Price of Life


I can’t explain it—trying to find the right words is just boring sometimes—but during flights, I think the most. The engines create sort a vacuum in my ears as if they want to deafen me from reality, the cramped seating forces me within my own boundaries and no one else’s. That stillness of the horizon is daunting, even if we are flying at a blazing speed, nothing seems to happen as though the rest of the world has stopped, until we land. Then we realize the world hasn’t stopped; if anything, the world turns faster the very instant we forget about it. Nonetheless, flights are moments in which I ponder.  

 

Day in and day out we are told that life is valuable. We are told every single breath is cherished and we should live each moment like if it were our last and-if we think about it—it’s fine to believe just that. But what if someone told us that we have to pay for life? That every breath is a quarter, a dime, or a dollar? It sounds unfair, right?

 

Well, it is unfair but it’s also true. At any moment in life, especially when you have been to the doctor, you have paid for life. Be it the comfort of knowing there’s nothing wrong with you or being told the worst news of your life, you’ve paid for life or the lack there of.

 

I’ve just left a tropical paradise, where the major distributors of a said brand—which we’ll call Pacifair—were called to promote the growth of entire Pacifair line. Amidst white-sand beaches, crystal clear waters and the two most dangerous words—open bar—, we are told that we are the fuel that moves the Pacifair engine. The product Vice-president even flew all the way from New York to be with us.

 

And that’s great! There’s nothing better than knowing that the company actually supports and believes in us. That’s not the chip on my shoulder.

 

We are given the schedule, the bracelet indicating we are over 21 is placed on our wrists and then we are told: “you’re free to do whatever you want, just as long as you make it to the different conferences.” Everyone nods and flies off to the sand, the pool, the ocean and the bar.

 

Everything is going great at this moment. So great in fact that no one wants to actually go the conference rooms when it’s time to do so—I understand it, though. Can you imagine someone from Pennsylvania in this tropical oasis? Of course they want to enjoy every minute they can.

 

Alas, it’s time to learn, it’s time to see why it is that Pacifair is important.

 

The instructors usually all begin the same way: with the principle or theory behind the product. In this line of work, most products come from doctors who look for ways to improve their methods. It is very probable that the improvement comes because:

a) Someone died,

b) The machine is too cumbersome or slow or

c) The previous method is considered risky and no one wants a death on the résumé.

 

Now, that’s not to say people don’t want to innovate, they do, but most of the time, innovation comes from mistakes. Mistakes in this medical world are costly. 

 

A bit of history is provided about the mind behind the invention. What really happens is this: The doctor designs a system and looks for a manufacturer to help him create said device. The manufacturer is either interested or not and if they are, they invest a heap of money and science minions to develop the product with a tiny detail that’s patented by them and boom! The price tag on whichever unit they sell is sent skywards.

 

Many companies, just like Pacifair, are always in the lookout for this (to the point in which they have hired doctors as consultants) and why not? He or she is a talented healthcare professional whose opinion is praised (companies don’t go after just any quack), looking to develop a machine that will either save money, time or both. Oh! And human lives as well but that’s secondary.

 

A machine that sells high, saves time, money and lives? Bingo.

 

Just as long as there are patients to use these products on, which is why conditions that are individualized and random usually don’t call for development of technology. It’s just too expensive for one person.

 

After the history, comes the theory. This is usually my favorite part because I’m interested in how things work. Being an engineer, there’s always a part of me questioning everything: if it fails, what happens? If it slows down or speeds up, then what? If I make a mistake, will it kill the patient? I ask these questions with a scientific point of view. Others ask them as well but with a commercial point of view. If something happens to the patient, the patient might die. That’s another life lost and probably a lawsuit. Money, once again.

 

The theory of operation is brief when I believe it should be the most extensive. Anyone related to the machine must understand it. If not, how would they explain it to the potential customer? Coincidentally, the theory part is usually the shortest as sales reps usually don’t care about it. They care about making bucks.

 

The slides are read in just minutes and the topic shifts to the commercial aspect. Who do I sell to? Who do I talk to so that I can convince them to buy this product? If the doctor is not the big boss, then must I talk to the twenty-three-year veteran nurse? Well, yeah, you should. You should also take some donuts and coffee while doing so. We all should if we want to make a sale.

 

In this section, all the possibilities of a sale are highlighted point by point, and the reps get all excited. They start imagining themselves talking to different doctors, convincing them of the greatness of this product, how it will save lives with a better infection control, lower operation times, improve scarring conditions and so forth. All great but perhaps all too equally great.

 

Finally—and this is usually the most entertaining part for me, as a viewer, not as a rep—the competition is explained or should I say dissected like a lab frog?

 

Why is this my favorite part? Because it shows how cutthroat everyone is willing to be for that extra sale. Pacifair’s competitors could only wish they knew the amount of units have been purchased by spy doctors just to be handed to the hands of Pacifair’s eager engineering minions to dismantle, test and review. Then all the flaws, like an ex-girlfriend being analyzed by a mother-in-law, are highlighted to us, the reps, so we can kick the competition in the shin.

 

Within the competition analysis, all points of attack are valid but patient safety is usually the most frequently scrutinized: all data regarding lawsuits, incident reports, deaths, injuries and all those sour events are sought after like gold. There’s even a website!

 

Using scare tactics is very delicate as with anything in this line of business. Once, a sales rep from another company told the doctor that the competitor’s product was harmful and his was better. The patient ended up dead because of poor instruction by the sales rep. 

 

The patient, however, is not really that important. It’s only his or her safety. Just look at this: if the patient has a better survival rate with Pacifair’s artificial heart and this product is more expensive, the price is justified, right? If Pacifair’s bionic kidneys are ideal because they never get damaged and all patients with them have survived AND they are cheaper than Mikotanabe’s brand, then it’s a win-win situation. Patients become numbers, numbers translate to money and money is what everyone is after.

 

So, as the conferences end, everyone’s excited. Reps are excited because they know their products can be easily sold with evidence. Money can be made. The company is excited to see the sales force excited. Money will come to them. Engineers are excited because more machines mean more work, which means more service fees. And everyone is excited because the beach is just yards away. So is the bar.

 

And, as the sun sets on the tropics, I board my plane knowing that in about one or two years, I’ll be returning here to get another boost of motivation to keep selling. I’ll probably see different faces, perhaps I won’t, but I know everyone will always look for one thing: to make money out of two things, life or the lack thereof.

 

 

**NOTE**

 

I understand that, as we are raised in a capitalist point of view, everything has a price. Everything included our health: if we want it faster, we pay more. Still, in Costa Rica, that will not necessarily mean better.

Little lumps


Little lumps all around. They are connected to machines, heartless machines that are the only source of life. With a beep comes a heartbeat, with a pump comes a breath. They look around but find no one. Little lumps all around.

It’s cold, it’s white, it’s gray. There’s nothing else to it but that.

Little lumps all around. Their black eyes filled with innocence stare at me quietly, expecting me to do something. If only I could pry those cables off, take them home and give the childhood they deserve.

Little lumps all around and they don’t deserve to be here. One cries, another one gets startled and for one second, does absolutely nothing. Then he remembers he is scared. Does he remember his mother is not around, his father is probably a worthless rapist and the humans around him won’t look at him with a kind gaze? They will make sure he survives and is sent off to a troubled life. He starts to cry. They all start to cry. I smile inside. They’re still alive.

Little lumps all around. Pale, scared, lonely.

God, I hate visiting the children’s hospital.

Biomed’s rule number 1.

Biomed’s rule number 1:


When I first got here, my superior told me one thing: it’s all about the machine, it’s not about the patient. When you work, you don’t look at their faces, you don’t talk to them, you just get in, fix the machine, and leave. It seems to be an interesting rule of thumb but I rarely obey it.

It just seems a bit unfair.

Why ignore them when they can have just ten minutes of company? After all, many of them have nobody, not even a distant relative that comes to visit them.

I regret ignoring that rule from time to time.

The Challenge: Introduction


Hello,

This is a brief introduction into a very interesting challenge placed in front of me just yesterday. For you to understand the challenge, I must explain the origins first. I am a biomedical engineer, I work in and out of hospitals, and I despise them. The mere thought of getting up in the morning and feeling that stench–a combination of bleach, blood, sweat and other unnameable bodily fluids–brings me just a bit down. Why do I do it? Because, no matter how much I try, I can’t bear the thought of having someone else do the job and do it badly.

After all, it is life we are dealing with.

This story begins one Saturday morning, when I got a call to deliver a much needed product to the hospital. I wasn’t supposed to get the call, they just couldn’t reach my coworker. Diligently I drove to the office, got into the warehouse and climbed up a ladder to the fifth level, approximately thirty feet off the ground. I wasn’t grumpy, I wasn’t displeased, I was just in a hurry.

That was the mistake.

I got the equipment, four small boxes, so I dropped them to my coworker, a nurse fortunately, who quickly stowed them away in her car. I then placed my feet on the ladder and, for just seconds, everything stood still. (Cliché, I know, but that’s what I felt). Then, like a fast forward button, the ladder decided to move, with me on top. Turns out Isaac Newton was right, there is a law of gravity.

I hit my shoulder first, I clearly remember, and it popped out immediately. I lost grip, my right arm didn’t respond. My body swayed backwards and my neck hit the edge of the fourth level. I bounced forward and my chest hit the third level–at that precise moment, I ran out of breath. I then bounced backwards and hit the middle of back with the second level.

I fell on my butt and bounced, only to land on my back, completely flat.

I couldn’t move. I couldn’t breathe. I couldn’t think of anything else but walking again. I tried and tried but for one and a half minutes I could not move my legs. My coworker rushed to me and the rest is a bit of a blur, until I got to the damned x-ray machine. The cold surface sent chills up my spine, my breath was quick and almost ineffective, and my entire chest seemed to compress.

“Don’t move, we don’t know the extent of the damage on your spine,” the doctor said. And so I did. I didn’t move. While the machine took more and more x-rays, I looked up to the ceiling and wondered: is this it? Is there anything else or am I not going to move my legs forever more?

That, people, is the worst feeling I’ve gone through: to be completely unable to answer a question as simple as: am I going to walk to the bathroom tomorrow?

Minutes seemed eternal. I could hear them speak–I believe a resident was there, all excited because he was getting an exciting case–whispering and I’m pretty sure they turned to me and analyzed every inch of my body as if I were a freak. The big-shot doctor walked over to me and looked down straight into my eyes.

I’ve never been so nervous in my life.

“You’re fine,” he smiled, “you’re just banged up.”

And here I am. What’s the challenge, you ask? I want you to try and guess it.

Welcome to the Hospital of Life


Greetings!

This is the Hospital of Life. What began as a journal (for lack of a better word) turned into this blog.

A basic question is: what do you think of hospitals? I work in hospitals, in and out of them. And I hate them. I work with healthcare professionals, I see them almost daily, and I fear them. I work with life, I sell it, I try to save it and most important of all, I cherish it. I’m not a doctor, nor a nurse, I’m an engineer who sees health from a different point of view.

The names and brands in this blog have been changed to keep people’s identity safe.

Cheers!