Updated: Jan 27
Below is a letter that I wrote to the CEO of the hospital that my friend died in. It won't bring him back as he had a very bad, aggressive #cancer that was untreatable. However, it is not OK how he was left in the hospital's care. It is not OK that he suffered. It is not OK that I had to go there and raise my voice to get attention and make threats to not leave until someone got the doctor in charge. I don't look for trouble but somehow it finds me and I will not ever stop fighting for those that can't or don't understand how to fight for themselves. You too have this ability. Please don't ever give up.
Dr. Thomas Koobatian
21 Elm Street
New Milford, CT 06776
January 8, 2022
Dear Dr. Thomas Koobatian,
I'm writing you to tell you about a patient that was in your hospital in December. Mr. Paul Swing was transferred to New Milford Hospital from Danbury due to Covid overflow (or that is what his family was told). Paul arrived via ambulance on December 3rd at approximately 5 p.m. I didn't know he was injured or ill at the time but was made aware that there was a problem on December 2nd as there was a Duchess County wellness check, and they came to the wrong house (he was my neighbor). He didn't answer the door when they knocked, and another neighbor went in to check on him after they left and found a very sick and ill man. Thankfully his team at Nuvance from Vassar made the call when one of the care team members became alarmed at a conversation she had with Paul, and he did not show up to an appointment. Thank God, she acted. The following day I called Paul and convinced him to go to the emergency room because he said he "fell." After looking at him, my other neighbor told me that his leg was in terrible shape.
My husband and I helped EMS get him out of his home and into the ambulance. He was yellow, and his leg was four sizes too big, and he had cut his pants up the middle to fit. He also could not put a shoe on his foot. I gave the EMS all of my information about his condition, his doctors at Vassar, and my phone number because Paul was very alone in this world. While he had some past demons, he had nothing but would give you the shirt off his back. He lived in a home without heat or hot water. He relied on neighbors, the town, and a barter system to exist in a world where he was left behind. He got hot meals from donations. We found a can of soup in his kitchen that someone gave him that he tried to eat out of the can cold before I found out how sick he was.
He was failed by many and didn't deserve it.
Why am I writing you? I did not think putting Paul into the ambulance that afternoon would be a one-way trip. Unfortunately, what I thought was a leg injury was much worse. He had an aggressive, untreatable cancer that was in remission from 2020 but was back for vengeance like a wildfire. Because I am not vaccinated, I could not see him right away because of hospital visitation rules. I understand this to a point, but I would not let my friend fight alone. I got tested twice during his treatment at Danbury and New Milford Hospital in order to see him. I went to see him on December 12th. I found an alert, cognitively intact man excited that I brought him a donut. We spent a couple of hours talking, laughing, and I even got the nurses to get him up in a chair, and he was thrilled to be out of bed. While his prognosis was grim, he still had life, a smile, and was not crying out in pain. He wasn't ready to give up the fight, although I think in my heart of hearts, he knew that when the doctor told him he would probably not make Christmas, he knew it was true. He was a very smart man with a history of bad luck and life challenges. On December 15th, a family member called me and said that Paul had had an awful night. I immediately dropped what I was doing and headed over to the hospital. My Covid test would expire, and I knew I needed to get there.
I found a completely different person than I saw 72 hours before. I found a naked man in a diaper that was sent to Danbury to get a drain put into his stomach the day before to drain ascites. His belly was full of it. Cancer had dug in its hooks bad. While I know he had very aggressive cancer; his family was unaware that they were sending him to Danbury to get a drain and then returned to New Milford. Under normal circumstances, this should not be an issue if his facility could not relieve the ascites, but he was in unbearable pain when I found him. He did not have his glasses on, so he could not see. He was cognitively confused and defeated. I saw a man crying out in pain from cancer and the surgical procedure he had the day before and was getting no relief. This is the same man I saw put breaks on a friend's car just months before laying in a bed of rocks in his driveway with an old jack solo. I got a nurse immediately, and she told me he was on PRN pain management ("as needed" or "pro re nata").
He could not see his glasses on the table next to him, nor reach the call bell and he kept taking the blankets off of himself because he had the "urge" to go to the bathroom even though he had no IV hooked up and a DNR sign on the door. He was left to die. His urge I had seen before with my mother who also died of cancer, and we both know the ascites in his abdomen will do that, and even if the patient is NPO or not taking in fluids if they are awake, this urge is constant because of the fluid sitting on his bladder. If I told him once, I told him 100 times in the four hours that I was there to "just go," and I pretended he was in the bathroom so he would not be so "worried" about getting up to go to the toilet which was a walk he would never take. He was too weak and incoherent. Why wasn't he on any fluids? His next steps were to go to hospice when something became available, why wasn't he kept comfortable?
I asked the nurse to contact the doctor or hospitalist because this was unexceptable and my friend was suffering. My God, was he suffering. I have never in my life seen a human being suffer more. The nurse told me she had put in calls to the doctor as a family member had inquired to, and there was no response. I told her that I was not going to leave until I saw his doctor, so to please keep calling, and she agreed. The nurse also saw him suffering, but her hands were tied. After about 3 hours, a PA came into Paul's room and said he was on PRN meds. I asked her if she was looking at him and "open her *&^%$! eyes." I was angry as I had been holding Paul's hand for hours while he tried to get out of bed and get off of his side that had had a drain put in the day before. His body was writhing with pain. He could not get relief in ANY position. He was not "due" for pain medication or benzodiazepines, so he lay suffering. After a tense discussion, the PA ordered IV pain medicine, Dilaudid. I asked her if this would have the same effect as morphine on the central nervous system because I knew by looking at him the end was near, and she said "yes." I didn't want my friend to die, but I didn't want him to suffer more. Roughly 3 hours after I arrived in Paul's room, the nurse hooked up his pain medicine. Within ten minutes, he was sleeping with his eyes open, and I knew time was short for my friend. I could tell by his breathing, and, unfortunately, I saw the beast.
My question to you is, why did Paul have to suffer? Why did nobody care enough about him to see he was suffering and not capable of ASKING for pain medicine? Why did it take me, racing over there to fight for him? I know I was not a welcome guest at one point as one nurse got close to his face and repeatedly asked him “who I was” because they wanted me out of there." I knew it because I have been there before. He was confused, and his body was continuously squirming because of his pain, and said, “I don’t know. I answered for him and said, “I was his daughter.” Maybe he was not confused at that moment because we joked about it just 72 hours before, and he knew the “code word.” That was the lucky answer, and she stopped asking him. I am not. I am just a friend, neighbor, human being that cares.
I understand that everyone in healthcare is tired, overworked, stressed, and quite frankly, some have severe mental illness from the last two years of Covid. I honestly have empathy for many of them. I, too, was a patient fighting for my life in October of 2020 from an unrelated illness, and one of your trauma doctors saved my life, and I'm grateful. But, you need to understand that what I witnessed on December 15th was not. It was not OK for Paul and some of the nurses trying to help him those hours before he had proper pain management. It should not have taken anyone to come to the hospital and demand that the doctor shows up in his room. It should not have taken the pharmacy almost three hours to deliver the medication. It was as clear as day that he was suffering. He was not quietly suffering; he was crying in pain and unable to hit the call button that was not even near his reach, along with being unable to see with his glasses off on the table next to him. The next evening Paul passed away. I didn't want to lose my friend, but suffering was far worse. When I left the hospital that evening, I knew it was probably the last time I would see him.
My letter is to let you know that this happened. I won't list names as you can check his records on who was on call during these days. I'm requesting that you follow up with those involved and tell them that no human being should suffer the way Paul suffered.
While the system may be stressed, I walked the floor the day I left, and for every patient, there were two empty rooms, so his floor was not at capacity. Please thank the nurses who worked on December 15th because they understood and were united with me to get help for a suffering patient. I understand that the system is far from perfect and that a person who has aggressive cancer can turn for the worse very quickly, but if they do, we need to do everything we can to reduce their suffering.
What if I did not get that call? What if I did not go? How long would he have stayed in such a state of pain and suffering?
I would be happy to answer any questions about what I witnessed that day. I know it is not easy today to run a hospital, but changes will not be made unless stories like Paul Swing's get to hospital leadership. I hope you will do what you can to reduce the next patient's suffering, and if they are in grave or guarded condition, have the doctors in charge of approving medication check in a little more and be readily available.
Your nurses have their hands tied and are on the front lines to the patients. They can only advocate so much as they are on the same payroll as their management and doctors.
Feel free to contact me at any time regarding the above letter. Thank you for your time.