Somebody Call the Bambalance!

Ruby had to be rushed to the hospital Thursday morning...according to her pediatrician, who was following "protocol", which is Latin for "please don't sue us, dear sir!"

Over the Easter weekend Ruby started coughing but showed no other signs of illness and was her usual spry self. By Monday evening her cough was unstoppable. We contacted her pediatrician who invited us over to her house for a look-see (yes she is awesome). She prescribed Albuterol and some other medication to help Ruby breath better. Her cough got much better but her overall condition worsened as the week progressed. Ruby has been sick several times this winter and this one, aside from the Monday night coughing fit, didn't seem terribly different than the other ones (not nearly as bad as the New Years week projectile vomiting). But eventually her energy was completely zapped and she turned extremely lethargic. Wednesday Kirsten took Ruby into the Peds office and was told to keep monitoring and let them know if things worsen. By Thursday morning her cheeks turned red and she seemed to have gotten a little worse. Kirsten called for an appointment and they said 3:30pm. After 30 minutes Kirsten decided not to wait another five hours and took her in.

At the doctor's office they examined Ruby and decided she might have pneumonia and should go to the hospital for a chest x-ray. They also informed Kirsten that Ruby has to go in an ambulance. I was not there to say, "But the hospital is like two miles away and we could get there before an ambulance even gets here." When the doctor says your child has to go to the hospital in an ambulance who's gonna question it? Kirsten called me and gave me the news. I asked why the ambulance (it's not like she was in acute distress when they left the house) and Kirsten was later told it's "protocol."

Soon an ambulance arrived (no sirens) with an SUV full of paramedics in tow, plus an extra MD. They wheeled a full-size stretcher into the office, through the waiting room, down the hall and into her room. They strapped her down and wheeled her out. Approximately seven people were earning their paychecks around 31 lbs of warm toddler. On to the hospital went Ruby and her mommy. Kirsten says Ruby was enjoying the whole production.

I had to be in court on a case that had been continued several times over 5 months (and I knew Ruby wasn't in serious condition, just really sick). Kirsten called and said they were in the hospital watching videos. They had given Ruby some oxygen and stuff and decided they wanted to keep her overnight. Well jeez, she must really be in terrible shape! Just as bad, Kirsten hadn't had a thing to eat since breakfast and it was getting on towards late afternoon - her blood sugar is volatile. I wrapped up in court, picked up an enormous sandwich at Sutton's Pharmacy and headed for the ER.

I arrived to find Kirsten and Ruby sitting in a room watching a baby animals video. Ruby looked better than she had all week. She was peppy, happy, curious and playful. Over the course of the next hour she was climbing the medical equipment and running up and down the hallway squealing with delight. I felt a little bad she was running around, getting in everybody's way but this child was showing the sick how to heal thyself! And no she was not drugged up. She'd had a little oxygen, some graham crackers and several bites of a Sutton's sandwich (and an existential sense of how much of a drag it would be for her parents to stay in the hospital overnight).

We decided we would not keep her in the hospital overnight. Our front porch was no more than three miles from that very room and we could not see a reason to keep her holed up in a building that is filled with disease. Plus Ruby had pulled her finger oxygen hookup off and wouldn't put it back on and nobody seemed to notice or care. .

We broached our plan to some doctor/guard on duty and he told us to wait for her doctor. In the meantime a student/MD talked to us about why they would want to keep her. She said Ruby's oxygen saturation level dipped below 90% while she was sleeping and this is cause for precaution. What is the consequence/risk when this happens, I asked. She replied it could cause brain damage. Um, I'm just a stupid social worker but that doesn't sound realistic er something. Kids pulled from under frozen lakes and revived might suffer brain damage due to lack of oxygen. Kids with 'maybe pneumonia' who are 'dipping below' the good point, not so much, I thought. I didn't guffaw or anything but I did disclose my interest in the medical literature and how it relates to Ruby's situation. I never heard anything more about brain damage after that (my mother informs me I was hospitalized more than once for pneumonia so you be da gudge). The real doctor caught wind of our plan and contacted Ruby's ped, Dr. Lawrence. Dr. Lawrence gave Kirsten the okay and the main doctor concurred but still wanted us to sign an "against medical advice" waiver. We left the hospital at 6:30pm.

Ruby is getting better. She is still sick but her energy is back - hopefully she will be healthy by the start of the week. We have pretty mainstream beliefs regarding medical care but, man, the process seemed filled with overkill. I don't disagree with her need to go to the hospital, but in an ambulance? With an additional SUV and a bunch of extraneous people in tow? Then she needs to stay overnight in a hospital to be monitored? Eventually we called bullshit. I have a hard time not thinking the overkill is related more to the legal/business needs and less to the medical necessity. Though you could find many-a-administrator who'd be able to deftly explain how all the steps were clearly "in the best interest of the child's well being", and make you feel like a fool for thinking otherwise. I see that a lot in child protective services. Plus she's got good insurance.