[my FIRST ever Substack original written below ^-^]
Follow me on Substack!
https://ngocthewhale.substack.com/p/same-houston-hospital-system-2-different?r=39221t
--------------------------------------------------------------------------
Same Houston Hospital System, 2 Different Locations: Memorial Hermann Hospital Care Comparison through a Family Case Study
Houston, TX. Home to the World's Largest Medical Center. My family's experience at Memorial Hermann TMC in 2025 and Memorial Hermann Southeast in 2026, from ER to Recovery to Long-Term Care.
There is a Vietnamese saying, “When one horse is sick, the whole stable refuses to eat.”
When I was living alone in Ohio, I remembered hearing so many stories of families taking care of loved ones. Waking early to tend to themselves and the ones they love. Going to work and heading home to look after their mother or daughter or elder. These stories echoed the ones I heard and saw at our family business, the nail salon too. Our older clients would wheel-chair in their spouse or carefully lift their family in and out of cars and trucks for a pedicure at Angel’s Nails. It’s a story that you hear someone else tell you. It’s a story you see in-person like one does through a window, but when everyone you love is healthy, I took that to be the norm. I took their good health for granted.
This is a case study about how our family navigated the downs and ups of my father’s health, from the ER to Recovery to Long-Term Care, at two separate times, a year apart. I never studied for a PhD, never published a paper in any academic journal, but I do enjoy writing. And though I’m a mere Econ college grad, living out every theoretical that my final year Economics Seminar class covered, plus an extra bit, nothing can be as good a teacher about Community & Public Health as real life. Being in the fog with my mother and sister as we made decisions that stacked on top of each other, in a span of a week or two, no one could fully prepare for us for everything we didn’t know until we were asked, “So what would you like to do?”.
At its heart, this is a story of my family, trying to do the best for each other and my father. We had so much to figure out in a pinch of time as events unfolded. We needed stamina, no matter what, and when the times came, we were a team. It was a blessing, when we met patient and kind people along the way.
And I do want to add, no part of this writing, from the first draft to the final draft, had any assistance brainstorming or writing or editing with AI. All of these thoughts are my own and if you find a typo, please bless me.
February 17, 2025 - MH TMC
He owned a very cute 2008 white Honda Ridgeline. He never knew that you had to rotate the wheels on 4 Wheel Drives. He never knew that you’re not supposed to actually drive 45 on I-45. And he certainly never knew that you’re supposed to change oil at every 6k, so once in a while, as if I was the mechanic that did it, I’d find the crinkle of the page I folded in his truck manual and in 2 minutes, make the “Oil Change” light disappear, as he wished.
My Dad loved his truck. He always drove it on the highway, leaving 3 inches of space between the truck and the left lane’s yellow-dotted line. Driving was his favorite. Once the house emptied, with Yen and I off to college, and his best friends slowly passed one-by-one like dominoes, my 81-year-old father gradually accepted that his body may be as fragile as his truck. The sense of time, the talk of his life’s accomplishments and the red of the Viet Nam War, of what was enough to make him happy — the world shrunk and didn’t grow beyond the limited Cable TV, our front porch where the birds would sing back to him, the Vietnamese Community Center, the Hong Kong grocery stores, and all the local gas stations with a lottery ticket reader. The rituals and any sense of familiarity were a gift. How rare the ritual of seeing old friends still healthy and still well, became.
On Sundays, my father would drive to Houston’s Asian Town for the Vietnamese Community’s flag-raising ceremony, commemorating the loss of life in the Viet Nam War. South Vietnamese flags would line the bottom of the statue depicting an American soldier and a South Vietnamese soldier, leaning against each other. A reliable gathering of ~15 people would show, everyone knowing each other by first and last name. It’s a ritual that borrows from the ceremony of the 1960s and 1970s, when he was a South Vietnamese soldier.
He couldn’t have possibly known that it would happen on a Sunday, on his way there. Maybe his ears registered the abrupt noise before his eyes did. That trusty, busted-up-ish White Honda Ridgeline crashed into the light pole, on a 4-Way Light Stop, 20 seconds from our house. It must have shocked. It must have hurt.
With that 81-year-old soldier’s brain of his, he somehow managed to reverse that now-dented busted-up-ish White Honda Ridgeline, and drive home. I was in Ohio. My sister was in Boston. My Mother was home alone with him. When she decided it was time to call 9-1-1, especially when he mistook our closet for the bathroom and thought the knife was chopsticks, she made sure we had one last family video call. My father was disoriented, but sure of one thing, before the voice of ambulance responders started, “Don’t worry girls. I’m going to be okay.”
The ambulance took him to Memorial Hermans Southeast, realized they had no capacity to handle a stroke patient, and re-ambulance-d him to Memorial Hermann TMC.
His MRI would later return as a hemorrhagic stroke in the right occipital lobe.
January 31st, 2026 - MH Southeast
Fast forward, 6 months later to August, 2025. This is when I moved out of Ohio and back home to Houston to be with my family in the wake of it all. My mother very quickly had caretaker burn out, being the only one there for my Dad’s every meal and doctors appointments after his stroke. It was a no-brainer, coming home.
Slowly the days passed and now it’s January 2026. My father often needs help locating his cane or his phone every hour or so. The little things that come with dementia. And this particular Saturday while home, I was there all day. We had a salmon and rice lunch together, when 30 minutes later, I heard my Dad doubling over in his room. I found him splayed in bed, like a frog, willingly saying words I never expected, “Take me to the hospital.”
You don’t have to be Vietnamese to know that Vietnamese men bite their teeth no matter what. They don’t admit that it hurts. At most you’ll get is, “a little bit,” so when I asked him, “Dad, on a scale of 1 to 10, how much does it—”
“10.”
I called 9-1-1, and explained that my Dad had horrible stomach pain. This doesn’t ever happen. That a 10, is a LOT, for him.
When the ambulance medics came, they asked every question they could think of. They couldn’t have been any faster, Jesus. “What did he eat? Is it possible it went bad? Has he taken medicine for it? Is this normal? Does he hurt his tummy a lot?”
When they finally pulled him out, the nearest hospital to us was still Memorial Hermann Southeast, so now we were sent there for real.
A 4-hour wait, followed by one 15-minute CT scan later, followed by 1.5 hours later to read the scans, we figured out, with the nurse coming in to apologize yet again for forgetting pain meds for my Dad, “Ah, I’m sorry about that. And a nicotine patch? I’ll let the doctor know. Your Dad has an acute gallbladder infection and dilated bile duct.” I started to ask a list of questions quickly, worried, before she cut me off, “The doctor will speak with you shortly.” I’m not kidding when I saw this, but my Dad is now upside down in bed, in pain, with our nurse soon hooking him up to morphine and antibiotics in his IV, hours after the fact.
“Had you been any more delayed, this would have been fatal,” the doctor said shortly after. And leaving just as quickly. It’s an ER after all.
So we removed his gallbladder and cleared the rest of the gallstones from his bile duct in 2 operations, 3 days later.
During these two health events, I couldn’t help but compare them directly in my mind. We were in the same hospital system for both health events after all, and so this piece came together.
What Am I Writing About Exactly:
This is a personal case study of my father’s healthcare journey.
Our family experience made me think of the logic behind a difference-in-difference model (what they teach you in the fun Economics classes), where two test groups exist in the same timeline. One group experiences a treatment at some point on that timeline, and the other group never does. Economists call real life events “experiments” when relevant. For example, when they see different U.S. States roll out different policies/solutions to the same problem. That’s often called an “experiment”. Most disciplines that measure anything policy-critical lean on this distanced language, distance from Ground Zero. Distance from the “I feel” statements. Closest to the data. Data, is what many perceive, the thing that moves Washington, D.C., and so it has quickly been the language of many Statisticians, Think Tanks, Economists, Non-Profit Organizations, Public Interest Groups, and Stakeholders involved.
Indeed, it is data driven decision-making that gives a size to a common experience, which I will always appreciate. The size of an issue or a solution can encourage change. The chance to measure how often or how likely something happens to an individual or group of people. That’s a language that’s embedded in Economics, and a big reason for my first fascinations with the discipline. You could measure health outcomes from a policy action, and can possibly, derive a plausible causation. I am straying here, but I will say, it is the chance to prove that Action A can cause Outcome B, that reasonably drives Washington, DC (that rhymes ohmygosh) and drives many a current, or former, Social Science student.
Just as important, I believe that stories are as powerful, if not more memorable to inform action. Stories make the textbook and make the policy briefs feel like the uncomfortable shoes that they are. Lived experience, day-to-day economics, too often and almost so easily shows you the causation, right there. You don’t have to be an Economics or Social Science student to have an inkling about causation if you’ve lived it and knew what factors made life easier, and what made life harder. But you know, stories are unique. Sometimes so unique that the person telling it can feel like they’re the only one experiencing it, the first and last of their kind.
Until we are willing to listen to the world around us, there is nothing that we are alone in. And so the story I am about to tell, certainly, is not an experience that is only unique to my family.
Despite my Economics training, it will be a bit of a downer then that the following piece is a big “I feel” piece.
This is not a difference-in-difference model — there’s no control group and no treatment group. It’s just, my Dad. In the span of a year, he had 2 different major health issues in the same Houston Hospital System, at different locations. And each health event, our family was prepared differently. The 2 hospitals in question were a part of the same not-for-profit hospital health systems in Texas, one of the largest in Southeast Texas: Memorial Hermann. But if you’re from here, they are EVERYWHERE in Houston, billboards all over the major Houston highways. Lastly, both health events needed immediate response. Both had only my mother, myself, and my sister in the frontlines.
Yet for being a part of the same Health System, our care experience was very different at the 2 locations. I write this piece to organize what exactly happened between the two hospitals, for my own documentation and to paint the patient’s and caretaker’s point of view, in times of a health crisis. I want to also highlight how important it is, again in times of crisis, the difference that kind people we meet along the way make. They are the bread and butter of how you could feel as the patient and how secure you feel as your loved one’s caretaker.
If there is any argument to be made, here is mine: I imagine a U.S. and global health care system and society that treats everyone in its reach with dignity and respect and patience. Patience is kindness in action. Dignity is the access to respect. And respect is love. These are the values I wish for in our United States.
And secondly, especially for the elderly or those who are sick all alone, I imagine a more robust and dignified long-term care program in the U.S. to support and provide for our most vulnerable in these brackets. Many Economic indicators are pointing to multiple stressors affecting what aging will look like for those close to or below the poverty line, with some current policy leaders suggesting delaying access to full Social Security Retirement by a year, which would only exacerbate senior poverty. Today’s story is very much about the hospital setting. Long-term care will be further explored in later pieces.
Aging with dignity. Being ill with dignity. That’s what I hope for.
Without further ado, here are the
Quick Stats (because I still love me some numbers):
Memorial Hermann TMC (MH TMC)
is in the heart of the Texas Medical Center, which in case you didn’t know, is the World’s Largest Medical Center
ranked #8 in Houston and #13 in Texas, as of December 2025
3.3 stars, out of 570 ratings on Google Reviews (had to chuck in Google Reviews)
When my father was here in 2025, he was treated for a hemorrhagic stroke. [It was swift decision-making by MH Southeast to say that MH TMC would have greater resources to treat it and redirected him in a separate ambulance to MH TMC.]
Memorial Hermann Southeast (MH Southeast)
is located in Houston’s Southeast area, serving a very diverse community of brown and Asian folks
2.5 stars, out of 762 ratings on Google Reviews
When my father was here in 2026, he was treated for an acute gallbladder infection. MH Southeast removed his gallbladder and gallstones successfully.
Note: Both experiences happened while my father had Medicare & Medicaid. Medicare is health insurance for the elderly, and Medicaid is health insurance for low-income individuals.
Now I will zoom into a list of factors, though not exhaustive, which contributed to the success of providing my Father (the patient) and my family (the caretakers) a health care experience that was the most comfortable and most dignified.
Room Sharing:
How spacious a hospital room is, and whether you’re in a single or double while you’re in-patient is a ginormous deal in your care experience. Our caretaking and Dad’s comfort was significantly affected by whether or not he had a roommate. Sharing a room with another patient while sick and being at the timetable of each other’s families when trying to rest and be comfortable, is simply a fact-of-the-matter. Due to space and staff shortages, it was often easier for hospitals to consolidate two patients going through similar issues into the same room. It does make sense at the hospital level to max out utility of every square footage and the ease of access that nurses can have to more patients, quickly tending to two people back-to-back.
However, when my Dad had a roommate, whether if it was in a hospital or his skilled nursing facility placement after hospital discharge, there was so much to be mindful about. It was an added sense you had to be aware of, and for patients who found it already difficult to sleep, like my father, hospital roommates made it more difficult for him to rest, affecting his recovery.
@ MH TMC - February 2025 - Stroke Recovery
Perhaps it was because of the severity or type of treatment he needed each time? But at MH TMC, we had a room to ourselves every time. There was always a door that could shut and a private bathroom for him and family to use. It was often spacious enough for one person to sleepover, next to him in the elongat-able couch, allowing us to be there with him and comfortable should we choose to stay overnight. And because it was the first time he’s ever had a stroke, we stayed over many a night in that room. It was not big by any means, but there was enough space for ourselves and other things that made him more comfortable, like a proper place to set a radio. Again, it might have been the fact that my father was neurologically monitored each time and needed that 1-on-1 care, but I noticed it was a pattern throughout MH TMC, at least in the Neuro hallways that I roamed. I didn’t see any doubles. Just singles, everywhere, and focused 1-on-1 care.
@ MH Southeast - February 2026 - Gallbladder Surgery Recovery
At MH Southeast, our first admission room was a very non-private single. A curtain separated the busy nurse’s station and our room, so there was a bustling and a brightness that we could never escape. There was barely space to fit his bed, food tray, and the one guest chair. It was 6 feet wide across and 9 feet deep. (I work in construction now so… I can measure a thing or two in my head, heh.) There was no private bathroom, so many patients shared the single bathroom. After the first minor surgery on his day 2, they moved him to a double, where you had all of 5-6 feet wide to yourself before a thin curtain separated you from the next patient. It was as small and cramped as before, but now you can hear the next person breathe, and the goings and leavings of their family, and the treatments they were getting and so did your caretaker. It reminded me of the skilled nursing facility/nursing home my Dad once spent some time in, where we first encountered such a double.
Being a caretaker, as I’ve learned now, is almost 50% advocacy. My Mother knew my Dad’s sleeping habits well enough to speak up that my father would not be able to rest otherwise, and rest was what he needed. His senses were heightened in shared spaces and when they did, those overstimulants caused him distress and frustration that he could not control. Because of my Mother’s advocacy, my Father was then moved to his own room, where he slept more comfortably at MH Southeast.
Language Access:
Thank god for translators, everywhere. They lived in the iPad stands that are pulled into different rooms for Language Access. They lived on the phone calls we had at night so my Mother could understand the heck of anything. English is hard for him to process today (though he used to be more fluent in English for his construction career in the US, much of his English has left him). He only has Vietnamese now, and luckily, many nurses know how to communicate to non-English speaking patients like my Father, whether they do so physically or showing or charades or the Live Language Translator iPad they pulled around at each hospital.
@ MH TMC - February 2025 - Stroke Recovery
At MH TMC, while my Dad recovered from his hemorrhagic stroke, we spoke to zero Vietnamese nurses, doctors, or nurse aides. Except for the very last 8 hours of his 1.5 week stay in the World’s Largest Medical Center, when there was finally a Vietnamese nurse assigned to him. We were just very surprised at the lack of Vietnamese speaking employees at MH TMC’s Neurology department. The majority of the time, my father struggled to communicate, with his recently bleeding brain, to the iPad voices that visited his bedside, a virtual Vietnamese translator on the other side assisting. Because he was still recovering from a stroke then and I totally understand from the medical personnel’s standpoint, it being a burden every time you had to pull the iPad Translator out to live-translate everything, the nurses, nurse aids, and physical therapists mostly skipped out on that language tool. If they needed my Father to do anything, some of them thought my Father would have a better time understanding their English if they yelled it at him, louder and louder, the same phrase, to his struggling brain. Or they were more frustrated, physically and emotionally so, when he still didn’t understand what they wanted to do and why. And those frustrations happened often, however the doctors, reliably always brought the language tool in and made sure my Dad understood as much as his little brain could and doctors, as I will write later at MH TMC, made their best efforts to notify family when they were visiting my Dad, so that we could all be on the same page: the care team, the family, and the patient.
MH Southeast - February 2026 - Gallbladder Surgery Recovery
Between the two hospital locations, language access was significantly better at MH Southeast for one reason: after the CT scan identified the gallstones he had, we were partnered, quite soon, with a Vietnamese Gallbladder Surgeon who explained everything to my Dad and Mom and performed the surgery himself. Right after surgery, he called my mother to explain the results in Vietnamese. Again, MH Southeast is located in a diverse part of Houston, full of brown and Asian folks, and that representation was also reflected in its hospital setting or perhaps, just in the Gastroenterology Department? What made an even bigger difference than the chance that our Surgeon was Vietnamese, was that our overnight nurse was Vietnamese as well.
She was the most helpful, most kind, most sweet being I’ve ever met, and despite my father, in his late-night Sundowner’s Syndrome causing enough fits that security had to be called, she saw the entire picture of care that my Dad needed so empathetically. So patiently. While I visited him in the evenings after work, I got to speak with her, as did my mother. Our nurse shared next steps on how to tap into affordable home health options for my Dad, psychological help/resources if his dementia exponentiates, and what she’s learned taking care of her mother as well. It really does take experience to know experience.
I highlight her because she was one of the first nurses, between MH TMC and MH Southeast that actually took the time to explain resources, beyond his immediate health care needs in the hospital setting, and she answered all our questions patiently (because omg, nursing is so hard and time is always of the essence!). At the same time, she understood so much about us without us having to start explaining where we’re at right now.
From a patient’s perspective, my Father’s face lit up, immediately, when he found out a nurse for the night was Vietnamese and could understand him and engaged with him so kindly, in his native language. Just simple people-to-people, made everything perfect, without the need for machines to facilitate or a game of charades or English repeated loudly and slowly, for once.
Language-access is easily one of the biggest factors of success and of comfort, when speaking to caretakers. We felt more seen than ever before and we felt the most comfort when we could connect with someone who could understand my Dad’s and my Mom’s Vietnamese and needs.
Can I trust adequate care is provided if no one visits in a day? & Nurse Responsiveness
The above metric is a question I had every single time I was having my own breakfast, lunch, or dinner, while my father was inpatient. “Has my Dad eaten yet?” And if he didn’t feel like eating, were nurses/hospital staff okay with taking back uneaten trays? Eating well, no matter what health issue you had, was a critical step to healing. Whether it was his stroke or his post-gallbladder & gallstones removal. This question plagued us all.
MH TMC - February 2025 - Stroke Recovery
He was only allowed soft foods in recovery. Nurses notated how much of his tray that he ate, 50% or 25% for example on the whiteboard across his feet, and for the week and a half that he was there, I noticed nurses encouraging him to eat more of his food and nagging that they wouldn’t leave the room unless he had more bites. He might not understand a lot of English, but when someone nags you to eat, that tone is universal. So, on a level of trust, I trusted the nurses at MH TMC to force him to eat some more bites. The first nurses he ever had, in the first days of his recovery were very good at asking him to have one more bite, just one more bite. The last nurses he had at MH TMH were not as good at keeping that level of relationship with him to encourage him to do so.
Overall though, nurses at TMC were mostly super nice. Some of them were very good with getting him to eat more, and others were okay taking back uneaten plates. Seeing proof of the emotional labor that some of our nurses provided to my Dad, egging him on like that, made us feel very warm. That they had our backs, if family wasn’t around to check.
Another factor is turning a patient over in bed, to prevent bedside ulcers. I don’t remember if they turned him or not, to avoid bedside ulcers, but definitely I did remember them egging him on to eat.
MH Southeast - February 2026 - Gallbladder Surgery Recovery
Unique experience here, but he had a strict no food and water regimen starting at midnight, for a full 12 hours, for the two separate procedures when getting all his gallstones removed. What was very, very frustrating at MH Southeast was he didn’t eat much of his lunch or breakfast, or dinner, and a lot of uneaten trays were returned. The nurses and care he had there —No one encouraged him to drink water or have more bites of food, in preparation for the 12-hour food and water fast the next day. Hence, he would call us around 4 AM, telling us how thirsty and hungry he was, and how hard it was for him to sleep because of these reasons. That thirst would continue with him til 3 PM the next day.
We trusted MH Southeast to be mindful enough to make sure he had sufficient water and food but that didn’t happen, at every turn. What was eye-opening to us, in terms of trust with MH Southeast, was when we were 1.5 hours post-operation, and my Dad at this point in time, had fasted well beyond the 12 hours. Because he barely ate dinner the day prior, he must have been at his 18-hr water & food fasting mark. His lips were incredibly chapped prior to the surgery, and he kept begging for water.
So now we’re 1.5 hours post-surgery. There’s no nurse, or nurse-aid available because they’re still at lunch. Since my father can’t sip even a little bit of water without a nurse’s or doctor’s consent, we waited all of that 1.5 hours. Our room was directly in front of the busy nurse’s station but after setting him there, no one else came. I noticed the Nurse-Call Alarm button to his bed wasn’t even hooked up to electricity to even use, so had my mother and I not been there, he had no way to ask for help on his own from the bed. I noticed no one looked our way to let us know next steps now that he’s out of operation, if he could or couldn’t drink or eat, so that 1.5 hour wait for answers felt like forever.
My poor Dad! When our nurse did return, another patient’s family was calling her, so she was on the phone for another 15-20 minutes and it really was my fault waiting like that, not wanting to busy her further. But that’s the thing about caretaking. Caretaking is 50% speaking up and advocating. His lips were only chapping more, so I got up and asked if he could drink water. She was confused for a second, looked over at my Dad, and said yes.
So people knew what he could do, but no one was fast enough to tend to him. Uneaten trays came back with ambivalence, even after he was moved to his other room. Just a comment that, “he didn’t eat, yeah…” instead of, “I egged him to have some bites.” Their responses on his uneaten trays were such a red flag that we brought in our own food and made sure to sit with him through his lunch and dinner and stayed so that he had every bite. sigh Older folks do that… they don’t really like eating when they’re alone. So often so many of our older folks are spending their time alone, across the U.S., and any part of the world. Our elderly are often alone. At MH Southeast, we had let the nurses know that he had difficulty visually processing if food is in front of him ever since his stroke last year, and it really felt like they couldn’t be bothered. But more than that, I think they were just super busy and had no way of remembering that and had to tend to too many beds. The patient to nurse ratio… is felt. I genuinely think it was that, because whenever my mother or my nurse talked to MH Southeast nurses, we could tell they really cared but were so, soooo stretched out. I could see the relief in their eyes when they knew family was there.
The earlier Vietnamese nurse I mentioned though did notice what his favorite snacks were, so this problem isn’t across every nurse and nurse aid at MH Southeast.
On another note, with MH Southeast, everything we said, we had an internal rule of 3. If we didn’t remind someone what we needed at least 3 times, and I swear by this, they wouldn’t have done it. Or they’ve forgotten. If he needed a new nicotine patch, if he could have his antibiotics in pill form versus through the IV (because he kept pulling out his IV -_-), whatever concern outside of the very basics of his treatment was, it was a rule of 3, for responsiveness with our nurses and nurse aids, at least.
They were all very nice though.
Doctors Experience & Responsiveness:
MH TMC - February 2025 - Stroke Recovery
MH TMC had much, much better doctor responsiveness. Every day at bedside, while he healed from his stroke, my father would be visited by a primary doctor and a neurologist and a psychiatric doctor. Three doctors to his care, who all got to know his silly personality and were ready to speak to family on the phone or in person in the early morning or late evening. And all of them were as patient with our questions on the phone as they were in person. A portion of my father’s first admittance days, I was still in Ohio and flying home. My father’s main doctor and neurologist both called my mother and I and both doctors answered all of my questions, with so much patience and grace. Their patience and quick understanding of his specific case put me instantly at ease. We always had a doctor visiting my Dad in person every day that he stayed at MH TMC and it made all the difference to know that, they were there for the big and small developments. They knew enough about my Dad that they remembered already, the jokes he’s already made. That was the level of doctor-patient relationship building that existed at MH TMC. Just, wow. They had it down to a science.
MH Southeast - February 2026 - Gallbladder Surgery Recovery
It was a very different story at MH Southeast. Doctors were not as available to patients here. Perhaps because they were more short-staffed - as short-staffed as their nurses were - or the doctors were all very booked, but we only met each doctor once in person, either at the day of the surgery or a day or two before. After that, it was all one or two phone calls max with the doctors, and never seeing them in person again. Which is such a contrast to our experience at MH TMC.
And if you did get a hold of your doctor or if your doctor did come to see you in person, the whole exchange often felt very, very rushed. There was time for questions certainly, but you could feel that your doctors needed to be elsewhere and had to go. This experience happened with 3 different doctors at MH Southeast: our ER doctor (which makes sense, he’s the ER doc! of course), Gallbladder Surgeon, and Bile Duct Surgeon. Different atmosphere than MH TMC. But still, my dad’s gallstones are all removed and so is his gallbladder. All of it done successfully. I’m not complaining too much there, but again, very noticeable difference in doctors’ experience. :) For the patient to know who the heck their doctor is and for the family/caretakers to be on the same page, it was just a much more hands off approach.
Social Worker Experience & Responsiveness:
Whether it was at MH TMC or MH Southeast, continued success after discharge is 1000% reliant on how good of a social worker you had. They’re the key players in discharge success. I would never recommend to ANYBODY, discharging a loved one from a hospital or nursing home, without developing a very VERY good outpatient plan with your in-house social worker. They are the ones that know policy, Medicare-Medicaid/insurance policy, and RESOURCES and people/community orgs to tap into if a family member is the sole caretaker and needs a lot of help. Sole caretakers’ best friends will always be the social worker. The nurses, yes. The doctors, of course. But your social worker is your lifeline because after discharge, you’re on your own kid and that plan better be thorough. Your social worker better know exactly everything that’s going on. I cannot highlight this enough, as a part of not only ensuring the patient’s ongoing recovery and follow-ups, but ensuring the wellbeing of the family/caretaker. Their wellbeing is absolutely in the hands of a very knowledgeable, and hopefully very friendly and patient, very very PATIENT, social worker.
Important notes like the usual temperament of a patient, taking a pulse on previous family dynamics between the caretaker and patient — these are details that must be shared, no matter what. The truth needs to be shared.
They are there to learn about your unique needs and circumstances. They help caretakers take the wheel.
MH TMC - February 2025 - Stroke Recovery
From the get-go, like Day 2 or Day 3 of his hospital stay, a nurse-social worker, (yes he was both which was phenomenal! because he knew the ins and outs of stroke recovery while also knowing the exact long-term resources we might need going forward), met us in person and really got to know our case, got to know my Dad, and was a part of the process very, very early on in his hospital stay.
He called my Mother and I on the phone every day to check-in, and met my Dad and every update I gave him went like this, “yes, my father was a heavy smoker and if he is still to stay here, would need some nicotine patches to get better settled Or he’d get very grumpy and frustrated.” And our nurse-social worker would respond graciously, “I will make sure our nurses and doctors know this. Will check up with you on that later if it’s been done.” He does all of this with a smile. However, his role was limited with us. He oversaw the social workers of the Neuro floor, and would not be the one to actually set up a discharge plan for our Dad, based on what the doctor thought he needed.
So we also had a second, more dedicated social worker to our case, the one who actually set us up to a skilled nursing facility for further stroke rehabilitation. I think this was the most interesting part of the social work-connective tissue process. We had the chance to pick from different skilled nursing homes. They had all the ratings for us and every recommendation our social worker made for us, she’s already accounted for distance to our home, if there were Vietnamese-speaking nurses and therapists, and other details.
Even though we communicated to our social workers in English at every point, we really did meet incredible people who wanted to be there for us. Outside of MH TMC, a social worker at the skilled nursing facility, upon helping my father dispatch, was so, so patient with us, even as she was rushed for time. She was the sole social worker for the entire nursing home/skilled nursing facility of 100 beds. It was… oh my god. But she was so, so good with my Dad. Even though my father couldn’t understand her English, we could tell how much she cared about everyone’s experience. We really did love her so much. And she shared the most sad thing after she interviewed us, “You folks really love your Dad and are showing up for him. There’s not a lot of that around here, in this nursing home.”
MH Southeast - February 2026 - Gallbladder Surgery Recovery
We didn’t even know our social worker’s first name or phone number, by the 4th-5th day of his hospital stay. Additionally by the time we did connect with our social worker, she could only call us at night, around 10:30 PM. It was a 45 minute call so it was thorough and she definitely definitely cared about the success of my father’s discharge. It just felt like a plan that was put together very last-minutely, down to the last 12 hours, that’s when we knew that we would have 6-weeks of home health for him. The nurses did send us home with a very organized health packet of all of his medicines and when to take them, with or without food, and that was very helpful as well.
However, this experience pales in comparison to how very soon we were connected our social worker and nurse social worker at MH TMC. You can notice the amount of availability to this critical resource already. Again, this is the same hospital system, but two very different locations.
Final Thoughts
I was still left wondering why within the same health system of Memorial Hermann, there is such a drastic level of care. This wasn’t a difference-in-difference. This wasn’t an experiment.
Between Memorial Hermann TMC and Memorial Hermann Southeast, this is what real life health disparity looks like. When you go from experiencing care that is abundant to you, careful and attentive to you, to one that is much less so just because of a location difference (and you’re still in the same city, because Houston is vast) and nothing more, it is a shock.
Location of the hospitals, then, became a significant factor in determining health outcomes and indirectly affected how confident we were as caregivers that my father was receiving diligent care. It really is zip code, isn’t it? Zip codes are immediately attached to the diverse communities that live there, the different tax brackets they pay into, and the environment and zoning regulations that directly and indirectly affect their every day health, among many, many attachments. Ultimately, zip codes with all of these attachments directly affect the investments made into services those communities have access to. One of them being, the quality of health care access most adjacent to them.
The fight for health equity, when centered on geography and zip codes and the diverse communities that exist there, is felt, and my family’s experience is an absolute example of health disparity in quality of experience, in action.
Through these two separate bouts of navigating the healthcare system, I learned 2 other big things.
My First Lesson:
The key to a dignified health care system, at least in my family’s case study, was ensuring everyone critical to the health care connective tissue, of my Dad’s care, had (a) the capacity, (b) the time, ( c ) the energy, and (d) the knowledge to
help us navigate to the next health step
provide us the patience so that important details weren’t glossed over
spoke to us kindly. Ensured we felt like people— that we were treated with compassion and provided patience.
The most impactful people we met along the way were definitely social workers and nurses. Nurses ensured he had extra bites of food when no one was there and nurses knew of legal and psychiatric, additional resources we could tap into, while we were there. Creative social workers helped map the very near days, weeks, and months with us, now that my father can no longer do certain things and will require new things.
My Second Lesson:
Time. Families and sick individuals need a lot of time to figure things out and to coordinate exactly what needs to happen next.
The health of a patient will only be as strong as the health of the caregiver. The caregiver navigates several things in the background that directly impact the recovery and long-term care a patient receives:
(1) Caregivers must navigate bureaucracy. Yes, a social worker hand holds our family for the first day or two after discharge, but must of everything else from the
(2)
So the vision I see of U.S. long-term care is one that incorporates the health
This is an intro-level summary of my family’s experience navigating the healthcare system. Some stories are difficult to paint fully, but perhaps as I continue exploring this vein of thoughts, other details & revelations will surface.
Lastly,
I wanted to end with is this: with any family situation or crisis you might go through, you need a team. I needed my Mum and sister there, as much as they needed me. Everyone had their strengths in different moments. Either it be, one person is super good on the phone and coordinating events/visits or another person is really good at big picture next steps or another has good intuition about my dad’s care, when combined, we were a force. There was hardly enough time in the day for one person to handle it all, at the peak of his crisis. Emotionally, we needed each other. Otherwise, it would have been extremely difficult to process and accept our changed father, on our own. Processing the new things he’ll need from now on. Accepting new responsibilities, adding new phone contacts on our phones should we need something.
For folks who take on every role, the breadwinning role and caretaking role, that is, just, oh my gosh. I saw my mother do it for the months neither my sister and I were home. I still cannot comprehend it but my Mother said it best when I asked how she did it, “It is easier when you do something out of love.”
But sometimes love isn’t enough.
She learned the hard way, even as she was stubborn for me to stay in Ohio and my sister to finish school in Boston that she could handle this on her own in Houston. She learned that caretaking my Dad, caretaking anyone, could not reasonably and not sustainably, be a one-person job.
Once all three of us: my Mother, my sister, and myself recognized this fact, some things became a lot simpler. Caretaking is a 24/7 job, and each of us needed time to be ourselves, have the chance to rest somewhere safe and the chance to be a girl. Time to love ourselves as much as we loved our Dad so we could provide the best possible care for him when we returned.
Yet so often this is not the case in our current America, when family earners are also sole caretakers. And some families and individuals are simply not financially or resourcefully prepared to hire additional help and prevent caretaker burn out. Again, the outcome of one’s health truly does rely on the quality of health and quality of life of the caregiver. The caregiver will often hold multiple titles, as the care admin, care coordinator, advocate, and more. Caregivers experience time very, very differently.
I have had much to say thus far, but finally, I do want to end with this.
How a country values its citizens is shown in many ways, but certainly one of them is how it treats its poor seniors and veterans and the ill. Without someone else advocating in the health care system for my father who faced language barriers and mobility issues, my mother and I doubt that he would have had a similar recovery.
We feared the trays would come back empty without a blink. We feared he would have had no place to go for recovery, or after the first Medicaid-covered 100 days at a Skilled Nursing Facility. We are absolutely sure his health outcome would have been drastically different if he lived alone and was left to only what’s currently available through the current U.S. long-term care system.
No comments:
Post a Comment