Colemanís 6th Law of Medicine: Hospitals arenít Safe for Sick People

Dr Vernon Coleman

A major study of patients whoíd had heart attacks showed that staying at home may be safer than going into hospital. The patients in the trial were allocated at random either to a hospital bed or to staying at home. The authors of the paper reported that the mortality rates for the two groups were similar. Whatever advantage patients might have had through going into hospital and being surrounded by machines, doctors and nurses, was matched by the hazards of going into hospital.

Before the industrial age, hospitals were built like cathedrals in order to lift the soul and ease the mind. Hospitals were decorated with carvings, works of art, flowers and perfumes.

Modern hospitals are built with no regard for the spirit, eye or soul. They are bare, more like prisons than temples, designed to concentrate the mind on pain, fear and death.

In the old days, nurses were hired and trained to nurse. Aspiring nurses (mostly but not exclusively female) were inspired by the desire to tend and to heal. Nursing was a noble profession. Caring was the key word. The most powerful jobs in the profession were occupied by ward sisters and matrons ó all of whom still had close, daily contact with patients.

Sadly, todayís career structure means that nurses whose desire to nurse is accompanied by even the slightest ambition must quickly move up the ladder to a point where they spend very little time or, more probably, no time at all with patients.

The actual hands-on nursing is done by junior staff.

This is, without a doubt, one of the reasons why modern hospitals are so bad.

In the United Kingdom the number of senior managers in hospitals has risen every year for decades. At the same time the number of nurses and cleaners keeps falling. There are more administrators in hospitals than there are beds, nurses or cleaners. It is not surprising that staff spend much of their time filling in forms while the number of patients contracting serious, deadly infections continues to soar.

Hospitals are designed and built around the needs of the staff. To the architects who design hospitals, to the managers who run them patients are, it seems, something of a nuisance, without whom everything would run far more smoothly.

Signs of administrators at work are everywhere. For example, it is the fashion these days to put carpets on hospital corridors. Naturally, this is dangerously unhealthy (since carpets are far more difficult to clean than other forms of flooring) but at least it means that administrators are not disturbed by the noise of patients being wheeled about.

A few decades ago patients were cared for in hospitals which were run by matrons and ward sisters ó nurses who still knew how to turn a patient, make a bed and empty a bedpan. Many patients cannot, of course, remember how efficient hospitals were in those days and so, because they donít know what to expect or what to look for, they think they are being well looked after.

In many countries, doctors (both in general practice and in hospitals) are now working strictly limited hours. As a result it is rare to see a doctor in a hospital at weekends these days. Patients are left lying in bed all weekend. No one, it seems, has heard of deep vein thromboses or pressure sores. You are between 8% and 26% more likely to die if you are admitted to hospital at the weekend than if you are admitted to hospital during the week.

Another problem is that you are more likely to catch a serious, life-threatening infection in hospital than anywhere else. The great danger is, of course, that you may catch an antibiotic resistant infection. Such infections were predictable (I predicted their development in 1977 in a book called Paper Doctors) and are avoidable (I explained how they could best be avoided in the same book) but as a result of worsening hospital hygiene and the overuse of antibiotics. These resistant bugs are now a significant health threat in hospitals.

Hospital staff seem unconcerned at this even though every incidence of MRSA infection is, like nearly all bed sores and most deep vein thrombosis, straightforward evidence of poor nursing. Even medical records, pens and computer keyboards are now known to be infected with superbugs. Some hospitals have no changing facilities and so nurses go home in their uniforms (taking bugs with them). Most hospitals donít launder uniforms and so nurses have to put their uniforms in with the family wash ó usually at a temperature which will not destroy the bugs.

And then there are the operations.

Operations are potentially dangerous procedures and are best avoided whenever possible.

Surgical deaths in the United Kingdom alone number tens of thousands a year but nine out of ten operations are done to improve life rather than save life. This means that many of the patients who die as a result of surgery didnít need their operations. Little research has been done to find out if all those operations actually do improve the quality of life for the patients who have them.

Another unrecognised danger of going into hospital is that you may starve to death. The food in many hospitals is dire. But there is another danger: the real risk that patients who are seriously ill will not receive the food they need ó however poor it may be.

I have seen patients in hospital unable to feed themselves who have clearly been slowly starving to death.

The problem is simple.

The staff bring round a meal and place it on the patientís table.

The patient is too ill or too weak to do anything with the food.

Twenty minutes later the staff come round again, collect up the untouched food and hurry away with a ĎNot hungry today, dear?í tossed over a shoulder.

The patient, increasingly weak and hungry, simply waves a hand in mild protest and then sinks back into the pillows.

Eventually the patient starves to death. This happens often. Patients in hospital need a relative or friend to feed them if they cannot feed themselves.

The bottom line is that (Colemanís sixth law of medicine) hospitals are not suitable places for sick people.

If you need to go into one, you should try to get out as quickly as you can.

Copyright Vernon Coleman August 2021

Vernon Colemanís book Colemanís Laws is available as a paperback and an eBook on Amazon.