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Aaron N. Tubbs

Dragon chaser.

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I’ve had relatively consistent pain in my abdomen for several months, idiopathic despite a few doctors and an ultrasound. On Monday, I woke up with it far more severe than it had been, and shortly after dinner in the evening it ratcheted up another notch and I decided to visit the emergency room.

The ER was an interesting place to visit. While I was at one once before, it was via an ambulance and the experience was quite expedient (had a bike accident in college).

Upon arrival, I was told to sit down and wait for registration; didn’t seem to matter what my condition was. I’m not really complaining here, but I always figured there was some sort of initial decision tree at this point. I guess the decision tree is “you didn’t arrive in an ambulance.” I was in line behind a family with a kid who had a fever and a man who needed staples removed from his head; I ended up waiting about 20 minutes for registration.

Registration was pretty quick, then I got sent out to the waiting room. Another 15 minutes passed, and then triage happened. There was exactly one triage nurse; I ended up getting to have many conversations with him that evening. Monday night is the busiest night in the ER by far, and this was no exception. According to the RN, there are supposed to be three of them on staff when it’s busy, but it was just him, and remained him for the entire shift.

Triage was pretty straightforward, he rechecked my blood pressure since it systolic was well over 150, and then sent me back to the waiting room.

Luckily, high blood pressure meant I was called within about 5 minutes thereafter by a physician’s assistant, who poked my belly a couple of times, ordered me some morphine, and scheduled me for a CAT scan. Unfortunately, the ER was packed, so he just had to leave me in the triage chair behind the nurse’s station.

They installed an IV and gave me morphine about an hour later. This was my first experience with it. My experience was it made me nauseous and took away some anxiety, but did absolutely nothing for pain management.

I got to drink about a quart of nasty contrast material, which was sort of like un-sweetened citrus powder beverage. And then I sat waiting for the CAT scan for about three hours.

So yeah, about four hours in the chair, you get to hear a lot of interesting things. The amount of people that came into the ER with clear drug-seeking behavior was absurd. There was a man who could not stand because his legs were in so much pain (he walked into the ER, mind you) who apparently was a regular. He eventually got belligerent and security took him out. Another half-dozen people were in there begging for pain meds, and got various treatments – usually some Tylenol and an EKG. I was sort of surprised by how much the RN still made sure they all got something, even though they were all clearly there begging for stronger drugs.

Several people came in after having taken some drugs and getting in a bad way. One was on meth, heroin, marijuana, and wasn’t even sure what else – he was pretty sure somebody added something to the drugs to screw him up. Most cases were on similar; all were paranoid that the ER was going to call the cops, but they were assured that wouldn’t happen unless they caused a problem.

There was a kid that came through with a pea stuck in his nose. A woman who came in that shot sriracha into her eye. I don’t remember many other specific cases. The drug-seeking and drug-consuming cases seemed to be the most common by the time I was in the chair. It was sort of surreal.

Meanwhile, a lot of ambulances kept coming in (they approach through a different registration and triage area, so I was never aware of them), which kept ensuring that any beds that opened up in the ER were immediately occupied. So I stayed in my chair. The morphine having not worked, I forwent any further doses.

Eventually the CT scan was ready for me, but the next ordeal was getting a wheelchair to take me; there was only one person in the whole hospital (!!) assigned to transport that evening. He was pretty livid about being understaffed as well when he found me half an hour later. I got carted off to the CT scan where they did a quick pass and determined the contrast hadn’t made it far enough. They gave me another quart of contrast and told me to dance and wiggle a bit to help it along. Because I felt like doing that when my abdomen was trying to kill me, you know? But I did it, because I wanted to move forward.

Another hour and a half in the triage chair, and I was back to the CT scan, where they were about to go home, but one of the techs said she decided to stick around to make sure I got my scan. Thank god. She confided to me that the other tech was called “Cushion” because she really likes the knee cushions, but that they make the imaging worse and therefore I wouldn’t be getting one. They hooked me up to this pump that injected me with stuff that supposedly would make me want to pee and make my chest burn, but I didn’t actually feel anything.

She finished up and sent me back, and wouldn’t make eye contact with me anymore, so I knew something was up.

Another hour in the chair, and then a doctor walked into the hallway. This was the first doctor I’d seen the entire evening. He asked who I was, and then said “I’m Doctor McGovern. You have appendicitis.” It was about 2AM and I was sort of punchy so I just laughed, but quickly confirmed it wasn’t a joke and asserted I’d need surgery, which he confirmed, and then left. This was the first time the RN had ever seen somebody go straight from the triage hallway to the OR without stopping in the ER. It’s good to be special, I guess.

Things moved pretty quick thereafter, by which I mean I was in an OR by about 3AM. I woke up in pain management where I was getting doses of IV Dilaudid, which weren’t really working, much to the chagrin of my recovery nurse. She indicated I’d had enough to tranquilize a horse, and was starting to look a little concerned. Reconfirms that, again, morphine makes me pretty damn chill, but doesn’t do a damn thing to pain for me. Double bummer. She switched me to Percocet, which thankfully did work.

Spent the day in recovery thereafter, which was more or less a complete logistical clusterfuck that I won’t rehash in detail. In short, they tried another painkiller (that started with a ‘T’) that didn’t work, I suffered, and they switched me back to Percocet again, and all was well. Pretty much anything that needed to be done took 1-2 hours to happen, including my departure, where it took over an hour to get a wheelchair to wheel me out once I was dressed (but there were three wheelchairs just outside my room when I left). It’s a miracle anybody ever makes it out of Hospitals.

Overall, it was an odd experience, I want to reflect on it some more, but the themes were pretty clear: Hospitals are understaffed, staff is overworked, everybody’s disorganized, communication is terrible, logistics are completely nonsensical, and the patients are the ones that seem to suffer as a result. I’ve reconfirmed that it’s probably best to do everything I can to avoid being in a hospital whenever possible. I’m glad they were able to do the appendectomy laparoscopically, or else I’d have had to spend another 4-5 days in the hospital, taking that many more random chances of being killed or neglected.