We myeloma patients spend a lot of time in and at hospitals.

Hospitals are places where wonderful things happen – lives are saved, the ill are made well, and worn-out bodies are restored – much due to what the cliché refers to as “miracles of modern medicine.”

There’s another side to hospitals, though, that demands wariness and requires that you pay the greatest attention to what’s going on around you.  Pat Killingsworth wrote about one aspect of this last week in Pat’s Place: Poor Communication Can Cost A Myeloma Patient Time And Money ^[1].

When you are the patient, however, it’s often just not possible to always be alert.  And it may not be enough anyway.

Because I am living with multiple myeloma, I have spent many more days as an inpatient than I ever contemplated in my previous “healthy” life – probably somewhere approaching 100 days at this point.  Then there are the countless days as an outpatient for procedures, tests, or some radiology demand.

The problem with hospitals, and it’s not talked about enough, is that for all the good they accomplish, they also do bad things to unsuspecting patients, and even to suspecting ones.

These bad things even have a name.  They are called “adverse events.”

An adverse event in a hospital is something harmful, even fatal, that happens to you while being treated, and is unrelated to your reason for being in the hospital in the first place.  Sort of like being in the right place at the wrong time.

Lest you think this is not a big problem, you should think again.

A recent report in the journal Health Affairs found that adverse events occurred in 32.3 percent of hospital admissions.  That means that for every three people hospitalized, one is going to have something happen to him or her that’s not good, that has nothing to do with the underlying medical problem, and was caused by an egregious mistake or bad practice.  It includes exposure to a pathogen/infectious agent, something that is of great concern to those of us with compromised immune systems.

I think that’s astonishing.

The joke you hear about this is that a hospital is no place for a sick person.  It’s no joke.

If the statistic reported in Health Affairs is correct, I’ve probably been fortunate.

That doesn’t mean I haven’t had close encounters with adverse events.

The day in 2006 when I went in for a lung biopsy, it was Linda, my wife, who staved off potential harm to me when she had a brief conversation with the anesthesiologist scheduled for this procedure.  I was but minutes from being whisked away to the operating room.   I’d already been drugged up and was well on my way to la-la land.

Linda asked him what kind of anesthesia I would be getting, and he responded that it was going to be a spinal – that is where they inject a numbing agent into your spine that blocks the nerves from sending messages to your brain.  You feel no pain.  It’s commonly used and preferred in many cases because it doesn’t bring as many risks to the operating table that general anesthesia can.

Messing with the spine of a myeloma patient, however, is generally not a good idea.  Those of you with the disease who have had to confront spinal deterioration brought on by myeloma’s attack on bones know this full well.

When told that it was to be a spinal, Linda looked at the anesthesiologist and said simply, “You know he has multiple myeloma, don’t you?”

The anesthesiologist was taken aback and turned to my thoracic surgeon, saying, “He has myeloma?  I can’t do a spinal on him.”  Fortunately, the anesthesiologist recognized right away that the plan to do a spinal was inappropriate and perhaps dangerous to my well-being.  Hastily, the operating team regrouped and changed to a general anesthetic.

Adverse event avoided.

It wouldn’t have been, though, had I not had an advocate in the operating room.

From the experiences I’ve had, I think that for the most part things run pretty smoothly in hospitals, and one gets appropriate care and treatment, without the prospect that something will go wrong.  It doesn’t take much to throw the system off-kilter, though.  A crush of patients with complex and demanding needs can get those with “everyday” problems pushed aside for a while.

As an inpatient, you need to keep your wits about you as best you can.  And ask questions.  When a nurse shows up with a new IV bag, for example, it doesn’t hurt to ask what it is, what it’s for, and why you’re getting it.

The unfortunate truth is that no amount of personal diligence is going to protect you fully from system and human errors and failures that are generally the root causes of adverse events – the ones that are preventable, at least.  Sometimes, adverse events are unexpected, arise from the unknown, or are related to new technologies and treatments.

When you step over the threshold into a hospital and become a patient there, you’re rolling the dice to a certain extent.  It helps to keep that in mind.