Tale of two ERs

Last Friday night, Nick’s glucose meter flashed “523.” We’re looking for numbers between 80 and 125; anything near 300 is considered “really” high. Over 500 and we’re looking for ketones and flashing back to the intial heart wrench of his diagnosis. To complicate matters, we discovered he’d somehow lost his insulin while running amok with friends an hour before. So, off to the ER we went.

But which ER? We’ve been to them all – St. Joe’s, Mad River, General’s Urgent Care – but Nick’s been to St. Joe’s most of all and it’s a bit closer, so through Eureka we drove.

Problem number 1: Look, I understand growing inured to the the relentless turnover of society’s underclass, but the place is still an emergency room. The receptionists should at least realize when new patients are waiting on the other side of the glass, five feet away. But one was pregnant and the other is throwing her a shower and the quilt they were ooh-ing and ahh-ing over was lovely. I’m pretty sure they’re doing a co-ed shower – because it’s silly to do two, after all – but I didn’t catch when she’s due. The party sounds fun, though, a big, backyard fest in the springtime. Eventually, my concern for my son outweighed the compelling back-and-forth conversation happening. I knocked on the glass. They turned around. We proceeded to fill out papers, hand over cards, explain the sitation to the triage nurse.

Problem number 2: Nobody expects ER waiting rooms to be fun, but do they have to be quite so dismal? And really, a Pearl Harbor movie running on the waiting room TV? When the place is filled with men wobbling on crutches, old people convulsing in wheelchairs, parents clutching feverish babes to their chests, do we need images of blood, bombing, dismemberment, families crying over their loved ones as corpses are dragged away over the tarmac? I’m going to say, no.

Problem number 3: The unavoidable intimacy with whoever’s on the other side of the curtain. In our case, although I never saw her, an old woman who’d fallen.

Doctor: “That’s quite a hole you’ve got in your head!”

Elderly woman behind the curtain in a small town hospital: “Oh, dear.”

Doctor: “We’re going to need to staple that up. Now, I can give you some shots to numb the area, but it’ll take three or four shots and since we’re only doing three to four staples, maybe you want to just get it over with?”

Elderly woman: “Well, whatever you need to do, you just do it.”

Doctor: “Let’s just do this stapling real quick, then. Now hold still.”

(cha-chunk, cha-chunk… The elderly woman moans softly, a drawn out cry of pain… cha-chunk, cha-chunk)

Doctor: “You’re a real trooper.”

Problem number 4: Instead of a shot, they gave Nick an IV and, when his blood sugar didn’t drop quickly enough, overdid his insulin, which meant by the time we returned  home three hours later, he’d dropped to 33 and we had to rush sugar back into him. Eat, poke, repeat. Pincushions have it easier.

Caveat: I am appreciative of the overall good care we’ve always had there and grateful to have a place to go.

So we endure that ordeal, but then, on Saturday, Bobby’s asthma attacks worsened from frequent to constant. I’ve been bugging him to make an appointment with Open Door for the past several weeks, tired of being kept up by wheezing and coughing, and scared he’s going drop dead, unable to get oxygen into his lungs. But once we lost our Medi-Cal, we lost the prescription coverage, too. The Advair discs run $200, making breathing a luxury item for broke asthmatics. So he’s been gasping and hacking, culiminating in attacks so severe on Saturday that I demanded we go to the ER. “I don’t care if we rack up a bill – I don’t want you to die.” He was too weak to argue.

For a change of scenery, I opted for Mad River Community Hospital this time.

Problem number 1: The intake system sucks. You wait outside a door opening to the tiny triage room, forced to listen to the problems of the person ahead of you. Except when that person finally left, two other people cut in front of me, insisting they were there first. Maybe they were. But my patience wore thinner each time Bobby strained for breath. Even taking a number would have been better than the “system” in place.

Problem number 2: Nobody expects ER waiting rooms to be fun, but do they have to be quite so dismal? A coat of paint and some decent magazines would lift the place from drab to bearable.

Problem number 3: The nurse (or whatever her professional title is) taking Bobby’s information recorded the answers to her questions so slowly that I thought we must be in a Seinfeld episode or maybe a Monty Python skit. A half-dozen people sit in the waiting area; two more wait in line. We’re in the tiny room. I’m standing, one hand on Bobby’s shoulder as he tries to steady his breathing.

“First name?”

“Robert”

“R… o… b… e… r… ”

We crawl through his last name, address, phone number. I answer for him as much as possible since he can’t, you know, breathe.

“Now… are you… in pain?”

Incredulous look. “I can’t breathe.”

“But… does it hurt?”

Problem number 4: Again, everyone’s overworked, underpaid and suffering from lack of a budget. But hey, I’ve been poor and living in small spaces; creating a pleasant environment is still possible. (And I don’t mean those “tropical” curtains!) Piles of boxes stacked hither-and-yon, hand-scrawled notes reminding transcriptionists not to forget to type the doctor’s notes into the patient’s folder – these are not symbols promoting a sense of well-being. “It’s kind of like being treated in a supply closet,” Bobby wheezed.

Caveat: I am appreciative of the overall good care we’ve always had there and grateful to have a place to go. Plus, the doctor scored us an Advair sample, so Bobby’s continued to improve. Maybe by the time it runs out next week, we’ll have Medi-Cal back. If not, something else will have to wait. The breath measuring device read just over 200 when he blew into it. The ideal is 750. More numbers and not good ones.

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3 thoughts on “Tale of two ERs”

    1. Yes, thank you – the two youngest kids have it. (Nick’s covered through California Children’s Services, too – at least till that program gets slashed.) But I made too much for Medi-Cal. Now that I’ve taken a 40 percent paycut at the paper, I’m trying to get Bobby and I back on that. Given all the budget madness, though, it’s hard to guess what will happen.

  1. Jen,
    ER rooms are so dismal. I wonder that a service group doesn’t take them on. Like maybe a garden club do plants and the Kiwanis a new coat of paint. I’ve spent some time there (though not as much as you) and your stories and caveats ring so true. I know the nurses and doctors see so much misery (and they’re in such dismal surroundings, too) that they have a hard time reaching out and acting human–but their humanity is just what we need when we’re there in the ER.

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