September 8, 2010

Linda is becoming despondent, for three reasons:

1) No one will let her talk to me or let me talk to her. September 5 was our wedding anniversary, and I wasn't even able to wish her a happy anniversary. She is all alone in her hospital room there without friends or family to visit her for days at a time. The lonesomeness is taking a heavy emotional toll on her.

2) She wants to be closer to home, and you won't let her go to RML.

3) She doesn't want to die in your hospital. I don't want her to die in your hospital. You don't want her to die in your hospital.

Every day she is unable to stay off the ventilator in your hospital increases the risk that she will become permanently ventilator dependent, and have to be brought home on a ventilator. Why not give RML a chance to do the thing it specializes in - weaning her off the ventilator? If they succeed, Linda comes home breathing on her own and can be cared for at home. If they don't succeed, Linda is no worse off than she would be if you sent her home now. She needs to be close to friends and family who love and care for her.

I'm sure you will acknowledge that Linda's emotional condition is at least as big a part of her ultimate recovery as her physical condition. You know she wants to be closer to home.

RML tells me Blue Cross/Blue Shield will not pay Linda's bills at RML if she signs out of I U Hospital AMA because in the view of BC/BS Linda would not have a primary care doctor at that point. As a result, Dr. Tector, you are in charge of everything because Linda and I don't have millions of dollars to pay for her lifetime of care if Blue Cross/Blue Shield will not continue her benefits. So, although there is no legal authority for you to continue holding her prisoner there in Indianapolis, the practical fact is that your pen is the key to her freedom to be home and closer to family and friends, where her spirits will be lifted by their companionship and her will to live can sustain her. Isn't that what everyone wants for her?  Without the motivation of a future she can see  materializing in her home town, what will motivate her to do all the work that remains to get back on her feet and resume an active life?

Although we have had our differences in the past, and have them still, over what is best for Linda when it comes to the details of her care and treatment there, please don't let your ego and mine be impediments to Linda's recovery. I'm merely asking three things of you - all of you involved in the process of transferring Linda back to the Chicago area:

1) Please leave some line of communication open between me and Linda so I can tell her every day how much I love her, need her and want her to get well. Surely hearing those sentiments won't interfere with her progress.

2) If you aren't going to write an order for Linda's transfer to RML right away, please lift the restriction on my visiting her in person at I U Hospital so she won't be so very lonely day after day. I'd be willing to accept whatever time limits you think reasonable on daily visits, so you don't think my presence will interfere with your medical care for her. Since she is now conscious, competent, and able to communicate her own consent for proposed treatment, I don't see any need for me to be in her room 24 hours a day.

3) Please reconsider your resistance to letting RML take over Linda's care and treatment. RML is the best facility of its kind in the nation, and it is owned in partnership by two fine Chicago area teaching hospitals - Rush and Loyola - that both have their own liver transplant programs should she need any urgent attention in that regard. Right now her biggest problem is with her lungs, not her abdominal organs.

Finally, whether or not you are prepared to grant any one or more of my three wishes, please believe that I am prepared to do whatever is required to make a comfortable and adequate place here at home for Linda to be cared for once you conclude at whatever point that there is nothing more you and your colleagues can do for her, so that she doesn't have to spend the last days and hours of her life in your hospital, should it come to that. Surely you and the others at your institution can find it in their hearts to stop refusing me any opportunity to know what is going with Linda day to day, or to make it necessary for me to pay an Indiana lawyer $250 per hour to make a few phone calls I could well make myself to keep in the loop. In order to reduce the inconvenience and distractions for everyone, please name one point of contact I can call at some specific time every day to get an update on Linda's condition, even if you won't let me speak with Linda herself.

I continue to believe that I can be an asset along Linda's long road to full recovery, and I wish you would consider using me in that way. I know Linda is suffering from this forced separation, and I know it is in your power to end it. Please think carefully about this.