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My Husband’s Death Showed How Medical Supplies Are Wasted
You don’t need to be affected by coronavirus to see how inefficient the system is.
By Diane Brady April 7, 2020, 12:00 PM EDT
Nothing to spare. Nothing to spare. Photographer: Miguel Medina/AFP/Getty Images Diane Brady, a former senior editor at Bloomberg Businessweek, is the founder of dB Omnimedia LLC. She is the author of “Fraternity” and co-author of "Connecting the Dots: Lessons for Leadership in a Startup World.”
Read more opinion Follow @dianebrady on Twitter A few weeks before my husband died on March 7 at the age of 55, the oxygen arrived: a concentrator for everyday use and a backup tank in case of an emergency. That Barry had never struggled to breathe in the 10 months since being diagnosed with cancer didn’t seem to matter. Once he went into hospice, our living room was stuffed with pieces of equipment, a cornucopia of drugs, diapers, wipes, gloves, masks and whatever else the agency felt he needed to die comfortably at home.
Unfortunately, what he really needed was a level of pain relief that pills couldn’t provide, and care from professionals who could move him without damaging his brittle bones. So my husband spent most of his final days in a single room in the hospital that serves our neighborhood in Brooklyn before leaving to die peacefully at home.
In some ways, Barry’s timing was impeccable. He entered the hospital as news of the novel coronavirus was entering public consciousness in the U.S. and died just days before New York City went into full crisis mode. That meant he could vacate a hospital room and give back ventilators that would soon be in short supply as the number of Covid-19 cases mounted. It meant my children and I could hold a hug-free memorial for him with friends before retreating to our home to do our part to stop the spread of the virus. It meant he was able to die in his sleep from cancer instead of from septic shock or acute respiratory distress brought on by the coronavirus.
But caring for my dying husband also drove home the system’s inefficiency and waste. Among the unwanted possessions that were bequeathed to me after Barry’s hospice stay were an unused commode chair, a shower chair he’d used twice, a bedside table, packages of ventilator tubing, unopened cartons of fentanyl patches and painkillers, boxes of nitrile gloves, masks and numerous other products that hadn’t been touched. Other than the bed, wheelchair, oxygen tank and concentrator, I was told to throw everything out. The hospice wouldn’t — couldn’t — take any of it back. I now understand how waste costs the health care system up to $935 billion a year, according to research by Humana Inc. chief medical officer William Shrank and colleagues that was published in October in the Journal of the American Medical Association.
If Barry were still alive, there’s a good chance that oxygen equipment would still be in our living room. Who’s going to take it away from a dying man, even if he doesn’t need it? We could have refused the machines, but their presence seemed to suggest that breathlessness was as inevitable a part of dying as losing the ability to walk. (The wheelchair lay unused, too.) That said, in the current environment, giving equipment to a dying patient on the off chance it could have some palliative benefit might mean it’s not available to save another person’s life. I find myself wondering how many other home hospice patients have machines sitting at home that could be put to better use. How many other masks, gloves and other supplies are piled up in the homes of people who don’t really need them?
Even with a terminal illness, it's hard to predict how we'll die. This time last year, Barry thought he had injured his back after yet another bout of double-black-diamond skiing with our kids. It turned out to be cancer of unknown primary that had spread to his bones. From the start, his prognosis was dire and his pain was debilitating. While his doctors at Memorial Sloan-Kettering kept him alive through radiation and immunotherapy, and his nurses helped with managing pain, it was a lonely battle with an inevitable conclusion. Coming home from the hospital, he'd greeted my suggestion of full-time care with the same raised eyebrows as when the oxygen machines were rolled in: It felt like too much. He just wanted what he needed and no more.
In health care, that's typically not the American way. Having grown up in Canada, we used to joke about all the procedures that came with an annual physical south of the border. Even as he approached death, my husband was bombarded with stuff. Amid this unprecedented pandemic, though, U.S. doctors and health care officials now face tough choices in doling out treatment. As they seek more resources and equipment, we need to take a hard look at how the current inventory is being deployed.
Wars are won through shared sacrifice, tough choices, and the courage to do the right thing. Ideally, they also lead to changes in policy and behavior to avoid repeating the same mistakes. Just as fighting the coronavirus has cleared the air in New York and the canals in Venice, perhaps it can help us see more clearly the cost of other choices we’ve made.
This column does not necessarily reflect the opinion of Bloomberg LP and its owners.
To contact the author of this story: Diane Brady at [email protected]
To contact the editor responsible for this story: Tobin Harshaw at [email protected]