Medicine in Coco: You could say, “Different.”

I did something Tuesday that I think very few people have done before (missionary doctors and nurses excepted). I gave my blood to a patient yesterday. As in, I went to the lab, had them draw my blood into one of those bags you always see at the Red Cross, and then a short hour later, I hung that blood on IV tubing and gave it to the patient in the OR. That cheesy Hair Club For Men commercial kept going through my head: “And remember, I’m not only the president, I’m also a client.” “Remember, I’m not also your nurse, I’m also your blood supply.” Talk about having patients suck the very life out of you…

(After donating said blood, David, the lab guy handed me a little slip of paper declaring that I was Hepatitis B and C and HIV negative…woo, what a relief. I’d have been a little taken aback if anything was positive.)

But really, around here, this is all just par for the course. Things are done a little differently around here. And some of you may be thinking, “Oh, third world health care, I can only imagine,” but I’m actually going to give you several reasons why we may just be the best healthcare system operating in the world these days…

--We are preventative as opposed to curative. Those are fancy words meaning that we work hardest at trying to prevent disease instead of waiting until things get so out of hand that you spend lots of effort and money trying to fix it. (Many suggest this as the root of the problem in American healthcare…we are curative as opposed to preventative.) So for instance, the basketball size mass that has been growing for 25 years in your belly, that we all looked at with wide eyes and took pictures of today during surgery, yeah, we’d like to prevent those things. Therefore, we offer a wide array of consult services, vaccination clinics and prenatal clinics to prevent disease (unless yours is going to be particularly interesting, then we’d like you to wait 25 years to see what it does.)

--We believe in incorporating creativity into healing. Some would have you believe that medicine is all about exact science, but deep down we all know this to be a farce. And besides, creativity is good for the soul. So when we encounter a problem that doesn’t have an exact scientific answer, (in other words, we are just not sure how to fix), we like to stand around in little huddles brainstorming, after which, we head to the warehouse and sort through donated supplies. Whoever finds the best looking solution to the problem wins the creative touch award for the day. It goes something like this: Our nurses don’t have watches, so it is difficult to time things when taking vital signs. Go to the warehouse. Oh, here are a bunch of wall clocks. They now carry around wall clocks while doing vital signs.

This is how popsicle sticks and tape became a replacement for mechanical ventilation in newborns. (I’ve described this elsewhere, but it bears repeating. Instead of intubating babies—which would be fruitless since we don’t have ventilators—we use these contraptions to lift their chest (taped to the top of the incubator) and keep it from collapsing on itself. Upon seeing such rigging for the first time, I was stupid enough to ask if there was an actual device manufactured for this in the States… uh, duh, it’s called a ventilator.)

This is also how we ended up with a laparoscope that uses a giant hook and crane to operate. In the States, laparoscopic surgery is done with a scope that is passed through a tiny slit in the skin. The scope uses compressed carbon-dioxide to move tissue around so that the doctors can visualize the organs they need to see. Having no such compressed gas available, we make a slightly larger cut, insert a large hook, attach it to a bedside crane and lift. The effect: all that crazy tissue and skin is lifted up and the scope can go looking around inside! Works great on skinny people! (May be the reason it hasn’t caught on in the States yet…)

--We’ve said, “To heck with all those silly FDA regulations.” Expiration dates are nothing more than a bureaucratic power-trip that serve only to waste medical resources and money. We personally don’t believe in them. You poor saps still living under their tyrannous, bean-counting ways, can save your new (or gently used), but expired medical supplies and medications for us! We love donations! Oh, and don’t even get us started on JCAHO…

--We offer a personal, human touch. In addition to causing severe latex allergies, all the protective gear used in other healthcare settings makes the patient feel like some sort of lab rat. We offer a more personal touch here, using gloves in only extreme circumstances. Before donning gloves, we always ask these questions: Will I really be exposed to anything contaminating? Are there ways to move this or that item to accomplish what I would have done with my hands if I had gone through the trouble of putting on gloves? If I am likely to get some “contaminate” on my hand, will I be able to just wash it off really quick?

--We believe in helping people develop healthy body image. We all have bodies, and every body does some crazy things. Hiding these “functions” in the privacy of your own room is so over-rated and only causes you to have complexes about what is very normal and natural. Time to feed the baby? Go for it! The hospital ward is a little warm? Show a little more skin. Just had some random body organ removed in surgery? Don’t worry, we’ll take it out and show it to your family. You may think it is crazy at first, but it is a whole lot cheaper and effective then tummy-tucks and nose jobs.

--We involve family in your care. In the States, healthcare systems have gradually come back to the idea of involving families in the care of the patient. They’ve started expanding visiting hours and some “out-of-the-box” doctors are now including them in rounds. Well, here in Coco, in addition to cooking all of your meals for you while you are hospitalized (I mean, really, who is a fan of that hospital food anyway?), family will be on hand to clean you up and help you get around. They’ll be sleeping outside under the tree on their mats if you should need them at night. You need medications? Great, we’ll write your family a prescription and they can go get it from one of the local pharmacies. Emergency need for medications? No problem, we’ll just supply it up front, and you can restock us at the time of your discharge.

--We have gone green. While the words, “Single-use only” and “disposable” have become commonplace in American healthcare systems, we believe them to be dirty words. We much prefer, “reduce, reuse, recycle.” If it can be sterilized, we do it. If we can wash it with dish soap and bleach, we do it. Oh, you are done with that nasogastric tube? We’ll take it and wash it up for the next patient. Done with that foley catheter? Yup, we can sterilize that too! (On a personal note, this one gets me…) Empty bottles or plastic trays? Save them, our nurses will take them home and find a way to reuse them.

--We have cut costs. Who needs insurance companies? Come to Coco and you can have your baby for $21, out the door. Or if you can pony-up and pay the $12 for your 10 prenatal visits with us, we’ll cut the cost to $17. Prenatal visits + delivery + hospitalization=$29. Can you even pay your deductible with that? Sick kid? Swing by on any week day, pay the $0.75 immunization fee and we’ll make sure the baby is current on their vaccines and we’ll see them as well.

--We recover all our costs. In the States, healthcare systems believe in the reliability of the mail. But what if the patient moves and the bill gets lost in the mail? What if they simply don’t pay? We’ve solved this problem. Before you can be discharged, one of your loved ones will be given a bill that they will need to pay at the registration desk. Once it is paid and stamped, we’ll give you discharge teaching and instructions. (Charity aid is available to those who need help paying.) The couple with the largest bill ever seen in our hospital just checked out the other day. They had a $900 bill, but it was for a month and a half in the hospital for mom and the triplets. Two of the triplets had multiple operations, and the family had a private room. (They were a family with means…)

Mayo, John-Hopkins, and Intermountain Healthcare…please take note. You’ve just been schooled.

*I may be off in some of my above figures. I don’t have the hospital price list in front of me (nor the bill of the family), but they are as close as I can remember.