October 30, 2009
I am a Canadian. I am young enough to have had access to “universal health care” my entire life. I still have the doctor I had growing up, he is a one and a half hour drive from my current city. Before I can have a doctor in the city where I live, I have to find one that is accepting patients and stop being a patient of my other doctor; it has been 5 years. But I want to share an experience I had at a hospital in a city with a population of 90,000+.
3AM. My wife shakes me awake. She is in distress. Her abdomen is in pain, it has been since 2AM when she started her pacing. The sweat was rolling down her forehead when she tells me that she is going to vomit from the pain. She leaves to the bathroom and proceeds to haunch and choke in the bowl. As the sleep leaves my mind I begin thinking, asking her questions and combining it with what knowledge I have. I know that the wait will be long but the risk is too great not to go.
330AM. We arrive at the hospital. I enter the doors to the emergency area. Though the floor is free of debris it has years of filth encrusted in the linoleum tiles. It was easy to detect that the floors had once been blue as the floor was much cleaner (looking) under the worn furniture, however all the food pieces and garbage that had been missed by the cleaning staff over the days gave me an idea of how clean this waiting area was.
Despite the muddy looking floor our shoes squeaked as we walked across the wax encased, filthy tiles toward the triage nurse station. There is an overweight girl accompanied by her mother, clearly she is in pain. Neither of them make an effort to look up, they have both been here too long. They are both in pain but for their own reasons. There are two police officers off to the side. They are not here for a specific case, this is Saturday night turned Sunday morning, they are here for prevention. There was no one at the nurses’ desk, they are in the other hallway trying to make more room in the hall for the patients on stretchers; they are the priority.
345AM. The eyes of the room glance up every now and again. They also waited a long while to be triaged. They are not as concerned about my wait or even the long series of events that turned their health care system into this. They are concerned with our ailment. If we are sicker they will be waiting longer. The nurse takes my wife back to ask some questions to determine whether she is worth getting what little bit of health care is available to go around this morning. I leave to move the car.
4AM. I am back in the waiting room. She is sitting in one of the chairs far enough away from everyone elsee to give them their space to be ill and with their own supporters. This is the etiquette that had been established, she would not challenge this. I sit beside her and start to think about the myriad of things that could be causing my wife such pain. I try to be rational with my assessment but when you come to this place it is because the time has come to admit that something could be very wrong. Could their be a bowl perforation? Or perhaps an inflamed appendix? I remember that people have died in these waiting rooms due to a miscalculation by the nurse; the tired, over-worked nurse, in combination with the child-like faith in our health care system to which many cling . It may be time to remind the nurse that this could be serious.
410AM. The lab tech comes for my wife, she is going to take some blood and asks for a urine sample to run some tests; these results will tell us whether we are in trouble. As she walks away to get her blood drawn an ambulance arrives. The triage nurse is having a busy night. One of the paramedics informs the police officers there is a belligerent gentlemen interested in seeing them. They follow him out of the room. The vacuum left by the departure of the police draws another soul into the room. The triage nurse closes the access point to her office. The visual of worn out brown penny loafers connected to the man decked from head to toe in blue jean combines with the potent smell of whiskey. The report from these two senses alone is enough to decide that this is the reason there are police here tonight.
[efoods]The man in jeans recognizes the homeless man using a chair as a bed. He sits facing the sleeping man who has awaken. They are 90 degrees from the direction I am facing. All that is left of their brief, one sided, conversation is the smell of whiskey in the air.
My wife is walking past carrying an empty jar towards the bathrooms. She will have to carry it past everyone again when it is full with her sample. She is going to hate this but apparently dignity is not cost effective in hospitals. The triage nurse is busying around in the office when the man in jeans begins issuing his challenge to everyone in the room. Perhaps he felt his attempt at intimidating everyone will keep him safe from any harassment or maybe it was a rather lucid precursor to his next move. He walks to the nurse who is behind the shatter resistant glass. The man tells the nurse he wants a bed in the mental health wing and adds the threat that he is “trouble.” She is tougher than the glass she is behind. Her answer is rational and rehearsed and means “no”. She has outwitted him and he leaves.
430AM My wife is pacing near me, it helps with the pain. The elderly gentleman at the back of the room has had enough. But there is a lot to have had enough of. It may have been the group of teens that were sitting with their friend who was punched to the point of injury out on the street. The constant back and forth of this group between the exit to go smoke was something to have had enough of. Maybe the loud metal music playing aloud from the cell phone they carried was something to have had enough of. Perhaps he had enough of listening to the man at the other end of the room who was trying to regain the pride he had lost from being jumped by a gang, by speaking of all the things he would do to get his revenge. The injuries he had suffered was not what was hurting him the most, what hurt was that no matter what he did or said getting medical attention was out of his power. The elderly man went to the nurse with his wife to decry the lack of any attention after their eight hour wait. This was the reason he gave for leaving. The nurse did what she could to reassure them that they would be fine without seeing the doctor tonight. Truth be told, if this man’s wife did die that night no tears would be shed by a system that had given up on her. The real reason the man had enough was because every minute in the room was a reminder that the system he had invested in for so long was not there. It was a brief illusion and what was there could offer them nothing.
515AM. My wife is in pain, she is pacing. Have her samples been processed? Has anyone looked at the results? She assures me that she isn’t getting worse. I believe her but I would like to see a leukocyte count to be sure there is no impending crisis.
The man in jeans has returned but so have the police. This time he is chatting with an officer who is still learning how to play the role of the man in charge but he has a partner if he should lose his audience. The officer and his partner begin asking the man in jeans questions about his identity. He hopes the information is false so he will have cause to arrest the man in jeans and try to take the respect that was not offered. Dispatch responds and shortly the police leave. It is okay, the sun in coming up. That which lurks in the night won’t need to be scared off until the sun has again departed.
530AM. The nurse comes out and calls a name. No response, they were tired of waiting and have left the room, or consciousness, joining the others passed out in various spots around the room. The nurse has not had time to put names to faces, she doesn’t see any sense in waking people to identify them. She crosses the name from the list and calls the next name and the process repeats. The third name called has a person connected to it. She follows the nurse beyond the doors to wait in another room.
A woman comes in with her infant child to stand in front of the unoccupied nurses’ booth. She is worried. As she is bringing in her infant child a father is escorting his drunken man child to the washroom where he is left for a time. The man tells the nurse that his son is too drunk and rowdy to receive care for the massive laceration in his arm. He explains that it is in everyones best interest if he just takes his son and seeks treatment later. But he has deluded himself into believing that had he stayed treatment would come. No. This father would be taking care of his son’s injury had he stayed or not. Attention is now paid to the woman and her child. The nurse likes infants more than drunks and man-children.
6AM. The door to the treatment hallway opens and I catch a glimpse of the three occupied stretchers in the hall. Help is not coming. The newly triaged infant is now expressing how all of us in the room feel. Her mother is rocking her and humming a tune I recognize from my days when I was as helpless as I felt now. It was time to get some answers. My wife stands in front of the empty nurses’ station. It is shift change. She will be waiting.
630AM. A new nurse digs through the patient files to find my wife’s on the bottom. She tells her that the results of the test don’t show anything to indicate the worst. With the information that my wife is safe to transport we indulge in our own delusion that going to a larger city will make a difference. That somehow this town is the anomaly and it is here where the doctor shortage is. When we are told that it will be four hours minimum before we will see a doctor. I leave to collect our things and get the car while my wife waits in-case a doctor appears to treat her.
7AM. My wife is sitting on the chair she has hovered around for hours. All of the same faces are in the room. In an attempt to expedite our service at the care facility we are heading to we ask the nurse for our test results. We are told that the results are the property of the hospital and we are not entitled to them. No, if we left we would be starting over. New fluids would have to be collected, new tests run, new results coveted. We get into the car and begin our travel because the care we were told about all our lives must reside at the next hospital.