Connections: On the Mend

When my last column went to press, my husband, Chris, was a patient at the Lahey Medical Center in Burlington, Mass. The good news is he is now in a rehabilitation center in Waltham, Mass., and his treatment is well underway. Although Chris’s doctor has informed us that this four-month course of chemotherapy will be no walk in the park — and that it might be six months or more before Chris regains his full strength — the good news is that his form of lymphoma is a very common one, and this particular treatment has been standard for 45 years. The outlook is excellent.

Leaving the hospital for rehabilitation was anything but simple. We do not have a plethora of “acute rehab” options here on eastern Long Island, so it was evident quite soon after we began our search that Chris would be extending his stay in the greater Boston area, and that I would be clocking a lot of time on the Cross Sound Ferry.

Many rehab centers that, in theory, accept patients on chemo, in practice avoid doing so. The job fell to Chris’s brother Bob, who happens to live in Massachusetts, and me to take a sort of tour to have a look at those that do. We spent a long day visiting and trying to evaluate each thoughtfully.

All of these centers, in Massachusetts as well as here in New York State, rely on Medicare funds, and as the day went on, the idea of health care equality was prominent in our thoughts. 

Even if different centers receive the same amount of money from Medicare for a given patient, the treatment he or she finds from place to place is anything but equal. The facilities we toured were widely diverse. 

The head nurse who showed us around the first was sullen and unsmiling. It was a small, institutional building with neat grounds, but the patient rooms were below ground and had few windows. The main physical-therapy room was small, and the young woman we found working there confided that the place was under new corporate management. It was not up to scratch.

The next center was old but modernized and huge by comparison. We were greeted at the entrance by two men in wheelchairs who looked at us with what I interpreted to be hostile thoughts. Physically, this facility — with its tiled hallways and slanted walkways — was attractive enough, but we saw hardly anyone out and about.

How is one supposed to judge a medical facility as a day visitor? 

I looked for pleasant environments, apparently adequate staff, and, principally, whether staff or patients smiled as we said hello. The breakthrough didn’t occur until the next morning; the last place on the list got high marks. 

Finally, we had found what we were looking for. It was of modest size, with attractive single bedrooms and pullout couches for loved ones to spend the night. A staff member told us she had worked there for 30 years. Everyone smiled. One of the first people we met was the facility manager. He was changing a lightbulb because the maintenance man was out shoveling snow. 

Poking around in these rehab centers came as something of a shock: Some patients, clearly, are getting much more for the government’s dollar than others. One thing was clear, and that is that there is a grave need for more comprehensive oversight of how taxpayers’ money is being spent.