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Thursday, November 03, 2005

THE BEST

I’m heading off to New York on Sunday to visit my Dad. He’s been deteriorating and I have felt powerless to do much about it until just before the Holidays. My mother got him into a Nursing Home Subacute Rehab Facility at my insistence and he started to eat better and they were getting him out of bed and doing therapy with him. So naturally he hates it there. But he hasn’t spent much time there because he’s been hospitalized twice since he was admitted. I don’t think this is any reflection on the care he received at the Subacute. Rather, I think he probably needed to be hospitalized all along but either my Mom or his former physician didn’t realize this.

I’ve been meaning to write about the value of THE BEST™. It seems New Yorkers, or maybe just New York Jews are obsessed with THE BEST™ (TB). “Who is the doctor? Is he THE BEST?” “He’s in THAT hospital?? That’s not THE BEST!! You have to transfer him!” I’m still trying to figure out how someone gets labeled as TB. I recall a visit to NY a few years back where my sister dragged me along with her son to the pediatrician so that I could meet him. “He’s THE BEST™,” she gushed as we waited, for a while, in the closet-sized examining room. When he did come in, he never made eye contact me, never gave my sister an opportunity to introduce her BROTHER, THE DOCTOR™, and grunted a few things at my nephew and handed her a prescription. On his way out the door, she blurted out a brief introduction, and he looked at me and blinked, I think, then exited the room.

When I told my sister I wasn’t too impressed, she was dumbstruck. “But he’s THE BEST™!” If he’s the best you got, I could make a killing there. Same story with my Dad. My mother and sisters had insisted his docs were TB, but again, I was not impressed. After multiple long distance discussions with them concerning doctors, Nursing Homes, Medicare HMOs (oy), Geriatricians, and HOW I DO THINGS™, we got him into the NH where things are starting to sort themselves out. But I guess the doctors there aren’t TB.

Well, I’ve had an opportunity to appraise the care he’s gotten from TB and Not TB, because of the two different hospitals and the two sets of doctors. And I have to say that I’m more impressed with the NTBs than the TBs. The NTBs call me back, in fact even gave me their cell phone numbers, discuss his care at length with me and also my Mom (G-d bless them, that can’t be easy), and see him frequently. The TB never responded to phone calls or a fairly succinct typed letter that I faxed to his office prior to the hospitalization where I explained my concern that, I don’t know, I THINK MY DAD NEEDS TO BE HOSPITALIZED. I got a call from a “nurse” two days later with a very half-hearted plan to address this. So I have not been too upset that his care transferred to the NTB when he went to the NH.

However, despite all of the above, I have to say that I still think he would be getting much better care if he were here in Wisconsin with me. And it’s not just because of HOW I DO THINGS™. I think that the doctors I work with provide better all-around care. Maybe we’re not as overworked as the New Yorkers. Maybe we have more time to sit and look at a patient and recognize things that are obvious and maybe not so obvious. Whatever. It matters not, because they won’t even consider relocating here.

So yes, it’s been frustrating to me as the family doctor to be running the show from 900 miles away, dealing with TB doctors who won’t give me the courtesy of a return call, playing the heavy to my sisters who insist on transferring him to TB hospital (where they don’t allow visitors before 2pm and apparently don’t feed my Dad or get him out of bed), and trying to reassure my Mom that she’s doing the right thing by putting him in the NH. That’s why I’m going out there Sunday to eyeball the situation and spend time with my Dad.

Afterwards, I plan to take my Mom and drive to Manhattan to pick up Fudge and go out to eat at a nice restaurant. And then hop a flight back to Civilization. Maybe we’re not THE BEST™ out here. But we get the job done.

26 comments:

dilbert said...

I hope everything goes well, and a refuah shlema. It funny how people get a reputation, even when it isn't deserved. In my area there are a number of people who have TB reputation, and I wouldn't let them touch my pet hamster. There is nothing like meeting the doctor and interacting abit, and you get a very good idea if they really do provide the best care or not.

I am sure that your dad would get much better care with you, having nothing to do with his being family. Unfortunately, its hard to find someone who cares enough(and has enough time) to take care of everything that needs to be done.

When one meets one of TB, and you realize that you are better then they, the feeling is a mix of elation and sadness. One that, hey, I am just as good(if not better), and the other that, sadly, not only is excellence frequently not recognized properly by the public, but that the standard is so low. TB reputation often comes as a result of a single news release, article, or famous patient that did well.

btw, I blogged about medicine recently also, if you wanted to take a look in your massive amount of free time

Steg (dos iz nit der šteg) said...

I'm a New Yorker but i have no idea about this "THE BEST" thing... but then again, since i moved back from Israel people in my new neighborhood've been telling me that i give the impression of being from Out Of Town. I mean, not even from the suburbs, where i technically was born (sssshhh don't tell anyone), but from much further out. Maybe they think i'm from Milwaukee.

Refu’a Sheleima for your father, i hope everything goes well and THE BEST don't get in your way too much.

Ezzie said...

Ah - I'm so sick of "The Best"! I had a very similar situation with my wife's TB specialist, whom turned out to be so good he wanted her to get the wrong procedure done, didn't want her to get a 2nd opinion, and didn't want her as a patient when she said she would anyway. :::grumbles about NYers:::

I've tried to explain to other NYers (such as my in-laws, who are "out-of-towny" NYers) that they need to get off this TB kick, but to no avail. Everything is "TB!!", but I'm skeptical - now, I'm the cynic.

(sorry for vent - just right up my alley with that one...)

Anyways, refuah shlaimah to your father. Hopefully your coming will serve to remind them that someone is paying attention - sadly, in NY, that's how things get done.

What restaraunt? We've got a party at Le Mairre tonight, which I've never been to for a variety of reasons, most of them involving cash flow.

Doctor Bean said...

Have a good trip, and I hope your dad improves.

Dilbert, you'll like this.

When I told my parents I was going into internal medicine, my dad said (word for word, I swear to you) "But isn't neurosurgery THE BEST™?"

PsychoToddler said...

Thanks for all your well wishes. As a doctor, I hate to meddle in a family member's care, but in this situation, I think my obligation as a child outweighs professional issues.

Re: Restaurant: I don't know yet. I asked Fudge to get the name of a good chinese place in Manhattan (I used to go to China Shalom--in the late 80's). But I'm open to suggestion. Something fleishig and something that I can't make myself at home. This will be Sunday night. I'll be with my Mom and daughter.

Of course, if other bloggers happen to frequent the same restaurant...

Steg (dos iz nit der šteg) said...

THIS Sunday?
Dagnabit... this is the second meetup i'm missing this coming Sunday because of this retreat thing i have to go on... grr.

If you're looking for suggestions, a lot of people (including me) seem to like Eden Wok.

Steg (dos iz nit der šteg) said...

Are you still going to be around Monday evening?

Jack's Shack said...

Sorry to hear about your father. I am not trying to be insouciant, but I do wish you the best and a refuah shleimah to your dad.

It is hard to be so far away when a parent is sick, I know because I did it. It sucks.

dilbert said...

here's one for you, Dr. Bean.

After I went into the specialty of #^$^&#&&$, my brother finished his training, and went into the subpecialty of *#^&##$*#$. Upon hearing my brother's plan, my father said(and again, this is an exact direct quote, from someone who I never heard swear before) "great, now we have another shmuck in the family"

Although he was proud of us, I think that he would have been happier if we had followed the path of our grandfather(who was a Hebrew teacher) rather than his own(he was a physician also).

MC Aryeh said...

Definitely, the further removed from NY, the clearer you see that "THE BEST" is usually code for mediocre but expensive.

Hope your dad will be ok.

I actually think the better chinese places in NY are outside Manhattan, but they are quite a trip from the vicinity of Broookdale Hall...

Priss said...

Best wishes for a swift healing to your dad. And off topic, I just linked to you.

http://www.livejournal.com/users/pr1ss/106202.html

Jaime said...

Where I live, there is a well respected local magazine, that every year publishes their top 100 Best Doctors in the region. I made the wrong assumption and thought these doctors really were very good with care, bedside manor, etc based on their listing in the magazine. I was talking with a friend of mine about an ENT doctor we both use and how disappointed we have become. I said "but he on the list." She laughed and said, "you know my husband is a oncologist. You really want to know about those lists. It's the golfing buddies that nominate each other for those list. Pay no attention and just go with your gut." Great advice.

As for nursing homes, my girlfriend's mother has been in one in New Rochelle for over 20 yrs. Supposedly it's "the best", but my girlfriend stills bribes the nurses with "tips" and expensive gifts just to make sure her mother's care is up to at least average standards. She know's that the NH is suppose to be one of TB, but she also knows reality from fantasy. It's very heartwrenching when you need to make the decision to put a parent or relative into a nursing home, but you are making the right choice.

I wish you and your family peace of mind for your decision and I hope you father gets well soon.

tuesdaywishes said...

Up here in the Great White North, the question is not "Is s/he THE BEST?" but "Who can you get?" or even "When can you get in to see SOMEONE?"

Just to be fair, primary practioners here are required to be gatekeepers for almost all specialists,(referrals are required for everything but mental health and ob/gyn) and even so, the ones I've met are caring people with a definite 'whole person' approach. Hey, if they were in it for the money, they would have moved to the States.

Neil said...

Hoping all goes well.

torontopearl said...

Have a safe trip, and refuah shlema to your father. I hope you're able to get some answers and gain some peace of mind when you're in NYC.

I must ask, if every doctor is deemed THE BEST, then who's BEST OF THE BEST?

Stacey said...

I am so glad you are going up there. I have been thinking about your father and hoping he was doing better.

Ezzie said...

Firstly, my wife referred to something tonight as "The Best" - I couldn't stop laughing...

Final grade on Le Marais: B-. Good, nothing special. Hard to hear each other talk, even though the 14 of us had our own little area. Expensive.

Eden Wok's food is very good, but I only ate at their "other" restaurant, and only once.

"The best" Chinese in NYC is actually in Queens on 108th Street and around 64th Avenue, called Cho'sen Garden - incredible food, excellent ambiance, space between tables, and good prices. Worth the trip if you've got a car - the speed of service makes up for the ride.

Mr. Broadway is pretty good, and has just about everything at a good price. But it's nothing you can't get somewhere else, and the ambiance is eh.

If you want to shell out big bucks, Prime Grill is about as worth it as you'll get. Lots of people like Wolf and Lamb too.

Enjoy!

Shira Salamone said...

Thank goodness you're finally able to get to NY to have a first-hand look at your father's medical treatment. I'm sure that's a great relief. As you said, a few posts back, "I haven't written much about my health, or my Dad's health, but the two are closely related." I hope that just being in close enough proximity to make a difference helps take some of the pressure off your blood pressure.

The Punster and I wish your father a r'fuah shlemah, preferably bi-m'herah.

queeniesmom said...

Refuah shelamah to your dad. How silly of you - this is NYC, the best, most important city of all, of course all the drs. are "the best of the best". nothing exists outside of nyc - the old New Yorker posters say so.

you're right TB have attitudes that are in direct proption to their bragging rights. reality is actually an inverse relationship to braggging rights - so go w/TNB and get great care and haimisch drs. they do still exist but won't appear on the cover of any mag.

food suggestions - Estihana (upper west side around 74th and Bdwy) has great sushi and scallion pancakes. food is a mix of various asian cuisines, so it's different from your reg. chines. for something totally different - Colbeh (Persian food Mid 30s near 6th). the food is typical Persian food, meat/ chicken served with rice and grilled tomates. the portions are large and they are use to people sharing the main courses, especially if you order some different salads/hot starters (dolma - stuffed grape leaves are great)first.

Shabbat shalom. Niseah tovah.

Kiwi the Geek said...

Why don't my comments post half the time?

Once, at a free clinic, I had a doctor who heard me screaming with a needle in my arm, and came back in the room to offer comfort. IMO, he was TB, and if I could stand to have men doctors doing sensitive things, I would have made him my permanent doctor after I got insurance.

Dilbert, I can't find your post about medicine. Permalink? Thanks.

Jewish Blogmeister said...

Great post! refuah sh'laimah to your father. I hope to hear better news soon.
I must take up with Ezzie-the cheapest and best chinese in is "Annies Kitchen". They have have 2 locations which is a testament as to how well she is doing. The one on Main ST. is the no frills cheap but great food. The one on union turnpike is fancier with a larger menu. Execeptional chinese however is in Great Neck at Chosen Village. Very nice place and prices are moderate. The best restaraunt in manhattan is certainly "domani" and has great food and service. Prime grill is a close second.Enjoy!

Essie said...

Refua Sheleima to your Dad. I hope the trip is productive. Enjoy spending time with Fudge, too!

PsychoToddler said...

My mother takes out from Annie's kitchen every time we're in NY, and I find the meat to be a little tough and the food a little generic. Maybe it's better when it's fresh.

We used to eat at Chosen Garden all the time before my mom started ordering in. My old drummer's brother owns the place. Great food. But I think we'll stay in Manhattan. Is Eden Wok the one across from Stern? Fudge says it's no good.

Do they have regular Chinese dishes at Estihana? I loooove sushi but I think I'm the only one.

Thanks again for all the well wishes. You can probably tell from my writing over the past few months that I've been under a lot of strain. It's nice to have a "virtual community" for support.

PsychoToddler said...

Current plan is for Estihana, Sunday night between 6-7. But it can always change.

dilbert said...

here is the link to my medicine post(I try not to post links on other blogs unless asked):

http://bavadilbert.blogspot.com/2005/11/state-of-medicine-i-am-trying-not-to.html

Ezzie said...

Jewish Blogmeister - Annie's is AWESOME and cheap. But it's not much of an eat-in restaurant. We used to buy it before Business Law and bring our teacher some.

PT - Enjoy! Tell us how it was :)