A Patient's Perspective: Acute Care
By Tim Mahoney
My life changed forever on what started out looking like a perfect summer’s day. Little did I know then that July 18, 2011 would become a date that I would never forget. I was downhill mountain biking with a friend in Park City, Utah when I had a catastrophic accident while riding over a teeter totter in a terrain park. The impact from the fall immediately dislocated and fractured my vertebrae at C6 and C7, but otherwise I didn’t have so much as a scratch or scrape on my body. When I couldn’t move either my arms or legs to straighten myself out or get back up, I realized something was horribly wrong, and I knew in that exact moment that my life had changed forever.
Fortunately, help arrived quickly and the only Level 1 trauma center within hundreds of miles was just a short 10 minute chopper ride away at the University of Utah Hospital. After a series of tests, CT scans, and other painful interventions, my wife and I were greeted by a neurosurgeon who confirmed my worst fears. She told us that it was unlikely I would ever walk or have normal function below my chest-high injury level. Within hours of this news my spine was fused from C5 to T1.
I was now officially a quadriplegic.
I spent the next five weeks at the University of Utah’s intermediate rehab unit trying to come to grips with my new situation. Not only was my body irreparably broken, but I found myself in an unfamiliar world of doctors, nurses, clinicians, and therapists that, quite frankly, was completely foreign to me. As somebody who had always been fiercely independent, I was relying upon strangers and family members for literally every aspect of my care.
While the care I received at the “U” was excellent, my home and my businesses are in suburban Philadelphia. With the school year approaching for my three daughters, we needed to get back, and I wanted to continue my rehab at a facility that specialized in spinal cord injuries. After a fair amount of due diligence, my wife and I agreed Magee Rehabilitation Hospital in downtown Philadelphia was where I would continue my care. I was transferred by air ambulance from Salt Lake to Philadelphia in late August 2011, and I would spend another seven weeks at Magee.
My decision to seek out an acute care facility that specialized in SCI was both pragmatic and consistent with my core business philosophy. As a real estate developer, I know the importance of assembling a team of professionals that have the specific knowledge and experience in the type of complex projects I build. When millions of dollars are on the line, I demand – and my investors need to know – that we have the best, most experienced team to execute our vision. Similarly, I was determined and highly motivated to find the very best medical team to help me mend my broken body. I had already accepted the reality of my paralysis, so my goals were fairly clear and realistic. I intended to leave Magee as a highly functioning person with as much independence as reasonably possible.
Shortly after I was admitted, I was greeted by the person who would be responsible for directing my care, Dr. Guy Fried, Chief Medical Officer at Magee. Following a delicious cheesesteak sandwich ordered in by the hospital’s concierge, Dr. Fried returned to my room and began an extensive evaluation of my injuries and current capabilities. Afterward, he gave me a brief outline of what my days would involve, what he would be doing for me, and what I could reasonably expect to achieve during my stay.
Magee has 96 patient beds, and the six-story building has three floors dedicated for that purpose. The third floor is for recent amputees and others with general orthopedic rehabilitation needs. The fourth floor is for patients with traumatic brain injuries, stroke patients, and others with similar cognitive injuries. The fifth floor, which is where I was placed, is specifically for patients with spinal cord injuries. Each floor has its own therapy gym, and virtually all PT and OT occurs on each floor for its specific population. This fact is important since at most hospitals, there is only one therapy gym where every patient with any type of injury is rehabbed, and the PT and OT professionals you see may be different from day to day.
At Magee, I was with people in very similar situations who were dealing with all or many of the same issues and challenges that I was now facing. Likewise, my PTs and OTs were assigned to me for the duration of my stay, and they had extensive experience with SCI patients. Every Monday through Friday, I saw the same two smiling faces of Kelly and Erin who were there to help me get stronger and learn how to use my new body. They became invested in me and my progress and pushed me to expand my capabilities.
Another significant departure from the typical hospital is that Magee encourages its patients to eat in a communal dining room on the second floor. If you are mobile and not a fall hazard, this dining option is available to you. The food was good, and table service is provided by both helpful staff and volunteers. Most importantly, the communal dining provided a valuable opportunity to socialize with other patients and trade war stories. Interestingly, the number one topic at most tables, at least for the SCI patients, was coping with bowel and bladder issues.
I could easily list dozens more reasons why an acute care facility is the best choice when deciding where to go for your own rehab or to place a loved one who has recently sustained a debilitating injury. The hard fact is that our country is in an environment of increasing healthcare costs and lowered reimbursements, and many hospitals, both small and large are adding rehab beds at a frantic pace to capture this additional revenue source. Having experienced rehab in both scenarios, I can objectively say that the acute care facility experience was the best for me. There are many great acute care rehab facilities spread around our country, and I was fortunate enough to live in a city that was blessed to have an institution as excellent as Magee.