Serial Killer Fruit

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Allergies, like so much data collected on medical visits and admissions, are checked off, put on a bracelet, and then filed in an uncaring computer. Usually, a diligent pharmacist or nurse will notice drug allergy data, but what about food allergies?

Yes, I know; you put your food allergies on the form. Do you think someone actually reads those answers on the forms? A few years back, I filled out a form that asked  Sex _____ (meaning gender.) I wrote “No, but willing.” Didn’t get any action on that one, and I’m guessing most of what you provide goes unnoticed and unused. A couple of times, it nearly cost my husband his life. He had numerous hospitalizations, procedures, and ER visits, and the fact is, he needed someone at the bedside 24/7 to guard him. Exhausted, worried family members should not have to fear taking a break, but the truth is they should be fearful. If a nurse and a communications professor cannot get important information across, heaven help the rest of you.

I worked in a busy hospital. I am more than sympathetic to the frenzied pace and high demands on staff, so when my own family encounters a problem with service, I strive to approach calmly, (at least on the first 4-5 tries.) Medical people can be pretty obnoxious as family members, so I almost always urge improve the system, not worry about what happened to us. This approach has been effective, at least until the Serial Killer Strawberries episodes.

“You gotta have a CABG. Now.” We were not in the produce section looking at cruciferous vegetables. We were in the cardiologist’s office, and he was sending my husband off to have triple Coronary Artery By-pass Graft surgery –a CABG–in our small community hospital. “Now,” he repeated.  Three of the four major arteries carrying oxygen to the heart were clogged and needed to be reamed out or replaced.

CABG is not a minor life experience. Some or all of your heart must be stopped while new vessels are grafted on and nasty ones removed. I was a nurse. I knew it was serious. Still, nothing could have prepared me for the sight of my husband in ICU. For one thing, the nurse had to tell me that it was my husband. He was flat on his back and immensely swollen with fluid. I counted twelve IV bags hanging around the head of his bed. The man had tubes in every natural opening on his body. He also had tubes in some openings they had created just for this occasion. Some fluids were going in and other draining out. His chest had been split down the middle like a roasting chicken, but ever cheerful, he opened one eye and said, “That was fun.”

He tolerated some ice chips, then water, and now it was time for a treat. A young man came shuffling into the bay, his long hair was smashed inside a white hair net. He plopped a little tub of red juice on the overbed table and turned to leave.

“Wait!” I said. “What is that?”

“Juice,” he said.

“I meant what kind. He’s allergic to strawberries. Very allergic.” I pointed to the red wristband that said so.

“It’s punch. I don’t think it has any strawberries,” he said, reassuring absolutely no one.

“Willing to bet my husband’s life on that?” I asked, trying to quash my inner nurse.. “Could you check on the ingredients?” He decided to take it back.

He was probably right: fruit punch likely has no fruit of any kind. But, this was not a minor itchy allergy we were worried about; this was a throat-closing, hives-like-pizza-sauce allergy. It was deadly. Once my husband tested it out in case it had gone away. (He was not a scientist.) He touched the very tip of his finger to some strawberry cream cheese and then to his tongue. Pink as Porky Pig within minutes.

Soon, our enthused servant returned and placed a bowl of Jell-O on the table. Care to guess what color? I grabbed the little tub and headed for the kitchen. The dietary office was down some basement hallways past the morgue and rooms with nuclear warning signs. The only person in the kitchen said the dietitian was not there. I said I’d wait, and when she did return, I explained my concerns.

“I’ll make sure his record has his allergies,” she said and headed toward her desk.

“It’s all over his records and on his wrist band, which was not checked, by the way.” I told her I was not there to get any individual in trouble, but wanted to know what they would do to prevent this from happening again (maybe to someone without an armed guard at the bedside.) She had no answer and looked aggravated.

“If my husband had an allergic reaction which stopped his heart,” I asked her, “how do you think CPR might affect those vessels newly stitched to his heart muscle?” There was no response.

Two days later, I arrived at lunch time and my husband held up a white bowl. I didn’t even need to look. I thought about the TV ads telling us how this little community hospital was so caring. Caring and murderous, as it turned out.

My husband survived his CABG and the equally dangerous dietary service and was discharged. I wrote a long letter to hospital administration. It was not strident, but asked how they would fix their system. I pointed out that had he been alone, confused, sleepy on anesthesia, had dementia, or been a child, he might have eaten those berries. Again, there was no response.

Two years later, in a state far away, in a larger community hospital with a top-notch reputation, my husband was being prepped for an outpatient heart procedure. I taped a sign to his bed indicating his allergy. The nurse gave me a “duh-we got that covered” look and pointed at his allergy bracelet. He did well during the procedure and recovery, so I went home to catch a little sleep. They brought him strawberries a few minutes after I left. I talked to the dietitian who had been taught to listen attentively and appear concerned. She must have skipped the afternoon session at that in-service, the one about actually solving the problem after one listens.

On to a fancy private hospital for a hip replacement. The room and menu rivaled the best New York City hotel. This hospital was top o’ the line, so it took a full two days to serve the strawberries.

Soon thereafter we had an ER visit. The nurse asked if my husband wanted a snack; he’d been there several hours and was diabetic. I told the nurse about our experiences with strawberries, and we all shook our heads. He ordered ice cream. The little cardboard container arrived within minutes. Who even eats strawberry ice cream? The nurse returned, took one look, and was horrified. They decided to admit my husband that day and while they packed up his things, I took a red felt tip pen and wrote “Allergic to Strawberries!!!” right across his forehead. This surprised the nurse who admitted him upstairs, but it was effective. It continued to be effective long after discharge; turns out it was a permanent marker.

Back to the previous hospital for a serious heart issue. This time, I took a roll of paper about ten inches high and wide enough to span the doorway to the room. I wrote in 6-inch high red letters “NO STRAWBERRIES. ALLERGIC! VERY.” I drew some berries as a border. I taped it across the doorway at eye level. Doctors, nurses, and visitors had to limbo their way into my husband’s room. His first lunch was served by a tall young fellow who ducked under the sign and placed a silver dome on the table. Like a fine waiter, he whipped off the cover. There sat a fist-sized strawberry, pressed into his pasta. I pointed it out. He said, “it’s just a garnish.” I ripped off the sign, picked up the berry, and started out of the room. As I exited, I heard my husband say, “Uh oh.” I passed the nursing station at a good clip, holding up the berry and the sign. To my surprise, several nurses said, “Go get ‘em!” I gathered they had an on-going beef with dietary.

Again, to the basement. (Perhaps they should bring these people up into the sunlight.) The receptionist said the head dietitian was in a meeting and would be done in an hour. She nodded toward a conference room across the hall.  I walked right that room holding up the sign, then the fruit. She started to blame the poor guy who had delivered the tray.

“Seriously? He’s in charge of vital allergy data and quality control here in dietary, not a professional dietitian?” She abandoned that tactic. When I returned to the floor, the head nurse suggested I call a patient representative.

The patient rep was terrific. Within a few weeks, she called and caught me up. She had presented our experiences to hospital administration. She met with dietary from top to bottom. Later, we received a detailed letter on actions that had been taken, including omitting strawberries as a garnish, since many people are allergic.

Weeks later, I called a national organization for dietitians and detailed our three-year fruit war. I asked if there were people doing research on managing allergies, on hospital system breakdowns, on communication about food allergies, staff training, etc. They said no. I did not believe them. I said surely there were grad students in dietary programs looking for research projects; how might we suggest this topic to them? The response was utter disinterest.

There are wonderful, responsible, knowledgeable people working in medical institutions. But, I am guessing many of them would not leave the bedside of a friend or relative. I know I wouldn’t.