As a couple of you actually figured out from my patterns of posting here, I spent much of last week taking care of my mother. I had to transport her to a hospital emergency room last Sunday night. The hospital released her late Tuesday. Then Wednesday afternoon, I had to take her back to the emergency room and she was in the hospital 'til late Friday.
She's home now and doing well so I need to fume about how awful things can get in a crowded emergency room. I've been in a number of them the last few years and it's maddening, utterly maddening. Because people are suffering, people are in pain…some are even on the verge of dying. There's a possible — in some cases, near-certain — cure there but then there are all these things, mostly relating to overcrowding, that keep it agonizingly out of arm's reach for far too long. Almost without exception, the doctors and nurses are wonderful and efficient and caring and everything you'd want them to be. Almost without exception, the admitting process and the red tape and the paperwork and most of all the overpopulation and the "waiting for a bed to open up" are disgraceful and — I'm sure, in many cases — killing people. That includes people who wait for long hours in emergency rooms to be seen and those who don't go there at all because they know what an ordeal it will be.
The Wednesday afternoon visit was one of the worst experiences I've ever encountered. Around 3 PM, I was leaving my house for the Joe Barbera Memorial when my mother's caregiver called and described symptoms that sounded bad. I course-corrected, went over there instead and stuffed Mom in the car. (Naïve optimist that I can be, I actually thought, "Well, Mr. B's memorial doesn't actually start until 6:00. Maybe I can get my mother treated and still get there in time for some of it." I was at the hospital until 2:20 AM…and would have been there longer if I'd just been quiet and done everything according to the rules. By the way, if you want a report on the memorial, my colleague Earl Kress has one up on his site.)
In every emergency room, you first encounter someone who does "triage," meaning they kind of log you in, check whether you're there for a heart attack or a hangnail, then prioritize who gets treated in what order. This particular emergency room was so busy and so disorganized that the triage people were running a good half-hour behind. I don't mean a half-hour to get the sick people inside so treatment can begin on them. I mean a half-hour to decide if someone is about to drop dead without immediate attention.
This, obviously, was not acceptable and I got into a very loud argument with one Triage Lady…which I guess was foolish on both our parts. Because while she was standing there yelling back at me, she wasn't processing patients and that was kind of the desired goal. So I broke it off, ran upstairs, snuck into a department that I shouldn't have been in and pressured my mother's doctor's chief nurse into phoning downstairs to demand a speedy admission. By the time I got back to the emergency room, my mother was undergoing the triage examination and shortly after that, she was wheeled inside. It also helped that I dropped the names of high-ranking hospital officials and the fact that one of my best friends from high school is a doctor in this particular emergency room. These are the times when you have to go into Full Bilko Mode, saying whatever it takes.
But you know, it shouldn't come to that. I kind of cheated and fast-talked and relied on connections to get her in there ahead of others…and I could only get that nurse upstairs to intervene because it was 4:00 in the afternoon and the rest of the hospital was still open. If we'd gotten there after hours when the upstairs departments were closed, that wouldn't have worked. The decision that my mother's condition warranted prompt action wouldn't have been made until a half-hour later, if then.
The call from upstairs got me got into another argument with the Triage Lady. She was furious that I'd gone "over her head" and she apparently felt that expressing that anger to me was more important than processing the dozens of people who were waiting for medical care…in some cases, critical medical care. Once again, I broke it off so she'd go back to doing her job…which I'm afraid was taking down their particulars, telling them to have a seat and then making them wait forever. Either that, or she told them it might be eight hours and they were free — hint, hint — to go to some other facility. Trouble was, she couldn't tell them where it might be any less of a wait. All throughout the evening, every time I passed through that waiting room, I saw sick people who'd arrived before we had, sitting there…praying to see someone who could treat what ailed them. It was very sad.
When I left at 2:20 in the morning, my mother was in the emergency room, waiting for a bed in the main hospital to become available. When I returned the next morning at 10 AM, my mother was in the emergency room, waiting for a bed in the main hospital to become available. They had yet to find her one so I spent four hours trying to hurry that up. Again, I had to bend/break rules, sneak into offices where I technically should not have been, go to superiors and ask them to intervene, etc.
This was more than just a matter of my mother's comfort. The doctors in the E.R. had signed off on moving her to the main hospital and to the care of specialists up there. That was right and fine. Trouble was, she hadn't actually been moved upstairs. The doctors who were now in charge of treating her didn't have her…so she was in kind of a Medical Limbo. The E.R. crew had stopped the immediate pains and problems but they were unequipped to deal with figuring out what had caused it and how we might prevent it from happening again. To get that part of the process underway, I had to get her upstairs.
It finally came down to the point where a room was assigned but the previous patient was still in it. A friend was with her and they hadn't left because the friend's son, who was going to drive them home, hadn't been able to get off work yet. They were eager to leave, I was eager to have them leave…so I gave them cab money, took them out and put them in a taxi. If I'd waited for the system to work, it would have been at least another three hours before my mother got into that room. And of course, getting her out of the E.R. freed up the space for them to treat someone else in there.
So I want to give you some advice. If you have an elderly relative and you care about them, do not ever let them go by themselves to an emergency room. Drop whatever you have to but get over there and fight for them to get prompt service. They cannot do this alone. They need you there to be an advocate, to stand up for their rights, to make the system work as well as it can for them. To the extent possible, accomplish all this by ingratiating yourself with the staff and following the rules…but don't stop there. If you have to, get loud and get in the way. And whenever the system doesn't work, circumvent it. This may be difficult because it will probably mean figuring out the system in order to figure out ways around obstacles…but you're a smart guy. Or at least, you'll be smarter than your unwell Loved One will be at that awful moment.
We're now hearing a lot in this country — and it's about time — about National Health Care. I understand all the arguments against government getting involved in this area and I would certainly not discount the possibility that the wrong action could make a bad situation even worse. But I also think we have to acknowledge the bad situation and do something to try and correct it, especially in the area of emergency care. One of the reasons that emergency rooms everywhere are so crammed and unable to deal with emergencies is that so many people today can't afford basic medical coverage. So they aren't receiving treatment for ailments when they're minor…and when those ailments get to be major, the only thing the infirm can do is go to some emergency room and overwhelm the triage people. This doesn't work for anyone. It doesn't even work for people who have decent health insurance — I do and my mother does — because we have to get in line behind them and either wait forever or do as I did and cheat a little.
I'll probably write a bit more about the past week in the next few days here. I have a few other relevant anecdotes. But I also have deadlines I'm now behind on. So stay tuned to this station for more grousing about Emergency Rooms and those who bar entry to them.