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Sunday, May 30, 2010

A Night in the ER


   Yep, the entire night.  From 1PM on Saturday until 4:45 AM on Sunday.  No it wasn’t Tim who was being seen, nor was it me.  It was Larry.  After taking him to the Immediate Care Center and being told he needed to go to the hospital, we arrived and were checked into the ER pretty quickly, actually.   The wait was not long but there were only a handful of folks in the waiting room, so it was looking like a good day for us, but not for long.  Shortly after being triaged, 2 ambulances and a helicopter arrived with a group of people who had been in an auto accident.   So off to a bed he was shuffled to begin the waiting process. 
   We were there because he has been having digestive issues for weeks that he would not pay attention to, even at my prompting.  Now he was in pain, dehydrated, and very weak.  I know that having no insurance was the primary reason why he would not seek treatment; and being depressed was another huge part of it and some of it was just that he was being a typical man.  I don’t think he was thinking he was invincible.  I think he was giving up.  The past 18 months of little employment has take a terrible toll on him and it is now manifesting in his health.
   Some treatment was given and a couple of hours later xrays; and a few hours later another treatment; and around 1 am, a CT scan was done.  Around 4 am the Dr. came and told us the results and wrote the scrips and gave instructions to take home.  It was about 4:45 AM when he was released.  We arrived home around 5:15 AM and both collapsed into bed for the rest of the day.  We have no insurance, so we have no choice of where we go for treatment as far as hospitals are concerned.  There is only one place you can go and that is University. 
   Lets go back a lot of years to my childhood.  We were returning from a trip to the U of L dental school where my mother had taken me for a check up, when we drove past a big brick building that looked forlorn to me.  There was no air conditioning on this hot summer day, so the windows were open and there were people sitting on the window ledges overlooking the street.   The majority of them were negros.
  It gave me a horrible feeling in the pit of my stomach and I asked my mother, “Mom, what is that?”  She then began to explain to me that it was the county hospital that took care of the poor.  I had seen hospitals before, but this one really scared me.  I had gone to St. Joseph’s when I was six to have my tonsils removed, but this place gave me the creeps.
   Over the years, the University of Louisville School of Medicine took it over and they have created a world renowned medical center that leads in research and treatments.  But the ER isn’t much different to me.  It still feels like that awful place I saw when I was a kid.  And they still cater to the poor, which now includes us.
   In the bed next to us, divided by a fabric curtain, we had 3 neighbors during our night’s stay.  Whatever HIPPA laws have done to protect a patient’s privacy, the fabric curtain and the nature of the person laying there has destroyed it.  The first was an elderly lady who was in need of dialysis.  She was quiet and promptly taken to a room.  Later a man was brought in and I suspect that he was in the advanced stages of kidney disease because he had fluid retained on his stomach and they had to intubate him to drain it off.  He was weak but he did not like the tube and he fought them for a while.  Eventually he accepted it and began to rest quietly until they found a room for him.    Then came number 3….  She was the young mother of at least one young child who had fallen down drunk and hit her head.  “Her children found her unconscious…” was what the EMT told the nurse.  Her mother had brought her there and dumped her.  The staff had no records to go by, no friend or relative to speak for her, and she was nearly incoherent.  When she spoke, her speech was so thick she was hardly understandable.  As the night progressed, she began to awaken slowly and as she did, she began to bellow at the staff when she wanted something.  They ignored her for the most part. She was constrained to keep her from moving because they wanted to be sure her neck wasn’t fractured in the fall. 
  I don’t know if she had some kind of speech impediment, but as the hours went by, if she was sobering up, her speech did not improve, neither did her choice of words.    She would not be still and continued bellowing relentlessly.  She would quieten for a minute or two when they checked in on her, but the quiet did not last long.  Larry had been given pain medication, so he slept through much of it, but I had to leave and go sit in the waiting room a couple of times just to get away from her.  As his pain meds wore off, he was beginning to get agitated. 
   On the one hand, I understand how families get frustrated and give up on members who are drug or alcohol dependent.  But on the other hand, the thought crossed my mind, “What if she weren’t drunk but was rather developmentally disabled?”  How callously the staff cared for her would have been a crime in such a situation, in my opinion.  She was difficult to understand and had no one there to speak for her.  Many families give up on their disabled members because it is very difficult to deal with, especially when the member seems to be intentionally doing the things that irritate.   Services are so hard to find and so hard to keep that disabled adults end up just like her, alone and hopeless.
   Society doesn’t want them.  They would rather they be put away so as not to be seen; out of sight, out of mind.  A huge percentage of homeless and addicted people are also mentally challenged in some way.  Somewhere along the way, they were given up on and/or they were allowed to make poor decisions concerning their care and the consequences overtook them.   I contemplate these things because I have a child who could become one of those statistics.  When we are gone, who will care?  Probably no one if we don’t find the care he needs before we are gone.  So far that search has been dismal. 

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