Patient Be Where

So let’s say you do happen to wake up in that seedy hotel bathroom in an ice filled tub with a throbbing pain where your kidney should be; what’s a guy to do? Well naturally your first thought would be to travel with all haste to the nearest purveyor of compassionate health care; the town doctor, nestled behind his white picket fence in the heart of the community, waiting diligently to tend to the needs of his flock with swift alacrity.   The wise doctor who brought you into this world and has seen you through all the trials and tribulation of life like he were a member of the family. The noble doctor who has only your best interests at heart.

Of course such a doctor no longer exists so instead you direct the GPS towards the nearest emergency room and hope for the best.   The welcoming glow of the ER signs (along with the commercial marketing campaign funded by the conglomerate that owns the hospital) promises a blissful resolution to whatever ails you and beckons you into its safe harbor just behind the sliding doors. Take that first step beyond the threshold however and all of your expectations come to a screeching halt along with your concept of space and time; in your mind you try and make conservative estimates on how much of your life you will be sacrificing to this visit but in this at least the hospital will certainly exceed your expectations.

You shuffle forward to the admissions desk where you are greeted with all the warmth of a frozen pizza. Trained by the palace guards at Buckingham Palace the job of this receiving nurse is to respond to your symptoms with poker-faced neutrality. You could report that an alien probe has dislodged your spleen and get the same regard as if you’d just shown her a shallow paper cut. She calmly takes your information, tags you like a wild seal and then sends you out into the vast ocean of the waiting room where everyone idles about, attempting to make limited contact with people, furniture and door knobs.   You navigate the germ encrusted surfaces, tune out the sounds of intestinal distress and take a seat until called by the triage nurse.

Triage is an important concept in the ER. This is where the nurses try sort the priority of your treatment based on your likeness to croak or to generate a lawsuit before your name can be called. If you have anything about to fall off your body or shoot out of your body you’ve got a better chance of being elevated to the top of the stack. Anything short of that and you get sorted into amorphous categories along with the rest of the wannabe patients. In general the healthier you are (or should I say ‘the less sick you are’), the longer you’re gonna have to wait. One would assume then if you walked into the ER completely healthy you’d never leave.

Put another way, there is a math concept called Zeno’s Paradox that basically says if you needed to reach a destination you’d first have to travel half way across the total distance, and to reach that half way mark you’d first have to travel half of that distance and so on. So if you always had to cross half the remaining distance you’d never reach your final destination since there are infinite ways to repeatedly divide the remaining distance in half. This is what the triage system brings to mind as you endlessly inch ever closer to being “next” without ever actually being called.

Once in this situation, I repeatedly asked the nurse for a status. She informed me that we were “next up in our category”. Apparently this category was “people we’ll call when hell freezes over”. It’s like the waiting room in the DMV or the courthouse where they do the similarly mysterious break down by category; you stare at your ticket with H112 on it feeling pretty good that they are now serving H110. After you see H111 called to the window you breathe a little easier with the knowledge that you’ll be the next one called. And then comes the parade of random tickets from every other possible category; X102, X103, F242, D117, X104, B001, D118,… on and on with no further mention of our precious H group. And so it goes in the ER as time stretches onward.

After several long hours of waiting to be next, you finally get called up to the big league. They announce your name and the thick double doors to the inner sanctum part with an internal glow of healthy radiance. Overwhelmed by the sheer sense of relief to finally be called you forget all about the pain that brought you here in the first place. You rise to your feet triumphantly wanting to pump your fist in the air or thank the academy, or some other display of wild exuberance. Instead you just shuffle on through to the other side and take a seat in a smaller room where you can continue your wait.

Having arrive in your new waiting place, the ER nurse now directs you to strip down and put on one of their swanky hospital gowns. It does not matter what you’re being seen for they just want you to get naked and experience the ass-numbing draft from their rear-opening apparel. Actually there’s an ulterior motive; without the gown they would have no way of knowing who was a patient, who was a visitor and who was doctor or nurse. Uniforms are very important in a hospital and you’re just being asked to play your part.

Another hour goes by. An entire shift of nurses has come and gone since you entered the building. You’ve been poked and probed (though leaving your spleen in place) and shuffled about to get you where you are right now. It’s all built up to this moment when you finally get to see an actual doctor. The selfless doctor that will care for you, empathize with you and cure you with his gentle healing hands. Instead you get the speedy doctor that flies in, assails you faster than a pick pocket groping for loose change, and then flies off again through the curtain like a ripple in the wind.   If you made a pie chart of the time you spent in the ER with the wedge of time you spent with the doctor you would have one very sad and very small slice of pie and the same sense of the lingering disappointment that the doctor leaves in his wake. His parting words are something about waiting for discharge (a horrible choice of words considering the context of your current situation) and the final paperwork from the dismissive nurse (not to be confused with the naughty submissive nurse from the Halloween store). When you have the stack of papers in hand they officially set you free by cutting off your bracelet and shuffling you back towards the big double doors.

The last thing you see as you head out for the parking lot is the collection of poor souls still stuck in the waiting room; some still waiting for relatives that went in before you, some just starting their own long adventures in waiting. You’re struck with mixed emotions, not sure if you should wave a flippant “so long suckers” or pat someone sympathetically on the shoulder. The ER is misery without the courtesy of dignity. Surviving it and the ailment that brought you here fills you with a sense of euphoria. In the big picture everything feels a little better and easier to endure. Maybe living with just one kidney isn’t so bad after all,… beats sitting in the ER.

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