Editor's Note
A Healing Place
This past Memorial Day weekend, exactly one year after he had been admitted to an intensive care unit with MRSA sepsis starting a six-month slog through hospitals and nursing homes, my father-in-law, Stanley, drove with my wife and me to Copper Harbor, Michigan. Sitting at the tip of the Keweenaw Peninsula, which juts into Lake Superior like a dorsal fin, Copper Harbor is a sleepy, unspoiled hamlet where, in the 1930s, Stanley and his father, with some CCC workers, built a log house eventually named Rocky Ledge. Except for a few years during World War II, Stanley hadn’t missed a summer at Rocky Ledge until last year when he was sick. Having made a near-miraculous recovery, he wanted to get back to Copper Harbor more than anything. Stanley had lived in Chicago for most of his life, but Copper Harbor was really home.
My wife and I had major reservations about leaving him 400 miles away from us for three months. He was still a little shaky on his feet. Would he fall? Here, he got at least one prepared meal a day. Would he keep himself fed? He mostly kept track of his medications, but would he do it when we weren’t looking over his shoulder? Saying goodbye on Memorial Day, we feared getting a call the next day but hoped that home would work its magic.
Modern medicine has been slow to acknowledge home’s near-mystical power. In the second half of the 20th century, as technology took over the practice of medicine, patients spent more and more time in institutions, first getting catheterized, CTed, and CABGed in hospitals, then traveling to nursing homes for recuperation. Few patients recovered at home and even fewer died at home. But in 1984, the advent of DRGs encouraged hospitals to chase patients out sooner and sooner, and, suddenly, making home more recovery-friendly became a priority. Since then, the home health industry has boomed with more and more medical professionals delivering more and more complex care in patients’ homes.
Home health care works for patients because they can stay where they are most comfortable and build relationships with the nurses and therapists who visit them. It works for hospitals as it’s an escape hatch for patients too sick to live independently but not sick enough to qualify for a skilled nursing facility. However, it may not work for payers, and studies are still equivocal about whether home health care decreases hospitalizations and thus saves money.
And it is not ideal for physicians. Fielding phone calls from home care nurses and signing faxed or electronic orders, physicians supervising patients in home care at times feel like they’re punching buttons on a remote for a television they can’t see. Telemonitoring may promise a high-tech answer for some physicians, giving them virtual hands and eyes to examine patients, but it likely won’t match the power of seeing the patient in the flesh. That is one of the reasons house calls are experiencing a renaissance. Seeing the patient face to face in the home environment provides physicians with a wealth of vital clinical and personal information, and staying at home allows patients to soak up its healing vapors.
Stanley returned to Minnesota at the end of August, having thrived at Rocky Ledge under the watchful eyes of folks in Copper Harbor. He stayed healthy, gained weight, and hosted 25 family members for his 90th birthday. Home is good therapy.
Charles R. Meyer, M.D., editor in chief
Dr. Meyer can be reached at
cmeyer1@fairview.org