There are two private rooms in Intermediate care and both were empty when we made the transfer from CCU. All the rooms are the same size, so that meant that a semi-private room gave you half the space of a private. As David, who is an architect, noted, this was equivalent to the size of a prison cell. I was spending about 12 hours a day at the hospital and had assumed the responsibility of David's non-medical care - changing his sheets several times a day when he sweat through them, staking out the least threadbare patient gowns on the laundry cart, scrubbing his bathroom, bathing him, and bringing in takeout food from the neighborhood for our meals together. This meant that there were two of us sharing his half of the room. A private room seemed like more of a necessity than an extravagance.
David's cardiologist had requested a private room for him, so we were surprised when they brought us into one of the semi-privates. The orderlies set David up in the bed by the window and then drew the curtain that separated us from the bed by the door. I surveyed our new accommodations. To the right of the bed was a small unit built into the wall. This held two low drawers that couldn't be opened because they were barricaded by the bed. Above the drawers was a small counter about six inches wide. Actually, calling it a counter is an exaggeration. It probably aspired to counter-hood, but it was really more of a ledge, or a very large chair rail. It was just big enough to deceive you into thinking it could be used to hold things, but for anything larger than a paperclip, it was out of its league. Above our little ledge was a narrow door that opened to reveal a cubbyhole with clear aspirations to closet-hood. Someone had optimistically installed a hanging rod and a hook, but it was too small for a coat, a handbag, or even a hanger. I rolled up David's clothes and stacked them in the cubby.
David was still too weak to complain, or even much care where he was, but I was getting annoyed. Surely hospitals have noticed that their staff is overworked, so shouldn't they be reasonably attentive to the requests of a patient who comes equipped with his own full-time maid. They can't have overlooked the fact that their budgets are shrinking while their expenses are rising. On the day David was transferred out of CCU we were told that when he left the hospital he'd have to look elsewhere for a cardiac rehab program because the one at Lenox Hill had closed six months ago due to budget cuts. So it would be reasonable to think that they'd jump on the opportunity to fill a more expensive private room for a week. But reason didn't seem to be part of the equation.
Here's what I did to try to secure a private room: I gently reminded David's doctor to look into it, I spoke to the senior nurses, I spoke to the Kiki, the Cardiac Fellow on the floor, I begged David's doctors, I begged Kiki, I made a business case for the advantages of paying the hospital more money than we already were, I waved my checkbook and offered to write a check on the spot. All the while at least one of the two private rooms sat unused, and sometimes both of them were vacant. The little pinches in my chest returned.
So why does a hospital let the pricey rooms go empty? I decided to direct my question to the one person who knew the answer, the Director of the cardiac care unit. Of course, he was virtually unreachable, but that didn't seem like much of an obstacle, considering what my week had been like so far. I knocked on his door, left him a voicemail and sent word through Kiki. The Director's lack of compassion was legendary throughout the hospital and we got plenty of stories about his temper and icy demeanor, but we got no reply. Every day Kiki would relay his boss's position, but each answer clarified nothing and only raised more questions: They were keeping the rooms open for emergencies, David hadn't been in the Intermediate care unit long enough, David had been the Intermediate care unit too long, they didn't accept people who were going to stay more than a few days, they didn't accept people who were only there for a few days.
I'd had enough. I had nothing to lose - they wouldn't withhold medical treatment from David and I had already taken over almost all of his non-medical care. I marched up to Kiki, checkbook in hand. "A private room has been sitting vacant for 3 days. David has 3 days before discharge. His doctors have requested a private room. We have requested a private room. I will write a check here and now for the difference. Can we have a private room?"
Kiki looked up from his papers. He saw that I wasn't leaving without the real answer, and so he gave it to me. "The Director has decided that David won't get a private room. No reasons given. There's nothing I can do about it."
And that is why hospitals let the pricey rooms go empty - for no good reason.
12:36:06 PM 
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