What the Emergency Room waiting area says about American Society
I had the unfortunate experience of going to the emergency room this week. I could have waited for the next day and gone to see my primary care doctor, but I was worried and wanted to be seen quicker. You know how it is, when a health issue is bothering you, you imagine the worst possible case scenario. A small lump becomes stage 4 cancer, a small pain in the general vicinity of the heart becomes a full blown heart attack or stroke. Obviously it’s all much worse when you actually google your symptoms - big mistake! Never do that.
There’s a billboard just down the road from where I live, it has a picture of doctors and nurses working hard in the ER and a digital counter in the corner telling people what the current wait time is to be seen in the ER. Today it showed 43 minuets - not bad I thought, I can wait that long to be seen by a doctor and have my mind set at ease. Anyway, I’m busy tomorrow.
There’s a billboard just down the road from where I live, it has a picture of doctors and nurses working hard in the ER and a digital counter in the corner telling people what the current wait time is to be seen in the ER. Today it showed 43 minuets - not bad I thought, I can wait that long to be seen by a doctor and have my mind set at ease. Anyway, I’m busy tomorrow.
So, off we go to the ER, my wife Elaine and I, thinking we’ll be back pretty soon having our minds set at ease.
The process starts fairly optimistically; you have a checkin kiosk where they basically take your name and you select a reason for coming to the ER. Pretty quickly you get called to have your vitals taken - everything feels great at this stage, the process is running smoothly, fairly soon we’ll be out of here!
Admins float around the ER waiting room with portable stations taking down more information, another taking insurance and payment information. We even got a discount for paying our co-payment in one installment! So far all is good. We felt very optimistic - they have their act together here I commented to Elaine.
Next is Triage. Within an hour of arriving they call me in for triage - not bad I thought, the sign said 43 minuets, it took an hour but 17 minuets is an acceptable delay seeing as they’re extra busy today. They take some measurements and send me back out to Elaine in the waiting room.
We sat there watching people come into the waiting room. I half jokingly said to Elaine, “where do the rich people go when they need an ER? They’re sure not here!”.
At the 2 hour mark they called me in. Elaine got up to join me in the ER, “Oh, no!”, said the nurse, “you can stay here, we’re just drawing blood. He’ll be right out”. They stuck an IV in my arm, took some blood and sent me out to the waiting room, now tethered to an IV - any thoughts of escape from the ER were now futile.
Around the 3 hour mark of waiting an old man, probably homeless, trudged into the waiting room with a little cart that he pushed in front of himself. His cart had a few belongings in and strangely enough - a folding chair taking up most of the space. He had obviously been through the routine of the ER many times before - he knew exactly what to do, what to say. I was fixated on the folding chair in his cart. I built in my mind scenarios as to why a homeless man would have a folding chair. Well, I thought, even homeless people need to sit on a comfy chair - why not carry one around with you.
He found a chair in the waiting room and awkwardly positioned his cart next to him, in front of a second chair.
The admin took his address; “Are you still on Canoga”, she asked him. “Yes”, he replied, “On Canoga near Roscoe. Usually by the bus stop at the corner”. The insurance and payment admin didn’t even approach homeless man. They must have known it was a futile endeavor.
Shortly after homeless man got called in for triage. He took his cart with him, awkwardly maneuvering it around the rows of chairs and people. When he came back out his seat was occupied, he looked perturbed and not sure what to do - he had selected that seat very carefully. He pulled a chair into the center of the waiting area and then proceeded to take out his folding chair. One chair for his cart and one chair for himself. He seemed satisfied.
By hour number 4 I was ready to cry, Elaine was grumpy. “What’s going on”, I asked the orderly who was on duty to take vitals. “Oh, they’re understaffed tonight and very busy. More people here than usual”, he replied.
By hour number 5 I was ready to pull out the IV myself and escape the ER waiting room. Elaine was mad.
Finally at hour 5 and a half I heard someone call my name - we both jumped up! “The doctor will see you now”. You can’t imagine how excited we were to finally be let into the emergency room- small miracles. “Go sit on one of those waiting chairs over there against the wall” said the nurse, “the doctor will be with you shortly”. I felt my excitement drain from my body as I slunk over to the waiting chairs probably to wait another hour.
When we finally got discharged at hour number 7 I commented to the nurse, “You must be busy tonight!”. “Nothing more than the ordinary”, she answered. “Sometimes I leave my shift and I see people in the waiting room. Those same people are still there when I come back for my next shift 10 hours later”, she responded. “It’s normal to expect to wait even 11 hours or more to see a doctor in the ER” she told me. This nurse obviously hadn’t been briefed onthe updated messaging for the day.
Healthcare as a measure of compassion
More than any other emotion, I would say that hopelessness is the word that would sum up what I felt while waiting in the ER. I felt that I was being run through a process pre-defined to break you down, to make you docile, to make you anticipate with excitement the next minor event - such as the orderly calling you to re-take your vitals since its been so long since they last took them.
“This absolute feeling of hopelessness and resignation to an unknown fate is one I never believed I would experience in my lifetime, certainly not in a place of compassion”
When you have no indication of how long you will wait, when you have no one to turn to, when you have a medical condition and are afraid, and when you are tethered to an IV - you can't escape. This absolute feeling of hopelessness and resignation to an unknown fate is one I never believed I would experience in my lifetime, certainly not in the US and certainly not in a place which values compassion and caring over all other virtues.
The lack of compassion, the lack of caring translated into human beings; very vulnerable human beings, being treated like animals. Their pains ignored, their concerns went unanswered, they became a number, a folder prioritized by color.
A very sick man was seated near us, he kept throwing up, was obviously in a great deal of pain. People kept telling the orderlies that he was suffering, yet nothing was done to help him. He was admitted to the ER only to be pushed back to the waiting room again and again. When we left after 7 hours, he was still in the waiting room, still very sick, still very ignored.
I believe that the health of a society is measured by how it takes care of its most vulnerable citizens”
As I mentioned in my opening; I believe that the health of a society is measured by how it takes care of its most vulnerable citizens. When politics, business interests, money and greed combine you have the perfect recipe for the underprivileged to be marginalized.
How is it possible that in the United States, the richest country in the world, the country that in 2021 spent a whopping 4.3 trillion dollars (that is $4,300,000,000,000) on healthcare, you receive care that is worse than in many third world countries? Where does that money go?
“Health care is not optional. It is a basic human right”
It’s all about money of course, and where money rules, there is no compassion; only greed.
In the US, health care is optional. Many people who do have health insurance can’t afford the co-payments and premiums which have sky rocketed in the past few years. President Obama tried to make health care mandatory but the Republicans in congress managed to remove the mandatory requirement. Now, people who can’t afford to see a doctor crowd the emergency rooms where they are guaranteed a few minuets with a doctor or nurse and maybe a diagnosis that they can do little with after they are discharged.
When did we stop caring about other people and started putting our own selfish interests above those of the community we live in?
Health care is not optional. It is a basic human right that in a country such as the United States can be provided to all its citizens. I’ve lived in several countries where various levels of health care are provided, but in all cases it is considered a basic human right.
As human beings we have a right and an expectation to be treated with dignity, with respect and with compassion. We have come to accept as normal; laziness, a job done halfheartedly, lack of professionalism, lack of motivation to help and more than anything a lack of compassion and caring when dealing with others. When did we stop caring about other people? When did we start putting our own selfish interests above those of the community we live in - when did we stop caring?
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