Searching for Hospitality at the Hospital

At NYU Tisch, disease may be cured, but patients are not healed.

Crossword puzzles and manicures to keep mom feeling less depressed in the hospital.

We had been in the ER for nearly 36 hours when my mother and I left that dungeon of horrors and were admitted to the medicine floor at NYU Tisch. I was so relieved. We would get proper care, more quiet, less chaos, and serious, thoughtful attention. How happy we were. Also, how naive. 

The hospital is an interesting construct. It is a place you go when you are sick; to be diagnosed, to be treated, to get better. The reality I found was this: a hospital may save you from disease, but it doesn’t save you. The disease may be gone, but in the end you’re so battered by the process and the gruesome nature of hospital care that you might be better off sick. Particularly if you are an 87 year old woman who cannot advocate for herself. In my mother’s case, her hospital stay was the beginning of her wish to die. 

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Over 10 excruciating days at NYU, my mother was slowly cured, but she was also left to rot. Let’s put aside the cause, whether a function of overworked nurses or understaffed hospitals. We were at a private hospital —NYU Tisch — paying lord knows how much (the bills still have yet to arrive) and were treated like we had walked into someone’s home uninvited and made to feel like intruders, stray dogs, not guests. 

My mother was completely incapacitated while she was at NYU; she was in constant pain, incontinent, and disoriented. The nursing staff treated her not only with indifference, but with what amounted to disdain; they seemed genuinely disgusted and put upon to be called upon to help change her, to care for her, to make her comfortable, to respond to her basic needs. 

There was eye rolling at most every request: “My mom needs to be changed,” or “My mom has not had her PT,” or “My mom needs water with a straw because she is too weak to lift her cup.” I was made to feel like a burden, like a nasty splinter to be rooted out. When the nurses did finally come to my mom’s room to change her, they rolled her over like a hog on a spit, swiftly pulling the sheets from under her as a magician might pull a tablecloth from a under set table. 

My mother, who is a retired nurse, was in pain; her joints were frozen from being immobile for so many days. They did not care. She was crying out: “Stop! You’re hurting me.” But they did not stop. They ignored her. There was no pity, no kindness, not an ounce of decency. There was no dignity in what my mother was going through, to be laid up, for days and days, crapping herself, and to be treated with such callousness. It was another level of heartbreak. 

Photo by Kenny Eliason on Unsplash

The doctors were slightly better, though getting a visit on rounds was about as easy as getting a reservation at Carbone. I stalked them in the hallways, wrangled them to her bedside, and made sure she was their priority. I was there all the time; I felt if I left, she would suffer even more.

Spending every day in the hospital was not easy. I nearly missed Eiji’s freshman final dance performance, and I had to see Sam’s 5th grade Food Truck project on FaceTime. I lost a new freelance job because I could not make the meetings. I felt like I was breaking apart, being pulled in two equally powerful directions: my kids, whom I missed and felt I was letting down, and my mother, suffering in the hospital, withering away. I didn’t feel like a sandwich as some folks describe this generation of ours who are caring for young kids and older parents simultaneously. I felt like a human mozzarella stick being pulled apart, stretched thinner and thinner, fraying more and more by the day.

Thankfully, a few days into our stay, mom’s doctor declared she was ready to be discharged. I was happy, but also suspicious. Mom was still in a lot of pain. How could they be sending her home? 

“No, her colon is clear, she can go home,” the doctor assured me. “The pain is just residual from the heavy laxatives.”

The next morning when I arrived, a new doctor was on the floor who seemed utterly shocked that I thought my mom was leaving. 

“She’s not going anywhere,” he told me. “Her kidney function is terrible and her colon still has a 7cm blockage.” 

I pointed out that the doctor from the previous day had said her colon was clear and that the transport team was on its way to take her to the assisted living I had furiously arranged for her. 

“She cannot leave. If you take her home, you will be back here tonight.” 

“Okay,” I said. “We will stay.” 

My Mom heard this and started screaming: “TAKE ME OUT OF HERE! I WANT TO DIE! GET ME A GUN!!! I WANT TO KILL MYSELF.” 

We stayed for five more days. I did not get her a gun. I did not assist in her quest to die. I calmed her, made her laugh, spent every minute I could with her to try to lessen the misery that was her life, and assured her we would be leaving soon, that everything would be okay. But I had absolutely no confidence that it would be. 

As the days went by, and the care team continued to treat my mother like she was already a cadaver, I thought a lot about the words hospitality and hospital. Interestingly, both take their root from the Latin word hospes, which means host, guest, stranger, or visitor. 

Both words speak to the relationship between guest and shelterer, but hospitality came to be known as the act of “entertainment of guests or strangers without reward or with kind and generous liberality,” according to Webster’s Dictionary, while “hospital” evolved to mean a place providing shelter for the sick and infirm.

How ironic I thought. Here are two words born of the same root, but somewhere along the way, “hospital” lost its compass.

In the restaurant business, we are taught a very different, very proactive form of hospitality. We are taught to take care of our guests; there’s almost this sense of reverence and honor around the notion of service, to create an environment of shelter, a place where the world stops spinning and finds balance. 

In Front of the House, we are taught to observe body language, to watch how the table is interacting, to pay attention to hundreds of little details so that guests’ needs are met before they even realize they exist. Hospitality is not only an art, it is a beautiful gift given to guests. 

Hospitals, in my experience, are quite the opposite. They are empty vessels where humanity is hollowed out and filled with billing cycles, insurance codes, and administrative bureaucracy; where vital signs are monitored with military regularity, but patients are never really seen, where staff assesses health without heart. The racket is shameful—a gross violation of a duty to care, the Hippocratic oath, and of all the foundational imperatives of hospitality. 

Photo by Hush Naidoo Jade Photography on Unsplash

Here’s a small thing: my mother’s hospital meals were kosher and therefore hermetically sealed, wrapped up with impressive amounts of impenetrable plastic. To open the meals, you needed scissors or very strong fingers. My mother had neither at her disposal. 

When I arrived that first day, I found her in her bed unable to reach her food or her water (even though she was horribly dehydrated and her kidney function was rapidly declining).

“Mom, why isn’t your lunch tray near you so you can reach it? And why isn’t it opened?” 

She said the orderlies were not allowed to open meals for patients. They could only serve the food; not ensure the patient could actually eat it.

“So how are you supposed to eat?”

“I don’t know. I called the nurse for help, but she didn’t come. They never come when I call.”

So my mom just sat there, inches from her lunch, riding through horrible waves of cramps, unable to eat it or drink anything. They pumped her up with saline to help with her kidney function, when they could have just taken the time to make sure she had access to water. They could have helped her open her meal.

These “rules” baffled me, but also the fact that human beings with hearts and minds were walking around these halls ignoring the call for basic needs: food and water; I found this to be nearly inhumane.  

We did make it out of the hospital, but where we went next, to “Rehab” was even worse, and I didn’t think that was even possible. But that tale is for another day.

In the meantime, I’ll end with this. Back in 2014, Danny Meyer consulted with a healthcare company in an effort to infuse hospitals with his “Setting the Table” philosophy.

Now his consulting business, Hospitality Quotient, is launching a new e-learning platform for a broader audience, called HQ+ so that customer-facing businesses like airlines, nursing homes, or hospitals can access HQ’s training curriculum aimed at providing “enlightened hospitality.”

NYU Tisch, at the very least, should be getting in touch so that the relationship between hospitality and hospitals can be seriously and immediately developed. Because medicine is only part of the equation; a person cannot be cured by treatment alone. A person — someone’s mother, father, sister, brother, son, or daughter — must be able to have dignity, to be respected. They should not be ignored, brushed off, made to feel small and ashamed, like a burden or a nuisance.

Without embracing hospitality, hospitals will remain in the business of treatment, but they will never be in the business of healing.