Last night Vicki, Susana, Coqui and I left around 9 p.m. By then Mom was in a bad mood and her speech and thought processes were on a dirt road, bumping around all over. Her sugar level once again went to the moon but this time we specifically requested a blood test. The "anomaly" the dietician told us about is no longer such. Now we have evidence that something weird is going on and hope to pursue this further today.

As time at the hospital draws to a close, at least for now, I can't help to think about some of the things that I saw and learned, good and bad.

I remember when we walked into the ER and how awkwardly set up it was. The admissions desk was over the far right of a room where about 20 chairs were lined up against two walls, in an L shape. The desk was at the end of one of those legs and one of the chairs was right up against it so in order to talk to the admissions person you literally had to talk over the person sitting there. In our case that person was a man to whom you could write at "Hwy 59 Underpass corner with Main" and he'd get the letter. With all the HIPAA hubbub it seemed odd that some rather personal information had to be shared in such an environment.

- May I help you?
- Yes. I have a fja;ls fjkd c;lkfjj...
- I'm sorry, what did you say?
- I have a fja;ls fjkd c;lkfjj...
- Could you speak louder please?
- I have a frickin' hemorrhoid the size of Oklahoma, alright?

I mean, how can you talk to someone about your medical emergency in a place like that and not feel worse than you did when you walked in?

And then we waited. The nurse that came to see us was a strong, kind-looking, wise black woman. She inspired confidence immediately. She talked with Mom, gently grabbed her by the shoulders and said, "We're going to take care of you." And she meant it. It was the kind of human care that we have experienced all over at Houston Methodist and we applaud them for that.

When Mom had her first seizure in the ER, I grabbed her and yelled "emergency!" but the response seemed slow, as if they wanted to see how badly it really was before doing anything. It's as if they think most folks exaggerate and maybe that's been their experience in the past. For me it was the first time I had to yell like that. So the slow staff response surprised me. Maybe I should have yelled "free donuts!" and gotten faster results, like what they say if you're being mugged. You're supposed to yell "fire!" and not "help!".

After the seizure they sort of bumped Mom up the chain of priorities. They got her on a gurney and not long after into a room. On the way there we passed folks on gurneys all over the hallways, what you would expect to see in a Bronx ER, but this was the Medical Center, Houston, TX. I already doubted the wisdom of having gone there.

But then when we got into an actual room things got better quickly. We started to get lots of attention and the ER doctor soon came to talk with us about the CT scan results showing the mass in her head. So it was a blessing that Paul Wells directed us there after all. When you're having a major event you need to get to a major hospital. Maybe the entrance is not exactly lined with a red carpet but if you have a serious condition you need a place with the staff and equipment to handle it. A lot of folks choose hospitals based on convenience. I think that's a poor choice in some cases. Not all hospitals are the same and the nice, new neighborhood hospital down the block may be able to handle a deep cut or a bad cold but not a brain tumor. If in doubt as to what you have, start high and work your way down.

The staff at Houston Methodist has been caring and helpful throughout our experience. I would choose this hospital again though hopefully that won't be necessary.

What is missing, however, and I think this is true everywhere, is a better form of communication with the patients. I don't know about its advantages and I'm sure there are some but HIPAA and the privacy rules have caused a lot of problems in my experience. Nobody talks to anyone about anything though the man on the chair by the ER desk knows about my hemorrhoid.

I personally feel that there's a lot more that can be done to improve the doctor/patient relationship. I would like to see a wall-mounted computer, for instance, perhaps a touch screen, where patients and family can exchange questions and comments with the staff. With all our technology the chain of communication feels primitive. Take for instance the high blood sugar recorded the night before. That information must have appeared in some chart but the dietician that came to talk about insulin hadn't seen it. There were blood results too and she hadn't see those either or knew about them. And the only thing that anyone said to Mom was an endocrinologist that stuck his head in the room for about three seconds and said, "I'm giving you four carb units," whatever that meant.

And the high number recorded last night? Who reads it? Who can pass it on to someone who can interpret this and give us some answers? Mom may be coming home soon and yet her sugar roller coaster is still not controlled or explained. We feel as if the right hand is completely unaware that there is a left hand on the other side.

My sisters, Aunt Christy, cousins Alexie and Jonathan, Coqui and I have stepped into the fray and it is through a team-effort that things have gotten done. Buford and Julia Wells, Susy Young, Andrea Higuita and Ron Jones have been regular visitors. If Mom didn't have her family and friends around, I shudder to think what would happen even in such a fine hospital as this.

By the way, Michael's advice to bring donuts and candy paid off handsomely. We did as he told us and indeed, it worked. Mom got a lot more attention yesterday.