Meeting Senator. John McCain

Jason asked that I be at the hospital at 8:30. When I arrived, Jason said, "I may be discharged today." The discharge RN came in, "Well, we are all set to go." "Who will do wound care?" I asked. "We'll send supplies with you," came the reply. I said, "No, I told Dr. Frisch I was not doing wound care. (I am a hospice chaplain, not a RN. The wound is long and deep and Jason had a 5 hour surgery.) We will have to change the 'discharge plan.'" I couldn't tell if she was surprised but I think the MD did not tell her my response to the assumption that I would do wound care or it got lost in the transmission or the discharge RN is to do creative problem solving with "painful parents like me."

The RN's immediate reply, "We send folks home after more serious surgery." Of course, this pushes my "red button of our inadequate health care system." I reply hotly, "The system is broken then and needs to be fixed." She proposes Alternative B: Jason will go to Mologne on a very liberal pass and be back in the hospital by Sunday evening for morning wound care as an inpatient. The wound will be checked on the weekend by stopping by the ward after PT at 11:00 and a RN will handle. If all goes well, the dressing comes off on Monday. The RN goes away to see if she can sell this alternative plan to the powers that be.

Jason and I head off to PT as Kyla is gone and I want to see what Greg has planned for Jason three days after surgery. Greg has also worked with Jason and knows what he can and cannot do. Greg puts Jason through his paces. Jason does bridges (buttocks off the mat), right leg to the right, right leg to the left, right leg up and to the right-that one was a "stop" for Jason. He did these while on the mat. Jason does a step up exercise. He is unable to step up a regular step length so Greg has him work out on a 1/2 step. On the mat Jason can now bring his right leg to about 70 degrees by himself. With help to 90 degrees on the surgery table to his nose. Greg tells Jason his diagnosis is "Gluteus maximus weakness lurching gait" this is not a joke. He tells us how the body automatically tries to correct for a deficit, this one in Jason's butt muscles which for Jason results in a gait with his right shoulder thrown back. The answer: "work those butt muscles to strengthen."

Greg says some guys call me "El Diablo" He says his gage for a good PT work out:

1. When a good sweat breaks out on the patient
2. When the patient reports muscle pain
3. When the patient yells, "STOP" or some variation on the theme; usually with cuz words. Jason did do this.

Jason skips OT because he wants to meet Sen. John McCain who is to come about 11:00. Jason is waiting today because he missed the senator in December when McCain did a no show. Mc Cain is about my height and you see the scars on his face. I did have the opportunity to say "Thank you" to the Senator and to keep up his good work on the hill. I wanted the Senator to focus on Jason but he didn't, McCain wanted me in the picture and really didn't spend time with Jason, it was more a photo-op than a visit. I think Jason may have been disappointed a little. Greg had told us that McCain was a really good visitor and spent time with each patient when he was in PT.

An Aside: Greg told us that he considers Ozzie Osborn and his wife among the best visitors to the hospital. "Totally real and very likable." They spent about 4 hours when the visited and talked to all the patients. Jason and Greg are laughing because of all Ozzie's behaviors; they say he could identify where the soldiers are, having done a lot of stuff in his lifetime. Lesson: You never know people.

After Senator McCain leaves the RN returns. Now we are at Plan C, "Jason is to be discharged. She will do the wound check and change the dressing before he leaves. Jason is to report in to the Ortho clinic at 8AM Monday to check on wound. She will type up the discharge summary and bring it back later. Discharge will take place when the medications are picked up at the pharmacy." She leaves to do...I'm not sure.

I begin to pack the room, Jody calls so I take Jason's ID to the pharmacy on the first floor where I am told, "The soldier must come to pick up meds." I reply, "I picked up the discharge meds before." She gives me a look, "Our procedures change all the time." I don't say anything because she is assigning me a number from the "number machine" and this is "How the mission is accomplished in the Army." Give a nod to the bureaucracy and do what works, my way to work within the system. I was delighted and said, "Thanks, mam."

After I decide that I will stop at the Patient Representative office since I know Jason is still on the phone and next week sounds like it will be busy. I won't repeat the story but it had to do with our "Getting Kicked Out of Better Places Than This" see blog entry. I hadn't reported it to anyone and this office should be able to interface with Mologne. I tell him the story, he says "Fill out a report" and we will inform Mologne management of your concern. I think "Humph" that is a nothing answer. I say, "You will call me after you speak to Mologne Management?" He looks like, "What a novel idea." I then ask, "I'll hear from you in a week? I'll write down a recommended solution for you." I am feeling, "He round files these complaints as soon as "the complainer" leaves the office." They haven't met me before now. I wish I would have asked for a written copy. Next time. He did tell me that the Army does hire a management firm to oversee the operations of Mologne House Hotel. As I wrote and told the gentleman today, the Mission of Mologne has changed and will be different for the foreseeable future, policy needs to change.

Back to the room on the 58th Ward. The RN returns to change the dressing. We discuss the wound length. I had written that the wound was 10 inches, she says, "I think it is 12." So I stand corrected, know it is long. Our conversation made me want to measure the size of the bone that was taken out of this wound. So I got a tape measure and the dimensions from the computer generated model are roughly;

The largest piece of bone was 3 3/4" high, 2 3/4" wide, with a 2" "stem" from the femur and about 1' thick but thickness varies. It looks like swiss cheese, it is not a solid block. This heteroptic ossification bone encircled the sciatica nerve.

The smaller piece that was removed was 1 1/2" wide, 1/2" thick, and 2 inches long.

The RN finishes the dressing change, we discuss changes to the discharge summary as she decides Jason should not take a shower as it now reads. I say the wound was not caused by a "gun shot" but by shrapnel. I said, "Let's keep the medical record consistent, it is going to be with Jason for the rest of his life." Jason verifies the truth, as she tells us, "I was told it was a gun shot wound."

I then ask about who will help move us; she says I must talk to the Ward desk. Jason leaves for PT and I head to ask about help. A CNA says she will help us take the wheelchair filled with items to the shuttle bus. I say "I've been here 5 months and I want to use a wheel chair and move," the shuttle is not reliable nor is the help on the Mologne end. I ask for a soldier from Med Hold as they helped us move the first time. Doesn't take long, but takes a call to Jason now in PT as I don't know his platoon number. Soon a nice soldier from Med Hold arrives, we pack up and head for Mologne.

A different experience: While we are packing Dr. Frisch and interns arrive to see Jason. I tell him the dressing has been changed and Dr. F could find him in PT. He goes away and comes back, Jason is not in PT. I say, "Sorry, I don't know maybe he headed for Mologne." So this is the first time for me that a "MD waited for a patient, not a patient for a MD." Finally, Dr. Frisch and all gave up and said they would try to see Jason in clinic on Monday. (Jason said he was in PT tucked away in a corner doing stretches so Dr. Frisch missed him.)

The Med Hold soldier and I head toward Mologne and he takes the wheel chair to the room. I unload the wheelchair and prepare to do laundry. Jason comes in at 4 says, "I'm really tired" lays down, takes off his shoes, asks me to cover him with his Bears blanket his favorite(we sent it to him in Iraq) and immediately falls asleep. Jason sleeps till close to 6:30. Maureen and her husband had offered to bring him dinner, Jason declines: too tired. We take a raincheck and plan on having a quiet evening.

Mother as soldier hero:

Doing laundry I met a woman too young to have a 22 year old son. She had come back from Tikrit Iraq with thyroid cancer. She has had the thyroid removed and was now going to undergo chemotherapy. Gladys has been in the National Guard as a Medic for 22 years. She loves the work, she loves being in Tikrit "on the front lines" knowing she is working to save our soldiers lives. "I want to go back" and has asked to go back. She said, "If I go they will not send my only son who is in the guard also." She truly loves her work as a medic and she loves her son. I told her "God Bless and God speed" and keep her safe. I am awed at her courage and determination. She is a hero. I thanked her on behalf of the medic that saved Jason's life the night he was injured. We promised to pray for each other and our sons and all the soldiers at Mologne.

May you all have a blessed weekend. Please pray for Jason's continued healing. He only takes percoset before he sleeps. I think the continued abscence of pain for him is a miracle.