You Are Free To Go (November 15, 2009)

Only in India (please correct me quickly if I am wrong) do you need a special agent to get you discharged from your hospital confinement.

David and I took a trip to Kathmandu and Pokhara for a trek up to Poon Hill to gaze at Annapurna as the sunrise set her alive. From the get go, David was not strong and able, suffering from an uncomfortable cold and a nagging cough. Not to be deterred by such minor issues, we unwisely set out for Nepal anyway. Not surprisingly (thus I don't know why some of us were not better prepared), our Nepal Airlines flight was delayed for an hour and a half. As David's medicine wore off and his chills set in, we were stuck at the deaparture area of the Delhi airport with no drugstore nor convenient medical station nearby. I walked around till I found a kindly looking man at the counter of the magazine and book store. I put on my fever face and asked him where I could get some ibuprofen or acetaminophen. He explained that the drug store was outside the departure area. having lived in this wonderful country for almost three years now (and I don't use the word wonderful with any hint of cynicism)I did not wonder why this was nor did I seethe in frustration at what was. I merely took in the reality and keeping "jugaad" in mind set about to work with the system. I continued to stand in front of the magazine man until he had to speak to me and come up with a solution to my problem. He called the drugstore attendant, consulted about what I needed then very kindly went to pick up the medicine. It is a wonderful country indeed!

Our trek to Nepal is another blog altogether....

We returned to Delhi Sunday with David eight kilos lighter, without an appetite and looking much the worse for wear. Was it all the steps up to Poon HIll that did it? Was it the morning, noon, and night Maggi noodles on the trek menus? Or was it something else more medically serious? He continued to cough and chill overnight. Come Monday morning I dispatched him to the doctor's office while I resumed my routine, beginning the morning with an hour of yoga.

In spite of my aching back, now firm(er) but abused thighs from 12 and a half hours of an 1800 meter climb, and battered calves from 8 hours of a constant downhill trek, I was happy to get back to my routine. My bliss was interrupted by a phone call. On the other end was a very weak sounding David asking me to come to the doctor’s office as the doctor wanted to speak to me. Those words never bode well.

I was advised to take David to the hospital immediately as he had a syncopal episode at the doctor’s office, having turned ashen and losing consciousness for 20 seconds. The doctor, playing safe, recommended confinement mainly to rule out any heart related issues and no less significantly a viral infection. We obediently set out for Max hospital in Saket.

Max has two wings, the second being a dedicated coronary wing. We optimistically went to the less frightening wing and proceeded to make our way through the maze of hospital admission. From one counter to the next, I questioned, submitted, threatened, and cajoled while David waited uncomfortably.

David received an sms from a Bharti colleague who said that someone had seen him at the hospital and inquired whether we needed any help. Why yes, of course, please, please help us navigate our way through this nightmare!

At the admission desk, having received the sought after admission papers, we were told there was no room available, that we should just wait. An hour, a couple of hours they could not guarantee.

Simultaneously we were communicating with our Bharti connection. We sat in the car to wait for an available room. Within fifteen minutes we received a call from our special agent (by the way he is not a Bharti employee per se but his job it was to navigate the ins and outs of hospitals) informing us that he finagled a room for David and we should return to the hospital. We obediently returned and proceeded upstairs. In retrospect I understand more clearly why we were able to get the room. It was the VIP suite of the hospital meriting a special directional sign on the 6th floor! The suite had a spacious and clean room for the patient. It had a blue faux leather couch and two arm chairs. There was a television set with a cable box which, in spite of the three remotes controls provided, played only Hindi programs and the Hallmark channel, this in the world where people normally have 600 channels to choose from in their homes! The adjoining room had the same furniture setup but was equipped with a small kitchen.

David was under the care of 2 excellent doctors and an efficient nursing staff. Aside from the constant poking and prodding, the unbelievably uncomfortable bed and the perhaps nutritious but certainly repulsive meals, I have only wonderful words for Max. Hospital. David was walking around and quite ready to be discharged after a 2 day stay. Ironically, we were happy with the dengue fever diagnosis as it was worlds better than discovering a coronary issue which we had earlier feared.

In the meantime, trek weary and ragged from my days at the hospital without proper meals nor rest, I was beginning to come down with a cold myself. But I had to “spring” David out of there so once again I had to divine our agent to do his magic. Let us give him a name now: Deepak. He was our guide through the Max Universe, our guardian angel, checking each step of the way that our needs were met and our issues resolved. He had previously warned us that a hospital discharge can take a bit of time 3 or 4 hours perhaps because hospital bureaucracy and systems made it impossible for a patient to simply and quickly “escape!”

By the time I got to the hospital David was showered and dressed, sitting on his faux leather sofa and concentrating on his Blackberry. Deepak had arranged his “Robin” (I am starting to see Deepak as Batman coming to the aid of those helpless against all evil!) to be there to help us with David’s discharge.

The process began at 1215pm. The nursing staff said they did not receive word from the doctor that David could be discharged. His Holter (a machine that continuously records the heart’s rhythms) had been removed and the doctor informed him that if the insurance papers could be processed before 1:00 pm, he would be ”free to go.” Why does that sound like what one would hear in a courtroom when the defendant is found not guilty? So back and forth we went between the discharge orders and the insurance issue standing in the way of David’s release. The doctor said keep him another day because he is on oral medication, the nursing staff said. Pardon me but has dengue completely incapacitated David that he can no longer pop a pill in his mouth and follow it with some water? The accounting department said that he could be released if the insurance papers were approved. Please note that it is now a release, not a discharge that we seek. I made a perfunctory call to the attending doctor to inform her, no to beg her, to please initiate David’s release. Again, she used the insurance clearance as the stumbling block to the discharge. Robin, having worked through this same issue before, very patiently worked her way back and forth from the doctor and the cashier and the insurance people. It was like being caught in an infernal spiral down to hell!

David paced around the room and I settled myself down to the hospital bed as my cold worsened. I tried to take a cat nap but was afraid that someone might hook me up to an intravenous drip if I got too comfortable.

Let me remind you that the discharge process started at 12:15 pm. Intermittently we would hear from Batman Deepak and Robin that the wheels were turning albeit exceedingly slowly. Twenty-five minutes, they are processing the bill. Thirty minutes, they are following up the insurance issue, be patient, so sorry, just thirty minutes to credit the account for all the unused medicine, just a quick minute they need to make a copy of the Holter results. The interminable delays continued for what must surely be a record time of six and a half hours! Where is Ripley–I must make a play for getting this record on the book of believe it or nots! It was so painful it was utterly laughable! And definitely blog-gable! At the end of the game, for that is the kindest way to label this ordeal, Deepak called to give us his congratulations, we were free to go! And so, ladies and gentlemen, please let me know if this has happened to you in any other country aside from my dear India. And let me give you a few words of advice. Should you find yourself trying to get in or out of a hospital in India, give up before you even try. Call my guy, he will weave his magic and get you in and out of there faster than you can ever hope to by yourself. My eternal thanks to Deepak and Geetha who expertly and patiently worked with the system to give us back our freedom.