I’ve learned a few things the past few years that I think might be of some value to my friends. When I was younger I worried about completely different things than I do now, like whether I am getting enough fiber and if doing crossword puzzles can actually stave off senility. The list below is short–the first item is not funny, but my wish is that you share it with your loved ones, do your research and become empowered to make the best decisions for your healthcare even in an emergency. This one is from the heart big time.

After that, well. Laughter is the best medicine!

In case of a medical emergency…

Many of you either knew my mom because you had met her or because you’ve read any of the countless stories that center around her big heart, personality and zest for life. The end of her life, while at the age of 89 may not have been entirely preventable, was certainly sped along by a fall which resulted in a broken hip which resulted in…her spinal cord accidentally being severed during a routine hip pinning procedure. If you’re WTFing right now, you’re not alone.

I’ll tell you why what happened to my mom is a critical piece of information that may save you or a loved one from a similar fate, but first let me explain why I should have trusted my instincts when the ambulance took my mom to the nearest hospital. Less than a year earlier I had broken my foot and I went to the same hospital—a facility known as an “outlier,” i.e. a hospital lacking Level I trauma verification, usually outside a major metro area, and without a 24/7 staff of physicians who specialize in othro, neuro, cardiac, etc.

“Outliers” basically have an emergency room doctor, although I never saw one even when my x-rays revealed two fractures, but instead I was diagnosed by an invisible radiologist and then some sort of administrator who showed me the x-rays, handed me an air boot, told me to get up and walk out, and to call an orthopedist “when I had time.”

Unable to walk even with the big boot on, I was denied crutches because the “home care boutique” was closed for the night and “we don’t give out crutches for free.” The next day an orthopedic surgeon at a major medical facility told me the air boot was the exact wrong thing for my fractures as it was necessary to keep all weight off my foot so that the broken bones didn’t “displace,” or move around, in which case I would have required surgery with rods and pins.

When the ambulance carrying my mother pulled into the ER at the same outlier hospital, I panicked, but my mom was in a lot of pain and we wanted her to have immediate care–not suffer through a bumpy half hour ambulance ride to a hospital with Level I trauma verification. Because outliers don’t have specialists on premises, an orthopedist had to be summoned. When he arrived hours later the operating rooms had shut down for the day, so my mom was scheduled to have her hip pinned the following morning.

I have no idea why they x-rayed my mom’s head, shoulder, elbow, knee and hip…but neglected to have a look at her back, which she had broken a few years prior and of which they had been made aware, because now we will never know how or why during a routine hip pinning procedure, my mom left the OR completely paralyzed—her spinal cord severed. She ended up being transported to a hospital with a neuro and spine ICU—a Level I trauma center—where she died 18 days later.

Here’s info you’ll want to digest and discuss with your loved ones:

If time and clinical stability allow, go to a hospital with Level 1 Trauma verification by the American College of Surgeons. (Find the nearest ACS verified Level I trauma center.)

In the event of possible stroke or heart attack, time is of the essence and an outlying facility can triage and administer first line interventions to stabilize the patient and then transfer the patient to a major medical center for a higher level of care. The patient (and family) can seek to establish the urgency of proposed interventions (surgery for a broken neck or back, for example) and inquire about transfer to a major medical center. There are sometimes issues of unreasonable distance, cost and insurance authorization that preclude transfer but the more you know ahead of time, when you’re not in crisis mode, the better.

In situations of medical emergency, there are also contributing factors of panic, confusion and fear so open a conversation with your loved ones now as to where you and they wish to be taken in the event of a non-life-threatening condition. For example, my family and I would not, if possible, wish for care at the hospital nearest us. This is important as it gives us leverage in the event I or a member of my immediate family is dazed or unable to speak for ourselves.

It’s also important to recognize that we need to advocate for ourselves and our loved ones. I would be fine with stitches at the local hospital but would definitely not want any significant surgery to occur at that institution. It’s hard to be an informed consumer in the middle of a health crisis, but empowering people to ask questions is a good start.

3 Lessons That Changed My Life for the Better

1. Just say no.

I finally understand the magazine clipping my mom kept on the fridge, held in place by a magnet that said, “Think I’m not a goddess? Try me.” Slightly crumpled and stained red from a cranberry food processing explosion one Thanksgiving, the clipping read, “I learned in my 50s that ‘no’ is a complete sentence.”

A friend asks, “Can you pick up the food, drinks and decorations for Fido’s barkday party tomorrow? I have a conflicting nail appointment.”

“No,” you reply.

Your friend will narrow her eyes to slits and it is possible her lip will curl, but you must stand strong and refuse to utter another syllable even if you are asked, with great incredulity, to repeat yourself. Understand that once you add words you are opening the door to some sick and twisted rabbit hole of negotiation out of which there is no escape.

“I’ve got so much to do tomorrow,” you make the grave mistake of offering.

“But you said you love my Fido,” she accuses, pointing at your head with what appears to be a perfectly manicured forefinger. And you’re sunk. But just say “no” and leave it sitting there like a dead trout and there is literally no rebuttal. Let’s practice, shall we?

Woman in your kid’s carpool: “I know it’s late notice, but will you please bake 500 cupcakes for tomorrow?”

You: “No.”

Awkward silence during which you mentally recite and repeat a recipe for the perfect margarita.

Her: “Uh, okay. I guess we’ll find someone else then.”

You: “Great.”

So simple.

2. You will never change someone’s mind about religion, politics or sex.

 “I believe god to be a rabbit, I believe Candidate Happy Pants to be the finest person alive, and I believe a girl can get pregnant by jacuzzi water.”

No matter how many facts in your arsenal, you will not convince this person that god isn’t a furry mammal, Candidate Happy Pants is batshit crazy, and the only way to get knocked up by jacuzzi water is if there is a man named Jacuzzi Water.

Your only options for recourse are to walk away (and in my case, delete my Facebook account) or change the subject, careful to avoid anything climate-related. Safe topics include favorite colors, kittens and lawn care.

3. Trust your instincts.

Every single time I second-guess myself it results in unmitigated disaster. If only I’d have gone with my gut when my first two husbands proposed—and shook out the bed linens before hitting the hay in the cottage on Spider Lake.

For some reason we have “evolved” to the point of basic stupidity. Cave people sensed danger and hauled ass in the opposite direction. What do we do? Talk ourselves out of it.

With enough love, time and money I can turn a deadbeat into a functioning member of society (and a darn fine mate). I’m sure they named it Spider Lake because it’s shaped like a spider, not because the place is overrun with arachnids the size of badgers.

Several years ago, I was travelling in Europe with my cousin Colleen. We had just boarded a flight from Prague to Rome when a Middle Eastern gentleman glanced out the window and started shouting in Arabic at the luggage being fed into the plane on a conveyor belt.

Certain pieces of luggage really got him going and all I could think was that he was fixin’ to meet his maker thanks to something he had packed, and that I was utterly unprepared to die.

“That’s it,” I told my cousin. “We are outta here.” I asked the flight attendants to let us out. We were informed the jet way had already been removed, at which time I became, shall we say, hysterical. The jet way was reconnected and we were escorted off the plane.

We took a train to Rome (for some reason no one would sell us tickets for another flight). On the train three men got into the compartment with us, covered their faces with kerchiefs and that is all I remember until Colleen and I came to and discovered our purses and cameras were gone. The ladri di treni (I learned the Italian for trainrobbers while the polizia grudgingly made out a report) may have taken our travelers checks and cameras, but they had not gotten away with our suitcases, and do you want to know why? Because, thanks to my finely-honed instincts, our luggage was on the other side of the country, on a carousel at Rome airport.

There’s no telling why the man was so excited to see his baggage being loaded onto the same plane as he. Perhaps he had flown Skywest Airlines in the past. We’ll never know. Instinctually speaking, however, my gut is never wrong and we were eventually reunited with our dirty laundry, an array of shoes that we packed but never wore, and a stinking package of prune kolache that had turned by the time we claimed our suitcases.

Happy New Year! Wishing you magic, joy, peace, love, happiness and laughter in abundance.

Loves ya,

Pam

(As you know, as of midnight tonight I am off Facebook, so if you like the blog I’d appreciate it if you’d share with your friends.)

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