Tips for being a good patient

AVIANO AIR BASE, Italy -- I woke up at 3 a.m. on Columbus Day with hip pain and fever. As a doctor, I know the combination of joint pain and fever is potentially a bad thing, but I still spent most of the day negotiating with myself about going to Pordenone hospital's emergency room. The base orthopedic surgeon was unavailable and clinics were closed for the holiday, so I finally had a friend take me to the ER.

Over the course of the next five days, I underwent a bunch of tests and finally had surgery. Brig. Gen. C.Q. Brown Jr., 31st Fighter Wing commander, checked on me early in my hospital stay and had one sage piece of advice to offer: "Everybody knows doctors make the worst patients, so try to behave yourself." I worked hard to take his counsel, and discovered the following:

1. Pordenone ER is a very busy place, just like any big U.S. hospital. Go there if you have an emergency, but try to avoid it if you do not. Triage nurses will do their best at prioritizing the urgency of your visit, but they will be working with very little information. Use our language experts, which are available to ER patients either in-house or on-call, to ensure the triage nurse has the best information you can offer.

2. "Patients" and "patience" sound the same for a good reason. A lot of my time in the hospital was spent waiting: waiting for rounds, tests, results and then surgery. I could choose to wait patiently or impatiently. Allowing myself to get aggravated would not move the clock any faster, and would just make the wait more unpleasant. I chose to wait patiently and found I was less anxious and annoyed as a result.

3. You don't have to know Italian in order to communicate, but it helps. Tragically, my Italian vocabulary is about nine words, and none of those have anything to do with inpatient care. While some staff members spoke a little English, most did not. In spite of that seeming impasse, we were able to get the point across to one another without too much difficulty. Our liaisons handed out a "cheat sheet" of common hospital phrases, and the rest was accomplished with smiles and hand gestures. I'm sure that it was just as frustrating for the hospital staff, struggling to communicate with me, and vice versa. Good humor, patience and hand gestures will almost always get the point across, aided by the timely assistance of our translators, available on call.

4. Italian medicine does not seem to be in as big a hurry as U.S. medicine. Most U.S. hospital business plans require hospitals to get patients in and out as quickly as possible, since payment is often made based on the illness rather than the time spent in the hospital. Thus, taking time in the hospital to watch the natural history of a disease unfold is often not tolerated in a U.S. hospital, as it could cause a hospital to lose money on that stay. Pordenone did not appear to experience that pressure, which worked out to my benefit. That additional time waiting allowed my doctors to watch my progress, and saved me from an invasive and potentially risky procedure that would probably have been done very quickly in a U.S. hospital.

5. Italian medical standards for pain control are quite different from what we're used to in the U.S. Pain control for post-operation was more of a problem than I would have liked. That's where the "patience" part comes in. You can't bully or harass the staff into giving you more medication than they have access to, so bearing a bit of pain may be required. Pick your own personal strategy to help; I called on my faith for strength, but you may choose a different approach.

6. Family plays a key role in your comfort and support while in the hospital. I had enough foresight to pack a bag before departing for the ER, and I'd advise any potential inpatient to do the same. You will need toiletries, pajamas, undergarments, shower shoes, and even bath towels or washcloths. I received a small bottle of water daily, but did not get the water pitcher, cup and ice combo that we routinely provide at our facility. It's not good or bad, just different, and planning ahead makes sure that there aren't any surprises. When you inevitably forget something, or if you don't pack enough clothes for your stay, call up a family or unit member and they'll take care of you.

7. Hospital food is hospital food the world over. It was edible and contained energy -- that's about it. If your medical condition permits, getting one meal a day brought in from family or friends makes your culinary world spin in a much more positive direction.

8. Ask the hospital staff for help if you get mosquitoes in your room. "Zanzari" (mosquitoes) are a problem in Italy. They get into my house, and they got into my hospital room. Once aware that I had mosquitoes, the staff plugged in a device that reduced the population of mosquitoes considerably. There's no need to suffer in silence.

9. Apply the Golden Rule. This advice is not hospital-specific and will serve you in any interpersonal encounter. If you treat people with courtesy and respect, you will likely receive the same in return. If you are rude, hostile or inappropriate in your behavior, you can expect a defensive reaction, at the least, and a return of your hostility in the extreme. This should go without saying, but it is important enough to use as a closing "tip."

While it's never fun to enter a hospital as a patient, it was very useful for me to experience Pordenone hospital from the inside. I left very confident in the care I received and grateful for their solicitous attention and generous spirit. With some very minor adjustments of my own expectations, I found my experience to be superb, and I can confidently recommend Pordenone hospital to those needing care.