it really put into focus the important things in life: my health and family. The seemingly urgent demands of work fade into the background when faced with a life-threatening disease. Part of what predisposed me to pneumonia was almost certainly exhaustion from frequent travel. To that end, I began clearing some things off my plate and resolved to pare back my fall schedule as much as possible.

We are all such fragile beings, and a freak accident or illness can take even the strong down a peg or two. I’m grateful for the care I received from the medical staff and the amazing support from my wife, family, and friends. There will be a long road of recovery before I’m back to normal, all I can do is move forward. While I was initially disappointed with my body for “letting me down,” I have gained a new found appreciation for what it can do and its near miraculous ability to bounce back.

—Eric