Knowing full well he was overstepping his bounds to a degree, Brian went to the door to the chart room and pushed it open. Instead of being full of charts as he was expecting, the room was made up of countertops and computer monitors. Dr. Raymond and several other people were busy entering data. The only noise was coming from the keypads.
“Excuse me, Dr. Raymond,” he called out self-consciously. “Could I please have a word?”
To Brian’s relief, she immediately stood up and came to the door. Speaking in a whisper, she asked what he needed.
“I’ve just heard my wife is being discharged,” Brian whispered back.
Dr. Raymond graciously stepped out of the chart room, allowing the door to close.
In contrast to Maureen, Dr. Shirley Raymond was rail thin and imbued with a nervous energy. “Yes,” she said. “I was informed of the discharge plans this morning.”
“So, this wasn’t your decision?” Brian was surprised to learn that she hadn’t been involved in the order.
“No, it wasn’t. It’s apparent to me that Emma still has an active viral infection. She also seems to be somewhat drowsier and more confused. And, as far as I know, neurology hasn’t finished evaluating the spasticity that’s emerged.”
“The current plan is to send her to Hudson Valley Rehabilitation Hospital.”
“Oh, I didn’t hear that,” Dr. Raymond said. She shrugged. “That will work, I guess. She should be under a seizure watch since the encephalitis is still obviously active, and they’re capable of doing that at Hudson Valley. Although, if it were up to me, I’d keep her here in an acute care facility.”
“I was told she was discharged by a Dr. Graham. Do you know her?”
“Of course. She’s one of the kingpins around here.”
“Is she a good doctor?”
Dr. Raymond laughed nervously. “That’s a strange question. Yes, I guess she is a good doctor.”
“To be frank, I’m a little worried. Do you think there is any chance that finances influenced the decision to discharge my wife?”
She shook her head. “No. That’s not how we practice medicine. There must be a valid reason Dr. Graham gave the discharge order. Perhaps it’s to free up beds for the expected Covid-19 surge.”
“That’s reassuring coming from you. Well, thank you for talking with me and thank you for taking care of Emma.”
“You’re very welcome. And good luck. I’m afraid you are in for a long haul with Emma. EEE is a persistent illness.”
“Yes, I’ve gotten that impression,” Brian muttered and turned to return to Emma’s room, significantly more confused and daunted by these conversations than he was expecting.
Chapter 9
August 27
It was just after two in the afternoon when Brian walked out of the Hudson Valley Rehabilitation Hospital and paused on the steps to regroup. He was feeling out of sorts. It had been a stressful morning. Emma had resisted the idea of leaving MMH Inwood, but there had been little he could do, and it was true to an extent that MMH wasn’t doing very much in terms of therapy. It was also true that Emma had not had another seizure since the one in the Emergency Department, so maybe the need for seizure monitoring was less important. Plus, the term “rehabilitation” had a nice ring to it as far as Brian was concerned, and he hoped that there would be more opportunity for Emma’s walking difficulties to be addressed. But that was before he had seen the hospital.
During the admission process, Brian again had to sign papers giving the name of their insurance carrier and committing to being responsible for all charges. Knowing what he did about Peerless, it was obvious he was accepting even more debt despite having no possible way to come up with the money he already owed.
And if all this wasn’t bad enough, Hudson Valley Rehabilitation Hospital had been a disappointment. In sharp contrast to the renovated MMH Inwood, the building was aged and shabby, especially Emma’s room. And worse still, the number of patients per nurse was significantly higher than at MMH, meaning Emma probably wasn’t going to be receiving a lot of seizure monitoring or monitoring in general. Luckily she seemed oblivious to the nature of the hospital surroundings and had fallen into a deep sleep almost immediately after she’d been put in her bed and her vital signs were taken. The transfer procedure had been stressful for her even though MMH had arranged an ambulance service, and she had been moved in and out of both institutions on a gurney. The ambulance ride itself had been only fifteen or twenty minutes, and Brian had been able to ride with her.
From his perspective, this whole experience of Emma contracting a disease that he had never heard of from an innocent barbecue had been a rude awakening. As a conscientious hard worker who followed the rules, he’d always felt reasonably in control. Now it was the exact opposite. It was as if he and Emma had been poised on a precipice and didn’t know it, and now that Emma had slipped off, Brian and his family were only holding on by their fingertips. To make matters worse, he’d never had any inkling that the cost of a week’s stay in a hospital could potentially upend his life thanks to an unscrupulous health insurance company. It seemed criminal that he was now almost two hundred thousand dollars in debt and counting.
Pulling his phone out of his pocket, Brian made a quick call to Aimée to let her know that Emma had been moved and to ask her to let Emma’s mother know as well. He then passed along the current visiting restrictions and requirements. Toward the end of the call, he experienced a sudden and unexpected surge of emotion, bringing him almost to tears.
“Are you okay, Brian?” Aimée asked, detecting a catch in his voice.
“This is all more stressful than I could have imagined,” Brian managed after a pause. He’d not shared any of the financial problems with his mother, nor his worry that Emma might have been discharged from MMH because of the bill. “I hope this Hudson Valley Rehab Hospital works out.”
“I’m sure it will,” Aimée assured him. “I’ve had a number of friends who have been hospitalized at HVR, and they did well. It’s not the Ritz or even MMH, but the staff is friendly and caring.”
“They better be, or there’s going to be hell to pay.” As quickly as his surge of emotion had appeared, it metamorphosed into anger, and he was reminded of his planned visit to the Peerless Health Insurance offices. “Mom, I’m sorry, I’ve got to go.”
“Okay, dear,” Aimée said. “I’ll let Hannah know that Emma is situated at HVR, and we’ll plan out a visiting schedule. You get home and take care of that darling daughter of yours. She needs your attention, too.”
Brian disconnected the call, eager to make the visit to Peerless. The question was: How to get there? With his anger ramped up and wanting to get it over with quickly, he decided on the subway. From Inwood it was by far the fastest way to get to Midtown Manhattan.
Ten minutes later he was on the A train thundering south, and as he rode, he thought about the hospital bill that Roger Dalton had emailed to him and that he’d glanced at briefly on his phone while waiting for Emma to be discharged. As Roger had suggested, it was mostly incomprehensible and in code similar to the ED bill, but there were some bits of it that were perfectly understandable and that riled Brian to no end. One of those was an outlandish charge of $970 for a supposed “physical therapy evaluation session.”
From the date of the service, Brian distinctly remembered the episode. A young, bouncy, and very friendly woman had appeared at Emma’s bedside, gotten her out of bed, and proceeded to merely walk her up the corridor exactly as he had done fifteen minutes earlier. Another was a thirty-dollar charge for a single ibuprofen tablet that Brian had requested for Emma on that same day when she complained of a headache. From Brian’s perspective, if such charges were representative of the entire bill, the whole thing bordered on being absurd, if not out-and-out fraud.