My mother’s death and the state of Hungarian health care

She would have turned 81 years old today, on June 20th…If they would have let her.

My mother always wanted to be on the go. Even most recently, for three straight weeks, every single day, we were going somewhere. We essentially visited all of Budapest. On the last day, February 11, 2018, when I had to send her home to Győr by car because I became sick and had a high fever, I was happier than she was to finally take a break at a pastry shop in Budapest. When I sent her home to Győr, the driver walked her up to her apartment.

In Budapest with me, after roaming the city. The last chestnut puree. February 18, 2011).

The next day, like she did every weekday for the past twenty years, she walked over to the local pensioners’ club without any trouble. The same was true on Tuesday. But by that afternoon–as I would find out by telephone–she became dizzy, she had a headache and she said that she could not get up from the chair. At the club, they measured her blood pressure, her blood sugar levels and found everything to be in order.

I recommended that they contact her local caretaker–the son of a childhood friend of mine–asking him to pick her up with his car, have her lie down at home and to give her plenty of fluids. If her situation does not improve, they should call for a doctor. They took her home, had her lie down, she had something to drink and in ten minutes, she was up and about in her room. She was no longer complaining about feeling ill and there was no need for a doctor.

On Wednesday, she once again walked over to the club (from where she walked home), but the dizziness returned in the afternoon. I received a phone call that the situation was now somewhat more serious than before, because her blood pressure had risen to 159 and as a result of the dizziness, she fell.

She was taken by ambulance to the Petz Aladár County Teaching Hospital in Győr on February 14th, initially to the emergency ward. It was not the test results, but my mother’s behaviour that led the hospital staff to send her to the psychiatric ward for observation. Their rationale was that “auntie is confused” (in Hungarian: “zavarós a néni.”) I was informed later that evening.

The doctor on duty at the psychiatric ward phoned me after she had received the patient. We spoke at length and candidly. She saw no reason to keep my mother in the ward. At her request, I not only listed all of my mother’s medications, but also dictated over the phone the contact information of her caretaker, who must be called to pick her up, when she is released. The sound recording of this conversation is available here.

Due to my high fever and illness, I was only able to visit my mother in person at the Győr hospital three days later, on February 17th, at three o’clock in the afternoon. In the most literal sense of the term, I found her in a frightening state.

It is true that I was aware of the fact that as of February 15th, she had been tied down to the bed and that hospital staff had found her to be deteriorating. But according to staff, she continued to eat and drink fluids and was communicating. But this was no longer the case when I visited.

This photo is from February 24th, when she was no longer eating or drinking, but still opened her eyes.

Right away, I considered taking her back with me to Budapest, as she had her regular family doctor in the capital, as well as her cardiologist and psychiatrist. But in such a serious state, I did not dare to transport her.

I visited her during the permitted hours (between 3 PM and 5 PM) every day. At the time, it was not necessary to feed her, as she was able to eat on her own. By Sunday, she ate the eight pieces of chocolate-chestnut puree hearts that I brought in for her. I was only able to speak in person with the doctor assigned to her file, Dr. Zoltán Greff, on February 19th. Until the time of my mother’s death, I communicated with him on several occasions.

From the beginning, he said that there were problems with the vessels in her brain. “There is no tragedy, but there are lots of little problems,” he explained. He added that he would try to treat her with different types of medication, in the hope that she would react well to one of them.

But he gave no explanation for the rapid deterioration in her health.

She would have turned 81 on June 20th, 2018.

I could not understand what was going on. In Budapest, I accompanied her to all of her appointments, we went to her psychiatrist together, which was required due to the changes in her mood brought on by old-age depression. Due to her arrhythmia and her pacemaker, she was examined every six months at the Göttsegen György National Heart Institute. The last appointment was on December 20th. On the last occasion, I was with her day and night for three weeks and absolutely nothing indicated that her health would deteriorate so rapidly, as it did.

She functioned adequately given her age and lived independently. What happened to her, especially so suddenly? I received this answer to my question:

“With such elderly people, a deterioration in their health can happen quickly, there is nothing unusual here. There are problems in the blood vessels of her brain and we need time to set the right medication for her. This can take 2 to 3 weeks.”

He tried to reassure me that they will see what medications work for her.

I had one consultation with him that I will remember for the rest of my life. When it dawned on me that my mother was drinking large amounts every time I visited her (sometimes more than half a liter at once, while previously it was difficult to have her drink a small cup of tea, glass of water or a soft drink), I thought that she was at risk of dehydration, as she is not getting enough fluids. Then I also wondered: are they feeding her properly?

But this was not what I spoke about when meeting with the doctor. I asked him: “If there is a problem with my mother’s brain, why are they not treating her in the neurology department? If she is in a critical condition, why is she not in intensive care?

Dr. Zoltán Greff had this to say:

“They do not transfer anyone from this department.”

“But why not?” I asked.

The doctor bowed his head and did not answer.

“Perhaps because she is old?”–I asked.

“That’s one way of putting it,” he responded.

“So my mother must die?”–I asked.

“That’s one way of putting it,” the doctor answered.

On that day, February 26, 2018, in a few hours, I received the phone call: tonight, at 7:40 PM, your mother died.”

The next day, I was in Győr again. I signed off on all the paperwork, including confirmation that I did not want an autopsy conducted. I organized the funeral and it was extremely painful that she was no more. But for a week, until I received by mail the death certificate, I tried to accept that there was a problem with her brain and this is why she could not live any longer.

Yet the death certificate and the attached pathology listed heart failure and high blood pressure as the cause of death. In addition to the fact that in these cases, and when being bedridden leads to pneumonia, the relatives of elderly patients are duly informed, I considered heart failure as the cause of death unlikely, as my mother had a pacemaker that had just been tested. And it is unusual for someone to die from high blood pressure when they are on appropriate medication to control this.

I received documents showing that it was not a problem with my mother’s brain that killed her.

With difficulty, I received copies of her hospital records, as well as the results of tests conducted in the emergency ward. I was only able to obtain these in person and by submitting a written request. It took a full month for me to receive these after I had already paid the required fee.

From these documents it became clear that the hospital never experimented with any medication in order to determine the “problems with her brain.” Moreover, during her 12-day hospital stay, not a single laboratory test or any other test was ever ordered by the doctor. In the hospital records, the only medication that was listed was that which I dictated to the first doctor I spoke with over the phone, and which my mother had taken for the past four years. Additionally, the only time my mother received fluids through infusion was on the day of her death, immediately before regular visiting hours. And perhaps this was for my benefit, not for hers.

My mother receiving infusion, because of me, on the day of her death.

After all this, I saw no reason why my mother would have been kept in the psychiatric ward. She was only meant to be here for a few days for observation, under the justification that “the auntie is confused,” after the emergency ward had conducted tests. These tests did not justify her in-patient treatment.

But why did they not investigate the causes of her confusion? It crossed my mind that my mother–who from 4 pm to close to 10 pm was being dragged from one test to another–was probably hungry and thirsty, since she had last eaten and had fluids at the pensioners’ club at noon. Due to being tired, hungry and thirsty, she was more confused than what might be expected following a diagnosis from a few years ago of moderate dementia.

If they kept her in hospital, why did not investigate her rapid decline in health? Why did not turn to life-saving interventions?

As soon as she arrived in the psychiatric ward, she was physically restrained to her bed. The explanation was this: “auntie always wants to go.” Naturally, while she had strength, she wanted to get up, she would have wanted to go to the washroom, but she did not know her way around and she needed someone to escort her. Of course the solution was not to escort her to the toilet, but to put diapers on her and tie her to the bed.

My mother tied to her bed on February 25th.

Finally, I must ask a stupid question: what happens if we tie a person down to his/her bed, thus making even the most basic free movement impossible and while we give her the usual medications, we do not provide adequate fluids and food? I admit, this is truly a stupid question.

Maybe I made a mistake, when I agreed not to ask for an autopsy. I did not decide against this because it is not permitted for Jews, but because at the time I did not think that chief physician, Dr. Zoltán Greff, had lied to me.

Yes, my mother always wanted to go.

Dear, God…

Eszter Garai-Édler

Translated from Hungarian by: C. Adam

32 Comments

  1. It was a tragic situation, very regretable and it was avoidable. Had the doctor been able recognize that the lady suffered a stroke. On the second photo it seems clear as she show no cognition. A c-scan would have immediateley confirmed it. Quick application of a clot-buster could have saved her life. That is easy, inexpensive,simple and fast acting solution. A healthy and active life style from there on, she could have live another 10-20 years.

    The tragedy on top of such a tragic result is that there is nothing any one can do about it in Hungary. You can not hold the doctor responsible for his negligence. One can not sue for his negligence. Likely no doctors can afford insurance to cover for his failures. No responsibility, no penalty. And even the medical society would not hold his feet to the fire.

    That’s how socialized medicine works. Everything worth what you pay for it. Beside negligence is a way of life in Hungary. That is what I keep reminding people here and on KMH. The general nationwide thinking and attitudes right down from the top to the general population. While they suffer the circumstances, yet they disagree to change or improve on anything over there.

  2. Similar with my mom who was only 75 – in New York. Healthcare is given up only for the “young” all over the world – over the age of 75, a patient is a burden.

  3. Also, what are you talking about autopsies? Right, not allowed on a Jew! And too bad she lived her life in Hungary.

  4. Health care horror stories are not particular to only Hungary. I talked to people in Canada about lack of adequate care due to having to ration it, sometimes resulting in death or prolonged suffering.

    Hungary’s health care system is a reflection of its wealth, as in its GDP/capita. For the fact that Hungary is currently not closer to the likes of Slovenia in this regard, we can mostly thank the stewards of Hungary’s economy during 2002-2010, which is when its fundamentals deteriorated significantly, with low economic growth rates and high government and consumer growth rates, which affected Hungary for long after 2010. Since 2013 Hungary has been once more catching up to its regional peers in this regard, growing slightly faster than peer average, but it will take a long time before it will catch up, even if present course is maintained.

    So, in the meantime no one should expect Hungary’s health care system to be as good as that of Netherlands, Luxembourg or Switzerland. Not even as good as Canada’s. Just like those in Ukraine cannot expect health care services to be as good as those in Hungary. I know for a fact that people in Romania, where GDP/capita is about 30-40% less, they have a high tendency to go for treatment in Hungary in search of better care.

    It is always sad when we lose a family member, and it can be infuriating when we suspect that something more could have been done, but has not been done. Been there myself! Sorry for your loss!

    • Hungarian Free Press says:

      No, there are horror stories that are absolutely unique to Hungarian health care. For instance, in November 2016 a decomposed corpse was found in a washroom of Jahn Ferenc Hospital in Budapest. The corpse had been there for days. Clearly, the washroom had not been cleaned for days. The hospital launched an internal investigation and determined that nobody bore any responsibility, but administration issued an apology to the deceased woman’s relatives and loved ones, as well as to patients and others who had been shocked by this news.

      https://24.hu/belfold/2016/11/29/tobb-napig-hevert-a-holttest-a-budapesti-korhaz-mosdojaban/

      Another horror story, specific to Hungary: An elderly man collapsed in the hallway of Szent János kórház. They tried to resuscitate him, but failed. The man’s body was covered with a white sheet on the floor of the hospital’s busy hallway, in the psychiatric ward. He was left there for several hours, as patients, visitors, doctors and others walked by the corpse on the floor.

      http://www.borsonline.hu/aktualis/orakig-kerulgettek-a-foldon-hevero-holttestet-a-pszichiatrian/135777

      If you are truly claiming that these types of things happen in Canada or the United States, then you are either dishonest or terribly ill-informed. Go visit a hospital in Hungary and just take note of what you see on any given day. And then we’ll talk.

  5. Anastazija Keckes-Chartrey says:

    My dad passed away at the hospital in Keszthely under horrible conditions 3 years ago , 10 days he was there, the physician I refer to as the Grimm Reaper aka doctor death !!! My dad did not want to die , he received minimal treatment , he fell out of bed trying to leave or go to the restroom , to be in a diaper made him angry . The hospital was and is understaffed 3 nurses to 52 patients , the bedding was shredded and we were told if he messes the bed more than twice they would not have clean bedding . I was only there for 2 days , and when mom went to visit him on Sunday she found him covered with a sheet having died during the night and they had no clue when … cause of death pneumonia he had early stages of lung cancer that was spreading .

  6. Christopher Adam says:

    Four years ago, my great aunt basically starved to death in a hospital in Budapest. A couple of months earlier she fell at home, ended up in hospital and gradually deteriorated physically as she remained bed-ridden. She lost a frightening amount of weight and when my mother was back visiting in Hungary and went to see her, she was shocked at how thin and weak she had become. My great aunt needed help eating, but nobody in the hospital took any notice. They would drop off the food in her room and take it away completely untouched from her night table after meals. When my mother visited, she fed her and my great aunt had a ferocious appetite.

    My mother returned to Canada and my great aunt died a few weeks later, having starved to death.

  7. StrandedinSopron says:

    First of all, my condolences Ms Garai-Edler; that sounds a truly horrific experience.

    Anybody who has experienced the Hungarian health system will not, however, sadly, be surprised at your tragedy.

    Yes, of course, money is an issue. Of course, the continued flood of Hungarian doctors going to work in the West ( according to official figures 5-6 thousand Hungarian doctors are working abroad now, which equals 10% of their total number. There were 7028 open positions in health and social care last summer) also doesn’t help.

    But there is a culture of corrupt (bribery is an *essential* part of the system) negligence is something which Hungary appears to be a specialist in. If a mistake is made, it is very quickly covered up by the other doctors. The older “professionals” operate a mafia-like system creaming off the bribes paid by the patients’ families and bullying those brave enough to stand up to them.

    But, hey! It’s not all bad a spanking new private “medical center” has just opened up in the city, Duna Medical Center.
    So, if you are rich enough or even just a mere politician, the top care is definitely guaranteed. For a price obiously but there will be no missing toilet rolls or light-bulbs there I guess.

    • “So, if you are rich enough” Yes, welcome to the glorious system of the US of A!

      • Reality Check says:

        Always deflecting and trying to point the conversation away from the issues in Hungary. Your sophomoric whataboutism is simply a way to shift focus. You can not clean yourself with the szar of others. Pointing at the deficiencies of the US system does not excuse what’s going on in Hungary.

        Fidesz has been in power long enough to improve the healthcare system. In other posts you make claims that the Hungarian economy is doing great and in this one you claim it still suffers for the alleged crimes of the previous governments. Things are good enough to build new stadiums and to place Orban’s office up on castle hill, but not good enough to pay doctors decent wages. You are simply a Fidesz sycophant.

        Hungary’s horrible healthcare system is one of the reasons I will not retire there. I’ll take my US system over Hungary’s any day.

        • “Your sophomoric whataboutism”. It never hurts to put things in context, except when someone wants to bullshit and the context exposes it, then it hurts the bullshitter.

        • Don Kichote says:

          „Always deflecting and trying to point the conversation away from the issues in Hungary.“ and he does not even live in Hungary.

          I wish such silly ignorant homophob people like Peter life-long in Hungary.

          I wish such stupidly ignorant homophobe as Peter life-long in Hungary … if I listen to his defense while he is old and sick in bed. . But he could never tell the truth.

          • homophobe? Seriously? I actually support gay marriage. So what about my comments I ever made here came across as being those of a homophobe?

          • Don Kichote says:

            You put economy above human rights, the economy is Orban’s oligarchs, millionaires. You are not interested in why people are dying here. When the Germans in Hungary become seriously ill, they go to Germany for treatment although they are also insured in Hungary that speaks volumes. One hundred million euros for Hungarian Probaganda in the USA. You said it’s normal … if that’s not homophobic, then what is it, just stupid?

          • Your argument is absurd, to say the least! Yes I believe that the economic well-being of everyone in Hungary is more important than many other subjects, including gay rights, which covers a small minority. A stronger economy is what would improve the health system as well. Cannot deny the two are not highly correlated. Not that I think it has to be either/or, in other words, I do believe Hungary’s government should be somewhat more accommodating towards the gay community.

            Aside from that, there is growing awareness across Europe’s gay community that between legalized gay marriage, but no public safety, and civil unions with public safety, the progressive option is the one that really stinks! In France, Netherlands, Germany and other places recently, gay people have been voting for right of center by a higher number compared with general public, exactly for this reason. If I were gay, I’d prefer Hungary over most West European countries at this point in time. Same goes if I were Jewish, a young woman and so on.

          • Don Kichote says:

            I did not write about gay people. You just have to read your writing.

            Peter:
            „I think a sizable portion of Western World population needs medical help frankly, because there is nothing healthy about self-loathing, leading to a desire for ethno-cultural suicide.“

            Peter:
            „On the other, there is the massive influx of non-Europeans, both legal and illegal. PEW research recently released a study showing that a country like Sweden could become 30% Muslim by 2050, which is in only 32 years.“

            ——————————–
            Peter:
            „Stop your anti native European hate mongering! All cultures on this planet are precious and have the right to preserve themselves. Any attacks on those rights is pure hate & bigotry.“

            Reality Check :
            „I get it, you are scared of Muslims. Fear makes people irrational.

            Peter:
            „No you don’t get it. All you get is the ability to write typical leftist talking points, which in the case of this conversation are out of sync with what I actually said. “
            ——————————–
            Observer:
            „Peter
            How many times will u mention “Nazi” regarding Orban? He’s not, he’s a fascist.“

            Peter:
            „Want to see fascist? Look left!“
            ——————————–
            Peter:
            „3) Hungarians are as native to Europe as were the Sioux or Hopi to North America. The fact that these groups may have lived somewere in a different area 1,000 years ago, does not make them any less native. Would you dare to make this argument in regards to their native status, based on this same logic? Probably not, so stop making it in regards to Hungarians!“

            Don Kichote:
            „3) This was my question, when they lived 1000 Years before elsewhere, what is with 2 years or 10 years or 30 years. And who is the Judge, because Hungary have a lot of Immigrants.“

            ——————————–
            You didn´t answer, because you cant!

  8. It is all negligence, irresponsible doctors and staff. On top of all that the “socialized medicine” that is rationed by government. All that is a moral decline in society by the long socialist attitudes. Nobody cares, nobody is interested, nobody is responsible, and nobody interested to change it. That is the result of all.

    Go, take your time and read the healthcare systems of the nations of the world. Everywhere where that similar system practiced, have the very same result. The worst is that since socialized medicine is rationed, the sick has to wait long time to be scheduled for treatment, operations,etc. People are not considered humans, just statistics.

  9. Edward, you missed the boat. The patient is not a burden, but a gold mine. Healthcare is the largest and most lucrative part of the economy. But only where there is some incentive in it. And that is what makes the world go around !

  10. My sincere condolences to the writer of this article; Eszter Garai-Edler. May your mother rest in peace. What happened in your mother’s case can be blamed on Socialized Medicine. We have the very best medicine here in the United States. Even people who can’t afford health insurance get treated under the umbrella of Medical-Medicaid. We never turn away a patient regardless if insured or not. I am a Registered Nurse and I have first had knowledge of this. Unfortunately Hungary has Socialized Medicine but it has been getting better since 2013. Hopefully the trend continues. Our Canadian neighbors and people from other parts of the world frequently come to the USA for care due to the long wait for treatment. The Liberals have been trying to get Socialized Medicine here in the US but thank God have been unsuccessful so far. I hope it never happens. I don’t want to see the elderly treated as your mother was treated. Please except my sincere condolences!

  11. Edwards;
    You perhaps misunderstood the Torah. NO knife upon the body ! You may need to consult your rabbi, if that also would mean the corpse. Or dead body also. But no need for such a procedure, it was more than clear from all the described symptoms that the lady had stroke. The fist was very mild, a warning, but the second become a killer.Immediate recognition and the proper treatment could had saved her life. Instead she was transfered to several specialty facilities for absolutely no reason at all. The case is very likely one of gross negligence.

  12. LIZ;
    Thank you for stating reality for all those power-hungry socialist wan-a-bees.

  13. StrandedinSopron says:

    “Unfortunately Hungary has Socialized Medicine but it has been getting better since 2013”

    In what way exactly?

  14. PETER;
    Most people in the USA do NOT pay a cent for their healthcare, yet receive all that they need.
    Even if you comply Obama’s law, you can get health-coverage for as little as $9 a week.
    http://www.healthcare.gov

    Foreigners come to US to get operations, all kind of healthcare, give birth, yet the government can not put an end to the “birthers”. Similarly the DACA children (790,000 of them. Now the “caravans” that flood the US ability to even try to process them.
    That past week you hear nothing but the horror of separating the adults and children. The press equates it to Hitler’s actions. Yet they keep coming, more and more. We have already 12 million illegals. More are coming, no end to it.

    • Have to say a very false claim you made here. Everyone I know in the US of A pays a lot for their healthcare. Most employer family plans cost in the $750-$1000/month range, with the costs being split between employee-employer. Then there are the deductibles. Unless you suffer a serious illness most of the time families pay more out of pocket than the insurance pays in any given year. From what I saw and heard those who have the right insurance get exquisite services, unlike their neighbors to the North. But it is also the most expensive system in the world on a per capita basis, yet many people do fall through the cracks. I pointed out the high infant mortality as an example.

      https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

  15. StrandedinSopron says:

    “Unfortunately Hungary has Socialized Medicine but it has been getting better since 2013”

    In the absence of your answer, here is a link which indicates the contrary:

    https://bbj.hu/economy/survey-shows-hungarys-healthcare-near-bottom-in-europe_128074

  16. PETER.
    In the US everybody receive health-care when needed.Most do NOT pay for it. That is why healthcare cost are the highest in the world. About twice as much as elsewhere. About 60% receive health insurance through their employment. Even if they may required to contribute to it.
    About 55 million receive Medicare. There is Madicaid for those who may be left out. “Obama-care” mandates by law to every one to purchase health-insurance. The penalty can go 10 times more than healthcare insurance cost. Untold number comes from other lands to receive healthcare free. The tax-payers pay the costs. $7 million on welfare receive everything free.

    Plus there is the “VA”, the actual government healthcare for military veterans. That is the WORST healthcare system in the land.
    The actual “social medicine”. I am a veteran myself, gave up on it many years ago. Would never dream of going to the VA.

    Read “Liz”s comment above !!!!!

    • Depends what you mean by “needed”. People showing up at emergency will never be turned away. But what about preventive medicine? Even those with top-notch insurance tend to be reluctant to do yearly screening, because it takes a while for the insurance to kick in. First costs are paid out of pocket. Lack of preventive care is part of the high costs of US health care. As for the infant mortality excuses, there may be some truth to it, but other countries have junkies and hippies. But lack of pre-natal care seems to be a major factor.

      I recommend you read this for more insight:

      http://time.com/3847755/mothers-children-health-save-the-children-report/

  17. Sorry;

    That is 47 million on welfare.

    And not $7 million !

  18. PETER:

    In life there is a reason for everything !

    US has rather high infant mortality rate for several reasons;
    1., Many refuse to immunize their children, in fear of “adverse reactions”.
    The serum, induces the very illness it may start immunity for.
    That case may be one in a million, but what IF that one in a million is your child ?
    Many feels the risk does not worth the possible benefit.
    2., The hight number of teen-age pregnancies. Young single girls on the streets, just do not care.
    3., The drug-apidemic. Far too many cocaine-babies are born. The most tragic condition. The war on drugs is being lost, as long young-bums on the street can get money for drug.
    In thew Phillippines they shoot them. In the US treat them, than let them out on the street again, and go right back to drugs.

  19. Ms. Garay; your late mother did NOT die of lack of fluids.
    More I go over repeatedly your statements, more and more confidently can see it was her second stroke.
    The first one was mild, a so called warning.
    The correct diagnosis and treatment would have very likely saved her life perhaps for another 10-15 years.
    Looking at her photo, she looked bit older than 80, but had nothing seriously wrong with her health.
    A slight degree of Altzheimer never killed anybody.
    It made absolutely no sense as of why she was transferred to the psycoitric and than to the cardiac section.
    There seems to be absolutely nothing reasonably assumable than failed diagnosis and the lack of proper treatment. Likely the application of cloth-buster.
    Deeply sorry for the tragedy.
    But please, do NOT blame yourself of not being with her or taking care of her.
    Life is a destiny, we can not control it.

  20. There it is folks, clear and concise evidence.

    “…there were problems with the vessels in her brain…”

    There it is , could not be a clearer admission that she suffered a stroke, yet was not treated accordingly.

    Everything else is meaningless.
    Just what else anybody has accepted ?

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