Tuesday, January 26, 2010

ER.

I'd never registered at an emergency room before Sunday night. Then again, I'd never had a leg clot, an immobilizing back injury, two consecutive tooth mishaps, or fibroid surgery before turning my current age last June. It just happens to be a half-year of new horizons for me.

The first thing I noticed at this particular D.C. emergency room lobby was that it possessed no atmosphere of emergency whatsoever. The chair at the front desk was empty when I arrived, and it stayed that way until a line of three people had formed and the security guard had to go find the attendant. It sort of reminded me of how CVS cashiers will say "I see three" over the loudspeaker to call for extra help when the line gets to three people or more. Finally, the woman strolled over and took our names. We took our places in the waiting room.

Like the relaxed desk attendant, none of the prospective patients in the room seemed to have a sense of urgency about anything. Most of them were busy watching the NFL playoff game or yelling at their children.

As for whether I was in a hurry, it was hard to say. On one hand, I had a leg clot (known in the business as DVT) and had gotten a new pain, some mild shortness of breath, and a racing pulse, signalling a possible pulmonary embolism, which can be fatal.

On the other hand, the shortness of breath had faded, my pain was very mild, and my clot was below the knee, making it a lower risk for embolism. My mood was somewhere between "Eh, this can wait" and "I'M A TICKING TIME BOMB!"

I had toyed with skipping this whole scenario, knowing it would be a rigamarole, but the alternative scenario of waking up at 3 a.m. with the clot in my lungs left me with little choice. If I'd known in advance about the 11 hours to come, though, I might have decided to risk it. That's another irony of emergency rooms: Assuming you're coming in on foot rather than via ambulance, the experience is likely to be a) longer than any doctor appointment you will ever have, despite the "emergency" factor and b) so torturous that you'll rethink getting treatment, even when things are serious.

After about 30 minutes, I saw an admissions nurse, who gave me an ID bracelet and told me to go back out to the waiting room. Now I'm on my way, I thought, looking at the locked ER doors expectantly and waiting to be ushered behind them. The hospital gods laughed above me.

Another half-hour or so went by and I saw a triage nurse, who asked many of the same questions as the admitting nurse. I returned to the lobby chairs and waited to be called again.

Foolishly, I'd come here without magazines. The only reading material in the vicinity was three copies of a publication called The Living Church, so I occupied myself by observing -- and, of course, judging -- the other people in the waiting room.

One man, whom I first encountered howling inexplicably just outside the ER doors, turned out to be with a very sprightly and mobile boy who had at least three adults ordering him around, none of whom was capable of getting him to behave. Another woman lumbered through the lobby swinging a baby carrier, letting it slam so hard against her large legs that I thought it must be empty. Nope, it contained a sleeping infant and future ER prospect. Another man sat reading so calmly and quietly for so long that I couldn't tell if he was waiting for someone, or just liked it there.

Eventually my name was called again, this time to be admitted to the hospital. The woman behind the desk looked so familiar... where had I seen her? "Do you work for Holy Cross?" I asked. She laughed. "Yes, I work at three hospitals," she said. I told her she'd admitted me for my surgery last fall. "Yeah, I get to Holy Cross at 5 in the morning, stay until 1:45 p.m., and then come work here from 3 to 11."

I watched her in awe. Not only was she able to put together my paperwork quickly and accurately, she was able to converse pleasantly -- two things, among several, I'd never be able to do on that little sleep. I didn't want to think about how many people behind the ER doors were in her same boat.

She completed my registration and I thanked her. "Maybe next time, I'll see you at the mall," she said. I laughed and said I hoped so. I'm at the mall regularly too, after all.

About three and a half hours after walking in, I finally gained access to the ER and was taken to a cubicle with a curtain (not sure what you call those: gurney station? treatment bay? Perimeter of Tribulation?) and given a gown. The first doctor came in and asked me some questions, then called in another doctor. "Dr. M____, can you come here for a second?"

The second doctor pushed back the curtain. He appeared to be approximately age 15, his blond hair styled into a sort of half-mohawk. "Well met!" he said upon introduction. It was like I'd entered a high-school Shakespeare production.

I told him my story: had a diagnosed leg clot, was told to come to ER if symptoms changed, noticed some slight pain in upper thigh, had some shortness of breath and racing pulse, freaked out and came in. He examined me. "How old are you?"

I told him my age. "Really?" he said. "Really. Because I would have guessed you are about 10 years younger. You could be 25, even. Seriously, you don't look your age at all. You look great." I couldn't tell if he was saying this just to flatter me, or because next to the average person he sees on the overnight ER shift, I really do look 25. Either way, I was so absorbed in the fantasy of looking younger than 30 that I didn't manage to return the compliment and tell him that he also didn't look his age either, assuming his age was over 21.

They decided to order an ultrasound and see where my clot was. I waited some more. In the next bay, a man moaned. From what I could hear, he had a sore on his backside that had gotten infected, and it was bad. Dr. Boy Wonder was called in to help as they dressed the wound. "Oh my GOD," he said to the other medical staff when he saw the situation. There was a pause. "I mean, you described it but..." The patient was either barely conscious, or they didn't care if he heard how much his sore appalled them. "I know," the other person said, quietly affirming the young doctor's horror. Boy Wonder emerged from the curtain amd looked at me, shaking his head. "You're the picture of health," he said.

My ultrasound results came back, showing that the clot remained in my calf and hadn't gone anywhere. Still, they wanted to do a CT scan to make sure none of it had gone to my lungs. At this point, it was 2 a.m. and I was breathing freely. Was this really necessary? I felt bad pushing back with Dr. BW, because he seemed to be a very smart and kind doctor even though he looked like he should be playing Xbox.

He politely offered to send in a supervising doctor to talk with me. The supervising doctor said because I had a clot and because I'd had shortness of breath, they had to do the scan. "At this point I'm thinking my shortness of breath must have been a panic attack," I said. (I'd never had a panic attack before, but cf. the first paragraph above.) "If you were a family member of mine, I would order the scan," he said, unmoved. His reasoning seemed iron-clad -- plus, he was a close-talker and I was outnumbered. I consented.

Meanwhile, there was more action behind my neighbor's curtain. Another doctor walked in with three or four staffers. "Mr. Adams, we need to turn you over so that we can take care of your wound, OK?" Mr. Adams refused, in a weak but definitive voice. "No. No no no no no," he said.

"But Mr. Adams, we really need you off that wound so we can look at it, OK? It won't last long. We can give you painkillers," the doctor pleaded wearily. The arguing went on for a few minutes. No amount of reason could convince Mr. Adams it was a good idea to let anybody touch that thing back there. "I'll call the police," Mr. Adams declared, a threat as sad and amusing as it was empty. The doctors proceeded, and Mr. Adams wailed. "Noooo! No don't! Po-lice! Po-leeeese!"

Where was that CT scan technician? I needed a break from the woebegone Mr. Adams, even if it meant facing a potentially dangerous dose of radiation and the prospect of scary errors.

CT man finally arrived and took me to the machine. "Now, I'm going to give you a contrast dye that will make you feel very warm as it goes into your bloodstream. Some women say it makes you feel like you're peeing, but you're not." At this point, I probably wouldn't have cared either way. I went into the machine, veins afire and bladder obedient.

The CT man wheeled me back. "Are you here alone? No husband or boyfriend?" he said. Again, I couldn't tell if I looked exceptionally alluring in my hospital gown, or if the interest was just what happens to any man who spends too much time among the Mr. Adamses of the world. I assured him that I was in touch with my boyfriend, who wasn't in town. "That's good. You shouldn't be alone. My wife and I are separated -- we have been for five years -- but when she had to have an appendectomy, she called and I came with her to the hospital. It's just nice to have somebody there with you."

He took me back to my Perimeter of Tribulation, which now felt a little lonelier than when I'd left. Mr. Adams was quiet, except for an occasional faint "Oohhhh..." It was about 5:00 a.m.

More waiting. The doctors affirmed that my lungs were clear and I could go. I was told to step up from the aspirin I'd been previously advised to take and go on blood thinners, which I would need to inject into myself. I'm not usually squeamish about needles, but the idea of using one on myself is just a bridge too far for me. I told them I wanted to hold out and see if the aspirin would work first. This must be one of many things within the perimeter of tribulations for a doctor: jackasses who don't follow your instructions.

Outside, it was still dark and pouring rain. I waited about half an hour for a cab home. In that period of time, about 10 minutes apart, two homeless people exited the lobby, shouting and hurling insults at the staff. "You're sending SICK people out into the STREET!" one woman raved.

I thought of what Boy Wonder had said to me as I waved to him on the way out, and redirected it to those people trudging out into the rain.

"Godspeed."

8 Comments:

Blogger Deborah said...

Glad you're OK. Not glad you had that ER experience, but you're lucky to have avoided it for this many of your 25 years. "Well met!"

I had to go to the ER in a provincial hospital in Israel when I was 15 and got food poisoning. I will never forget the doctor, proudly testing out her English by handing me a thermometer and saying, "Poot zees under your lung."

9:21 PM  
Anonymous Z said...

Holy crap, Chris! Glad everything is OK!

11:33 PM  
Anonymous KPC said...

Yikes! What an experience. I've worked on Fragmin and Lovenox (both for DVT) and on gadalinium-based contrast agent, so reading the patient experience is key.

Glad you went to the doctor. The CEO of a client has a younger wife & 2 sets of kids. Those from wife 1, and those from new young wife. He always, always tells people that his first wife died of DVT. He does for 2 reasons: 1 to warn people & 2 because people assume a CEO with a second wife, dumped the first wife.

6:06 PM  
Blogger Christina said...

Thank you for the comments. KPC, your post made me resolve for sure to follow up with a doc next week even though my symptoms have gone away!!

9:44 PM  
Anonymous KPC said...

I didn't mean to scare you, but yes, you should. DVT is not good. Did they get you on a drug to break up the clot?

4:30 PM  
Blogger Christina said...

They wanted to but bc it's in a minor vein below my knee I decided to try aspirin for awhile. But I think by next week I'll be on a real drug.

10:57 PM  
Blogger Jon-chan said...

Found your blog from your transcript of Murakami's Bakery Attack. Must be several years when I first came across that and now again, looking through my old bookmarks.

You're a fantastically talented writer. Hope you don't mind if I check back in here again.

12:54 PM  
Blogger Christina said...

Thank you Jon-chan, that is very much appreciated.

9:50 AM  

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