The sun was shining through the window on my last day in the hospital, beckoning me after a nine-day hospital stay. My wife was nervous about my leaving the place that had diagnosed me, protected me, and cured me of coronary artery blockage due to undiagnosed coronary vascular disease, a life-threatening condition
While the hospital did a phenomenal job in correcting my condition, giving me wonderful nursing care, providing me with post-op wound-care instructions, and giving me dietary recommendations, not one minute was spent discussing with me possible feelings of anxiety and actions to take.
“Come on, the worst is behind us now,” I said to my wife optimistically.
In the ensuing days after my discharge, she was glad I had come home. We were looking forward to settling back into our day-to-day routine of work and spending time together with our dog.
While she still had a vestige of concern, which manifested in making sure I followed post-discharge wound-cleaning instructions and not over-exerting myself, she was feeling better now.
I was not so lucky. Yes, I had no long-term effects from my stay; actually, I had a better-than-expected outcome. Getting back to work was a relief, and becoming productive was satisfying. But soon, I realized I was not myself. My demeanor was nervous and anxious, which led to a new, troublesome personality, and which I became aware of after the now-infamous coffee shop incident.
Our local coffee shop is the “chillest” place in our neighborhood. Just walking in is relaxing, knowing you will soon drink a great cup of java. On that now-infamous day, two new employees who were college-age women were working. I bought coffee for me and my wife and expected to have points added to my account in the frequent-buyer program. The new employees forgot to give me credit for my purchases. And I yelled at them! Everyone in the shop got quiet and stared at me, including my dog, who was in my wife’s arms.
We left the shop, and my wife asked me, “What made you yell?” I had no answer. And even though a short time later, I apologized, the damage was done.
My anxiety worsened. My conversations with my wife often ended with ill-tempered, snarky comments. In addition, I began to not sleep well and developed what I called the “what if” syndrome. What if I died? What if I never saw my wife again? My kids? My dog? My immediate family?
The following anecdotes are a few ways that anyone can get beyond anxiety that may occur during the transition from hospital to home. First, recognize what is causing your pain, by seeking help from family, friends, and professionals. These types of communications can help create a path for self-healing.
Reach out to those who are close to you. In my case, this included my wife. While others in my family were quite helpful, she bore the brunt of the day-to-day medical developments and was there with my children to help advocate for me. But what was most difficult for her was being alone in our apartment, wondering if we would continue on our life journey together.
While thinking of others in the depths of your anxiety is difficult, try to understand that your hospitalization had an impact on them too. Oftentimes, only patients are thought of, and not their caregivers. If possible, an empathetic back-and-forth conversation is therapeutic.
My Columbia University classmates helped. When I asked a physician colleague how he responded to patients who expressed irrational concerns, he suggested they use meditation and acupuncture. More importantly, he said if you think an irrational thought is rational, that is when it needs to be addressed. This statement gave me a sliver of relief.
The next instance of classmate assistance occurred at a Columbia school conference. I was speaking with a classmate afterward about the discomfort with my anxiety and future concerns for a second procedure. She in turn shared with me the discomfort and, yes, pain associated with having a baby in the hospital. After we finished talking about our respective hospital experiences, she paused, looked me right in the eye, and said, “You need help.”
So, I got help in a few ways. I made an appointment with Columbia Mental Health Services. In my case, it took only one visit because, unbeknownst to me, I was on my way to overcoming my anxiety through empathy and compassion.
First, I began helping others by writing a letter to a relative, urging him to look at my situation as a warning regarding his own health issues and to get his act together.
The second instance occurred in my coffee shop (you know, the chill one). There was a man with his dog waiting to get coffee, and I noticed his shoelace was untied. I said, “Your shoelace is untied.” He said, “I know, I have back problems and will tie it when I get home.” I said, “I know this will sound weird, but I don’t mind tying it for you.” He looked at me, sat down, and with great discomfort tied it himself.
Another instance that brought the cause of my anxiety into focus was during a conversation I had with a friend of mine who is a psychiatrist. He listened to my story and said, “Nothing happened to you.” I said, “What?” He repeated himself. I repeated myself. This went back and forth for a few minutes. Finally, he said, “You had no heart damage.” This was an epiphany to me.
And yet, despite the important mental breakthroughs, I still was not myself—until a chance meeting with an intravenous drug user. Through my work, I have spent time on vans in Upper Manhattan that help drug users with many of their life’s challenges. In one visit, I met a woman who was on her way to rehab. We were talking about our respective hospital stays, and she shared with me the stigma she had experienced.
I thought to myself: While medical reimbursement rates for patients are different, nobody is being treated for free. And unless she was cursing and throwing full bedpans at the staff, she was entitled to nonjudgmental patient care.
So right there in that van, I decided to give a lecture to intravenous drug users on how they can empower themselves in the hospital. A few weeks later, at a neighborhood church, I gave a short talk to a group of 15 people on how to get the hospital care they deserve. In the days that followed, my anxiety diminished, and I gradually felt more like myself.
Overcoming anxiety that occurs during the transition from hospital to home does not lend itself to a “one size fits all” approach. You can overcome this difficult situation by sensing personality changes, listening to those you trust, and seeking the help of mental health professionals.
- “Patient experiences of transitioning from hospital to home: An ethnographic quality improvement project,” Journal of Hospital Medicine. May 2012. journalofhospitalmedicine.com/jhospmed/article/127082/patient-experiences-hospital-discharge