“Bob,” Evie said, “maybe you should drive slower the rest of the way.”
The next day, as we drove back to Covington, Raj leaned over and whispered to me, “I think I need to see the doctor. I think I’m pregnant.”
Raj had mentioned she’d missed her period in February, so I should have known what was coming, but still, I felt surprised and a little bit hopeful at the same time.
The next day, I took Raj to see an obstetrician. After the doctor examined her and ran some tests, he confirmed Raj’s suspicions.
“You are pregnant,” he said. “You are about three months along.”
Raj and I left the doctor’s office feeling happy. Would the baby be a boy or a girl? How would we take care of it? There was so much to learn. At the same time, we felt a little scared. I did not know much about babies or pregnancy, and while Raj knew a little from witnessing births in her hometown, there was a lot she didn’t know.
As the months passed, I still lived like a bachelor. Whenever Bob called me to come down for a beer, I went right away. Also, when my friends invited Raj and me to a social gathering, I was always ready to go. Raj, on the other hand, was reluctant. In some cases, she did not go, preferring to stay home to knit or to prepare supper. I always went out anyway, coming home late and not thinking much about how Raj felt about my behavior. Looking back years later, I realized I should have paid more attention to Raj and what she wanted, but at the time, I was unaccustomed to having another person to look out for. Now, in a matter of months, I would have a second person to care for. This news sobered me up, if not right away, then eventually.
If there had been a book on the subject, maybe that would have helped me when it came to understanding how to be a better husband or to understand my wife’s needs. However, even if there had been hundreds of books written on the subject, I wasn’t seeking them out, and no one was giving any of them to me, saying, “Look, read this.” Marriage was seldom discussed in those days, and the matters between a husband and wife were mostly kept private.
As Raj’s due date approached, we began preparing a room for the baby. We did not have any baby furniture, so one day, while Billo Cheema was visiting with her sons, Billo mentioned that she could give us her baby furniture as she did not plan to have any more children. Raj and I drove up to Morristown, New Jersey, on Saturday, and I drove home with the furniture on Sunday, letting Raj stay with the Cheemas for a few extra days to talk to Billo about pregnancy, giving birth, and parenting.
A few weeks after Raj returned from the Cheemas’ house, she went into labor and gave birth to a beautiful baby boy. This was good news for our families back home. In Indian culture, it is a great celebration if the firstborn child is a boy, especially in those days. Now things are changing, but in some parts of India, a firstborn baby girl is still not welcome.
The hospital personnel wanted to know what name we chose for the baby. Since Raj and I didn’t know the gender until the moment of his birth, we hadn’t thought about it. “I don’t know,” I said. “We are still thinking about it.”
“You have to have a name,” the personnel insisted. “We have to prepare the certificate.”
Even though I worked there, it was a difficult task to persuade them to give us a few extra days to decide on a name. Finally, they agreed, and on the fourth day of Raj’s stay in the hospital, just before she was discharged, we decided to name our son Subhash after a great man of India who had played a huge role in helping India free itself from British rule. His middle name would be Jony, an American name that we liked.
I took Raj and the baby home at around 2:00 p.m. There was a lot to carry: Raj’s things, the baby’s things, and several vases of flowers. We did not have the car seat yet, so Raj carried the baby in her lap.
Raj warmed to the role of mother right away. She sang to the baby in Hindi and bathed him lovingly each morning in a small tub Billo had given her. Raj seemed happy in those days, content to finally have the baby with her and to take care of him. Part of me felt anxious because taking care of such a tiny person seemed like a huge responsibility. But Raj was a good mother, and she seemed to know what to do right from the start.
I took the first couple days off to stay with Raj and the baby. Once back at work, I couldn’t wait to go home to see how Raj and the baby were doing. Sometimes I would call Raj from my office to ask if there was anything she needed. I felt so proud to have a son that for a whole month I was walking on air.
Subhash’s arrival in our lives proved to be a great learning period. We were unaware of certain aspects of caring for a baby. For instance, at night we would feed him milk from the bottle then put him to sleep. However, ten minutes after putting him in his crib, he would start crying. Raj and I would go to his room, pat him on the back, and try to put him to sleep, but he would always wake up again with a cry. We fed him, so why was he crying? We did not know what to do. One day, Mr. and Mrs. Gilreath came to see Subhash at our apartment, and while Mrs. Gilreath held Subhash, she noticed that he was crunching his legs towards his stomach. Mrs. Gilreath, a nurse, mentioned that he had colic. “Does he cry in a low short scream?” she asked. We confirmed this. “Yes, he definitely has colic,” she said.
“What is colic?” I asked.
“It is something that happens when a baby has too much air going into his mouth from sucking on the bottle. The air has to come out, which causes him to cry. Don’t you know you are supposed to burp him?”
“No, what does burp mean?” we asked.
“Well, it is very common for a baby to burp, Kris. After you feed him, you hold him close to your shoulder and pat his back until he burps. This helps him get the excess air out.”
“Gee, we didn’t know,” I said.
Mr. Gilreath just laughed. “That’s very common. Call Subhash’s pediatrician, Kris. He may prescribe medicine.”
Subhash was quite chubby, but he loved to eat and was always smiling. Raj, strict with his feeding schedule, would always scold me whenever I tried to feed him too much. I was lenient, and whenever he cried, I would feed him. “No!” Raj would correct me. “This is not his feeding time.”
When he was around ten months old, Subhash weighed close to thirty pounds. Mr. Gilreath just died laughing when he saw how chubby Subhash was.
“Look at this double-breasted guy!” he said.
Indeed, Subhash looked as if he had breasts. Once, during a visit to the pediatrician, the doctor said, “Boy, your son is growing so well. Maybe you need to put him on a diet.”
We all laughed and joked about it, but Subhash just loved to drink his Similac milk and to eat the baby food whenever Raj or I fed him. He always wanted more and more.
A few years earlier, I’d learned that a person only needed a four-year degree relating to the sciences to become a medical technologist. Much of Raj’s coursework from her zoology degree matched the medical technology program requirements. She only needed to complete a one-year internship in a hospital lab, which offered a stipend of $200 a month. She agreed to try it, and in September 1972, she started her rotation in the pathology lab at St. Elizabeth Hospital after dropping Subhash off at the Toddler’s Inn daycare managed and staffed by the hospital.
Raj’s first assignment was to draw blood from patients, yet she did not feel comfortable sticking patients with the needle. It was especially difficult for her to draw blood from the little children in the Pediatrics Department. They would cry, and it reminded her too much of her own son. Within two weeks, one of her supervisors started giving her a hard time. Raj had requested to be assigned to a different department instead of Pediatrics because she was uncomfortable drawing blood from the little ones.
The supervisor said, “It is not your job to direct me what to do. In the lab, you are Raj. You are not Mrs. Bedi. You are not going to get any preferential treatment because of Mr. Bedi’s position.”
This statement hurt Raj. She did not expect special treatment. She was only trying to do her job, but she was new in t
he work environment and sticking children with needles bothered her. Raj said no more about it, but the supervisor continued giving her a hard time. Raj did not share her troubles with me then, but I noticed she was unhappy when I picked her up at the end of her shift.
“What’s the matter, Raj?” I asked one day. “What’s going on?”
We were in the convertible on the way back to the apartment, and for a moment Raj didn’t answer. Then before I knew it, tears began to roll down her cheeks. She shook with loud, heart-wrenching sobs. When we reached the apartment complex, I tried to comfort her so she could calm down and tell me what was wrong. After ten minutes, Raj quieted down and explained the situation.
“Don’t pay any attention to that lady,” I said. “You will be just fine.”
There was not much I could do about the situation, and I hoped the problem would go away.
It surprised me when Mr. Gilreath walked into my office one afternoon to discuss Raj with me. The supervisor had reported to the chief pathologist about Raj not feeling comfortable with drawing blood from children.
“Perhaps this program is too much on Raj,” Mr. Gilreath said.
“Raj is a very smart girl,” I responded. “She completed her master’s in zoology with honors. Perhaps she just needs to keep drawing blood, and she will get used to it.”
“Okay, that’s fine,” Mr. Gilreath said, noting my determination for Raj to keep the internship.
The first week of October, I was driving Raj to work at 6:15 a.m., Subhash sat in his chair in the back seat, and Raj sat quietly, wearing the white dress which was her lab uniform, her long hair wrapped in a bun. As I stopped at a stop sign, all of a sudden, a car hit us from behind, causing us to jerk forward. I was holding onto the steering wheel, but Raj didn’t have anything to hang onto, and the impact shook her head so hard that her bun came out and her hair flew forward across her face. She started crying, and we both turned around to make sure Sub-hash was okay. He was crying too, and at that moment, Raj said, “I’m done with the internship!”
Once the police came, wrote a report, and ticketed the person who hit us, we were so shook up that I simply turned the car around and headed back to the apartment. On the way, I tried to change her mind, saying, “It’s your decision, but it will be good if you can continue this. You will have a degree from this country, and if need be, later you will be able to get a good job easily in a hospital. It’s a decent job to work in a hospital lab.”
“No, I’m done with it, Kris,” she said in a firm tone. “I’m done. I’m frustrated with that supervisor and her constant taunting. And most of all, I am not happy leaving Subhash at Toddler’s Inn. He is only a year old, and I don’t like to see him cry when we leave him there.”
I told her that if she didn’t want to do it, that was fine with me. Later, I informed Mr. Gilreath, and he seemed relieved the situation worked out in the end.
In May 1971, a new facility named Providence Hospital opened in Cincinnati, replacing St. Mary’s Hospital which was ninety years old. The sisters (nuns) who started the planning of Providence had hired a consultant, Gordon A. Friesen, from Washington, DC, to design Providence Hospital based on new concepts he developed. Since there were only a small handful of hospitals across the country built on his concepts, it became well-known that Providence was built upon the Friesen concept. However, within ten months, Providence had lost one million dollars. Seeing that St. Elizabeth Hospital was making good money under the leadership of Mr. Gilreath, in March 1972, the chairman at Providence approached the board at St. Elizabeth to request the expertise of Mr. Gilreath for six months. The board agreed and assigned Mr. Gilreath to oversee the operations at Providence Hospital as well.
Within one week, Mr. Gilreath fired the administrator of Providence Hospital and began managing that facility. It was exciting for the administrative staff at St. Elizabeth, especially when Mr. Gilreath asked any of them to come with him to Providence so they could observe and become familiar with its setup. A few times, he asked Bill Poll, his assistant administrator, to come with him. If any of the administrative staff were asked to go to Providence, it was like a feather in their cap because it meant they were considered experts. Each time Bill Poll went with Mr. Gilreath, I felt disappointed. The whole time I hoped Mr. Gilreath would ask me.
Then, one day in April 1972, Mr. Gilreath asked me to accompany him to Providence Hospital. He had encountered several problems in the support service departments, especially with the Supply Processing and Distribution (SPD) Department.
“Kris, your expertise would be great in this area,” Mr. Gilreath told me. “I would like you to observe the operations in the support departments, especially the SPD, and then, I would be glad to hear your recommendations.”
I felt excited to be considered an expert in the eyes of the Providence Hospital staff, even though I knew nothing about the Friesen concept. The first step I took was to read Friesen’s manual and familiarize myself with the hospital’s design.
The Friesen design, a modern concept, meant that all the handling and delivery of supplies was automated. The carts moved on a monorail system which functioned by turning knobs to set what floor the cart should go to. Also, there were no nurses’ stations. On the patient floors, the nurses would do charting in the rooms, and they also used a cabinet, called a “nurse server,” built into a wall of each patient’s room. The cabinets could be opened from the hallway as well as from inside the room. The patient’s chart was kept in the middle part of the nurse server. The upper part of the nurse server contained clean supplies while the lower part contained the soiled linens that the housekeeping department could pick up from the hallway, consequently reducing the traffic going into the patient room. At least, this is how it was supposed to work. But the more time I spent observing operations at the hospital, the more I saw the employees struggling to make this work efficiently. The nurses always complained about running out of supplies and clean linens.
In short, I was impressed by the automated system’s ability to save labor costs, but the hospital faced several problems. Sometimes the equipment did not function properly, and the mechanics were not trained to fix it. Second, the employees found it difficult to adapt to the automation. The previous administrative staff had not been able to make the Friesen concept work because all the staff members came from an old facility and either could not adapt or were resistant to change.
After familiarizing myself with how Friesen’s concepts should work, I began observing the SPD Department, which centralized all of the hospital supplies. In a traditional hospital, each department has its own storage area where it kept supplies, but at Providence, all of the supplies were stored in one place and distributed throughout the different departments on the mono-rail system. Even the instruments for the surgery department were kept in the preparation and sterilization section of the SPD Department where all dirty instruments were transported on monorail carts to be reprocessed and sent back out, based on the number of surgeries scheduled for the next day. Again, at a traditional hospital, the instruments would be washed, sterilized, and packaged directly within the surgery department. However, at Providence, the reprocessing section was centralized for all soiled material, regardless of whether it was trash, linens, dietary trays, or instruments.
Within two to three months, I had made my observations and developed recommendations that I discussed with Mr. Gilreath. One change we needed to implement involved the way in which the instruments were being transported from the Surgery Department to the centralized reprocessing area. Currently, the instruments were not being soaked in saline solution while transported on the carts, so that by the time the instruments reached their destination, the blood on them would be so dried out that they took much longer to clean, and sometimes when they were sent back to the operating rooms, they would come out of the packages still dirty.
Of course, the preparation and sterilization personnel were blamed, but based on my academic background, I knew th
at I needed to further analyze the issue and get to the root cause of the problem. “Why don’t we try placing the instruments in the saline solution while they are being transported to the reprocessing section” I suggested to Mr. Gilreath one day. He accepted the recommendation, but we also needed to discuss it with Dr. Thomas Wright, the assistant administrator, who also headed the SPD and Pharmacy Departments and had a PhD in Pharmacology.
When Dr. Wright heard my recommendation, he became obstinate. “We cannot do it that way,” he said. “I am doing it the best way I know, and if we place the instruments in saline while they are being transported on the carts, the saline will splash all over the place. I think it is better to do it the way we have been doing it.”
A long discussion took place with Mr. Gilreath trying to persuade Dr. Wright to at least try my suggestion for a while to see how it worked. Finally, Dr. Wright agreed to test my recommendation. We set a date and time for Dr. Wright and me to meet so we could both observe my recommended method. Mr. Gilreath indicated that he also would like to be there to oversee our experiment.
On the scheduled day, I happened to arrive earlier than the set time. As I walked into the SPD area, I saw that Dr. Wright was already there, and he was testing my recommendation without me, hoping that he’d be able to prove that it didn’t work. Also, he did not want to be embarrassed if we both gave it a try and found that the new method did work.
I communicated what I saw to Mr. Gilreath who became furious and called Dr. Wright into his office. “Why did you try this process alone when we decided it would be done in the presence of Kris and you both?”
Dr. Wright felt terrible and did not have a good answer. Instead, he began crying. Mr. Gilreath’s expression softened. “Excuse us, Kris,” he said.
I left the office, and later, Mr. Gilreath told me that Dr. Wright cried his heart out and kept saying, “I can’t take this anymore.”
“Kris, I realized that Dr. Wright does not have the expertise to make the new design of this hospital work,” Mr. Gilreath said. “That is why I brought you here. Your background is in analyzing hospital systems and finding solutions. The Friesen concept for this hospital is putting too much stress on Dr. Wright.”
Engineering a Life Page 19