Five years ago this summer while under deep anesthesia for arm surgery number 3, I drifted above the line and joined the group called Numerators. I awoke with a Hospital Acquired Infection. Numerators are the most diverse minority group on earth. Our members include every race, every creed, every color. Some are very old, sadly some are only days old. Numerators have lost a lot to join this group. Many have lost organs, and some have lost all their limbs; all have many kinds of scars from their journey. It was not our choice to leave the world of Denominators (those at risk of getting a health care acquired infection) and many will struggle the rest of their lives to understand why.
Today Denominator docs argue with Denominator bureaucrats on whether 70% of us have suffered needlessly. All too often they blame us for being too dirty, too unhealthy, too wounded. We Numerators are a great embarrassment to both groups; thus they passionately count the successful Denominators but struggle daily to count us. There are lots of silly rules for not counting some infected souls as if by not counting us we might not exist. The Denominator world created a huge computer network called NHSN (Center for Disease Control and Prevention’s (CDC) National Healthcare Safety Network) requiring thousands of man-hours to run yet they still can’t find most of our Numerator members. Numerators that are identified are then divided by the Denominators to create a nameless, faceless, mysteriously small number called infection rates. “Rates,” like their cousin “odds,” claim to portray hope while predicting doom for some of us. Denominators are in love with rates, for no matter how many Numerators they have sired, someone else has sired more. Rates soothe the Denominator conscience and allow them to sleep peacefully at night. Recently, rates have even evolved into sadistic SIRs (CDC’s Standardized Infection Ratio) which ruthlessly sanction how many unlucky souls it is acceptable to infect each year.
As large as our Numerator group is, we are still plagued with great loneliness as Denominators do their best to make sure we don’t talk to each other. The Denominators created an act called HIPAA to protect the Numerators but somehow it became a means to steal our names and faces, preventing the world from knowing that we exist. Numerators have no organization, no colored ribbons, no walks, and no marathons. Our knights are few and far away. Our nightmare is devalued from disease to a mere “complication,” an event not even worthy of a simple apology. Yet as I travel the state of Colorado speaking, one third of all Denominators I meet have a family member or close friend who has become a Numerator.
Upon our initiation into the group, Numerators have only two real choices: either a slow painful death, or hand over your life’s savings for treatment. Sadly, some hand over their money and still endure a slow painful death. Numerators cope with the full physical, emotional, and financial burden of infections on their own. As tough as it is to be a Numerator, it is far worse to be a Denominator whose loved one has joined our ranks and suffered a slow painful death.
Numerators don’t ask for much from the world. We ask that Denominators look behind the numbers to see the people, to love us, count us, respect our suffering, and help keep us out of bankruptcy, for once we were Denominators just like you. Our greatest dream is that you find the daily strength to truly care. To care enough to follow the checklists, to care enough to wash your hands, to care enough to only use virgin needles, for the saddest day for all Numerators is when another unsuspecting Denominator rises above the line to join our group.
Kerry O’Connell, June 2010