Orwell wrote about all the important human experiences possible, including youth, poverty, begging, jail, politics of course and various aspects of society, recounting both his stealing and his police work, up to executions, war, etc. One of his most poignant testimony is in the hospital, with an Orwellian title that summarizes it all: How the poor die. Having myself spent quite some time lately in this environment, I found it entertaining throughout the long hours I was contemplating at the walls in front of my bed and at the various people occasionally crossing through, to compare my own experience with what Orwell immortalized at the beginning of the last century. This text is available as such or with illustrations, some of them being unceremonious and possibly troubling, so click with care.
The first difference, and it is a welcomed one, is that the fitting title of Orwell that captured the condition of the 20th-century society, would be outrageous nowadays. Although I have been convinced by Audrey Vernon that we, common people, are still poor, and that I have also crossed death's path during my stay, my experience is much more mundane and unimpressive. I have, however, spent considerably more time so I have had time to acquire more experience, observe recurring patterns and start to grow the familiarity of one's natural living environment. Although I will mainly focus on personal anecdotes, I will try to identify what remains true and what has evolved. Orwell being such an insightful and deep observer, there is surprisingly much which remains true.
My treatment was in a Spanish hospital (La Paz), while he was in a French one (Hôpital Cochin), and just as he did (more so in his other bibliographic segments), I will retain the original spoken expressions (hovering over will offer an English translation). The most obvious observation that remains true to this day, and which is certainly familiar to anybody who had to deal with the medical environment, is the de-humanization of the patient, who becomes a sort of product or raw material which is being probed, molded, investigated, queried, experimented upon and sent back and forth between various services as if in a factory chain. In Orwell's perspective that contemplated death as a possible if not typical exit, this took a much more pronounced character and one can see that, nowadays, there are many efforts made to provide a humane interaction between those who are in pajamas or gowns and those who are in hospital uniform. Still, it remains true that
My father died in a hospital, and although it was in my arms, it will remain forever a stain in my soul that it couldn't happen in his home, as he requested. The medical staff judged that it was enough little time left to save them the bother and possibly expenses. My father did not want to be hospitalized for what would be his last visit there, which we did not know by then but that he had guessed. In this case, in 2006, it would have been better to keep out of the hospital, which the family's obedience in an illusory medical power overruled. A stain in my soul.
In Orwell case, he recounts how the patient would be exhibited to a company of colleagues and students and his case discussed in his physical presence but devoid of any concern for his humanity and dignity. Nowadays, certainly as a result of a positive evolution in this matter, some care is taken by the medical staff to devote some personal time to the patient, if only in a vacuous protocol of superficial preoccupations: que tal esta?, como se encuentre hoy? Most of the time it is apparent that there is close to zero interest in such exchanges, that conversations are kept to a minimum, that the doctor is already on his way tiptoing backward towards the door with a drift proportionally increased as the patient's response shows signs of elaborations. The typical exit door consists of pero eso es normal, eso no nos preoccupa demasiado or a ver como eso va a evoluar, in reply to any concern or interpretation by the sick of his affliction. Obviously, doctors have little time to enter into discussions, but for one thing, this shows again how the illness more than the ill is what matters. For another thing, it seems instructive to gather various people's description or sentiment of how they perceive what science otherwise describes in colder and more technical terms. Medicine is far from an exact science and much is probably to be learned from the variations as they manifest or as they are perceived. Finally, it is not always obvious that time is so precious. Often visits are from couples, triplets and occasionally from an entire horde of people, and certainly it would be better to focus more attention from a single doctor than a perfunctory visit of a group of three. Also, in one case where a high-end surgeon was waiting for something to be brought to attend to me, she spent this time looking at the random TV program which the neighbor had put on, instead of talking or listening to me. So while it is clear that some effort is made to bring some human interactions between the two sides, it seems more part of a protocol and duty than a natural inclination to bother for one's fellow being. Also, I have observed from the sample of my own experience enlarged by that of 15 neighbors, that more attention was given after the operation than before, both with respect to medical procedures, which might make sense, but also in terms of personal interactions. Visits are more frequent, more lengthy and exchanges more elaborate and caring. This could be a mixture of the already mentioned personal familiarity with the greater interest in how one's job did turn out over the condition of someone .
I have little evidence that patients were systematically in greater needs of care, either physical or psychological, after rather than before surgery.
As an example, the food would come with a little menu printed indicating the callory content and the type of diet. If it would be your birthday, the menu would come with a Feliz Cumpleano felicitation.