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Critical Conditions
Martine Ehrenclou

August, 2008 on BlackGospel.com
Book Review by Jennifer F. Belot

France boasts the best overall health care system in the world, based on a 2000 ranking by the World Health Organization. With its universal healthcare coverage and municipally run system, the healthcare network ensures that all its citizens are afforded an equal level of care without regard to social class or financial ability.

The United States, on the other hand, is ranked 37^th overall in that same detailed report. In a medical system run by private industry and conflicting agendas, the best interests of the patient are sometimes regrettably overlooked, in order to achieve the bottom line, financial success. The culprits are not the doctors, whose oath requires that they “first do no harm,” but rather in the privately run insurance companies, pharmaceutical giants and politicians who’ve all staked out an interest in the profit-driven healthcare system.

Having herself been a victim in the labyrinth of a misguided, though well-meaning American healthcare system, Martine Ehrenclou, M.A. has written Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive. Borne out of necessity, the idea for this book came after the author experienced what she believes was the unnecessary demise of both her mother and her godmother at the hands of an overloaded and occasionally inept healthcare system.

This book is by no means an emphatic doctor-bashing recount; instead, it is a matter-of-fact analysis of the American health care system and a simple step-by-step way of averting seemingly avoidable errors. The author herself states more than once that she believes that health care professionals are doing the very best they can; however, the inherently imperfect system makes errors virtually unavoidable. After over 150 interviews with nurses, doctors, social workers, and other hospital staff, Ehrenclou repeatedly arrives at the same conclusion throughout the manuscript, “you must have someone, a family member, in the hospital with the patient at all times. Hospital care is in crisis.”

In 17 concise chapters, Ms. Ehrenclou writes from a patient-focused approach, which encourages family members to be proactive and vigilant in the care of their loved ones. The author does not purport to have all the answers; however she does bring very informative and helpful suggestions on how to compensate for overworked doctors and nurses, who are physically and emotionally spent. The author provides critical suggestions to potential caregivers, in an era when patients-to-nurses ratio is at an all-time high, despite laws implemented in many states to counter this troubling trend.

Critical Conditions puts a decisively strong emphasis on communication strategies and avid documentation. This book simultaneously acts as a handbook, a diary of patient progress, a procedural manual, and a conversation reminder for the reader. The 80-page Quick Reference Guide at the back of the book contains a section for notes, a glossary of hospital terminology, and a list of useful websites for further research. It is an essential tool for anyone with a loved one in the hospital. Why, you may ask, is such a guide important? The simple truth is that a sick person under heavy medication and debilitating pain cannot have the presence of mind and fortitude of will to advocate for themselves against professional healthcare representatives.

This book is separated into three essential parts, the first of which is the informative introduction, which teaches family members how to be effective advocates by equipping the reader with a deconstructed breakdown of the hospital system. She explains the importance of taking detailed notes and provides space in the book in which to do so. There are two whole chapters dedicated to explaining the roles of the different hospital staff, from the primary nurse to the specializing physician in the care of patients. Her pragmatism is bold and intelligent, as she states in one instance that since it is proven that attentive and present family members garner better care, then one should bring cookies and candy with a thank you card for the nursing staff to show your appreciation.

Three chapters are dedicated to the prevention of medical errors, tragic falls and infectious diseases such as pneumonia and MRSA, all of which are alarmingly prevalent and more or less avoidable in the US system of healthcare. According to the Institute of Medicine, “A hospital patient can expect, on average, to be subjected to more than one medication error each day.” Thus, an attentive family member will take all the precautionary measures listed by Ms. Ehrenclou to avoid being just another statistic. Some common sense advice, such as wash your hands and avoid transferring bacteria from inside to outside and vice versa may seem redundant, but bear repeating because, as healthy human beings, we can sometimes become insensitive and carelessly forgetful of the simple things.

As Critical Conditions emphasizes a patient-focused approach, the last eight chapters of the book are dedicated to the patient and their family. With useful guidance on such issues as cultural differences, language barriers and what to do if you live out of town, this book gently guides patients and their families in the right direction to maximize care and well-being in a time of emotional and physical crisis. It also includes a section on how to best utilize the services of the hospital social worker and how to not only support and care for your loved one, but also how to take care of yourself in this time of trial. The sensitive issue of what to do and the options to consider in the instance of critical care is also addressed with informative captions on HIPAA Laws, Advance Directives, Power of Attorney, Living Will and DNRs.

What I love about this book is its positive outlook and appeal to the readers, as blatantly captured in the subtitle, The Essential Hospital Guide to Get Your Loved One Out Alive (notice that last word). And so, the last chapter, Discharge Planning and Aftercare, focuses on what to do after your loved one has made it through.

Hosea 4:6 says “My people are destroyed for lack of knowledge.” This powerful word is reiterated by the author who says in lay terms that the “...greatest antidote to a state of helplessness is knowledge”. When your loved ones are lying in a hospital bed, will you simply let medical care happen to them, or will you be a knowledgeable, educated, proactive family member, firmly equipped with the tools to accompany your fervent prayers for the healing touch of Jesus?