A month ago, in the course of having a test in a hospital lab, I incurred a severe injury to my hand -- loss of feeling and motion, three bedridden weeks in the hospital strung up on i.v.'s and other contraptions . . . the works. I am not telling you this to try to break your heart: my hand is still there and intact, and with a couple of months of therapy and medicine it should be workable again. Nor am I trying to establish a case here: the precise reason for my injury is still under discussion and review. But I do feel as though I have just come back from a foreign place worth reporting on, and one visited in the course of any year by many more readers than fetch up in Manila or Riyadh or any of the other spots from which I have felt compelled to record my observations.
This foreign place is, of course, the land of Hospital, a nation -- a universe, really -- of its own, within which one quickly and progressively sinks into the role of patient, analagous in the way it transforms your personality and gnaws at both your assurance and sense of self to being a tourist in an unfathomable, dangerous land.
According to the best figures I can get, not counting psychiatric care, more than 35 million of us spend some time in the hospital every year. I am sure my treatment was atypical, since once a hospital -- any hospital -- perceives that it has an inmate from the dread Daily Bugle in room 604, certain amenities and extra solicitude follow; and I know that even without that I would have been better off than patients with less means than I of looking out for themselves. But even with these advantages there was no escaping the distinctive, essential hospital experience of our times: a maddening combination of individual excellence and systemic incompetence, the one tirelessly and heroically saving life and limb, the other forever putting both at mindless risk.
The hospital is, in this sense, I think, the paradigm of our newly demystified high-tech institutions -- NASA, the agencies concerned with our air-traffic safety, you name it. Our inclination has previously been toward awe, submission, marvel at the wonder of it all and total, uncritical trust in the stewardship of others. The esoteric science and dazzling machinery involved have reinforced a disposition to yield up all authority, independence and judgment of one's own.
Only fairly recently have we been forced to acknowledge that this isn't good enough. In the same building with the state-of-the-art machine that can see your brain and hear your blood are the crumpled Kleenexes and old dressings that should have been disposed of, all lying there under the unconcerned eye of the technical assistant who is thinking mainly of lunch. Beside the sensitive electronic scanner of your transatlantic luggage stands the so-called inspector gazing into the middle distance or diverted by the chitchat of a buddy. Behind the towering Oz-like wonders of space travel nest the tight little bureaucratic substructures that impose their motives and values on people who should know better.
What we know now is not that these institutions are bad but that they are presided over and manned by human beings and that they are at a minimum fallible because the good guys and the good instincts don't always prevail. And we have to help them prevail. In other words, we have to assume responsibility for ourselves in relation to such institutions. We can't just lie back and let the old magic take over. There is no magic.
*This is a lot harder for a very sick hospital patient to accomplish than it is, say, for a layman congressman or business manager who is suddenly called on to assume oversight of a highly technical program. The patient is relentlessly reduced, by both external circumstance (his ailment, traditional hospital procedure) and his own powerful impetus toward passivity in such a situation. The sick person is in fact sort of re-created as a baby. We brighten and decorate his room to cheer him up. We wave gaily colored artifacts before him to make him smile. We send him gewgaws and toys and tricks.
I treasured each one of these offerings as it came in, along with the beloved sprays of flowers. Each attested to a friend "out there" and a continuing existence independent of my strange hospital life. So I had everything stashed conspicuously on windowsills and tabletops. But what was individually gratifying was cumulatively disastrous. By the end of 10 days my quarters looked like the scene of a five-year-old's birthday party. In one of my increasingly infrequent adult moments I noticed this. I noticed that, as with a child who needs to be patronized and humored, we had all taken to talking and thinking of me as "she" -- as if I weren't there: "She is doing better with her exercises now . . . she didn't eat her dinner . . ." etc. I rose up as best I could, being attached to a number of tubes and other fixtures, and commanded the artifacts out of my room. I was in search of my identity and the duty to care for my own fate that it implied.
I had wonderful doctors and nurses and therapists who rescued me, along with some superior hospital staff and administrators. They and their technological equipment operate against a background of remorseless human shortcoming, bureaucratic inefficiency and indifference. That, not some need to understand the exotic equipment or science, is the problem. What is required is a fundamental, painstaking re-education process on the part of a whole institution -- a relearning of attentiveness, individual accountability, care. And something similar will be required to salvage and repair all our ailing technological enterprises. It will be protracted, painful and very slow to show results if it is to succeed -- a little, I am afraid, like the hurting-healing therapist's drill. "Stretch," she says to me. "Ouch," I say to her. "Again," she insists. "You're kidding," I protest. She is adamant -- and she is right: "Harder."