ER Visit

My phone rang and I let the machine answer.  I had just gotten home.  My doctor was calling.  I'd just seen her a couple hours earlier.  When I'd had my appointment earlier, she'd ordered some blood labs and also had me undergo a simple abdominal x-ray. 

I picked up the phone when she said she had some results she was reluctant to give me over the telephone.  She said my abdominal x-ray had shown I had a dilated colon.  She was concerned about what might be causing this and suggested that I go to the emergency room immediately and get a CT scan of my abdomen.  She was concerned something life-threatening may be a possibility.  I almost asked, "Won't I be sitting in the ER for hours?"

But I simply said, "Okay." 

I was a little bit scared.  What if something really is wrong?  My stomach had been hurting more than usual lately.  I tried to find my neighbor's number that I'd written on a slip of paper in case they admitted me.  I couldn't find it.  So, off I went.

I was kind of disappointed because I just wanted to relax and watch a movie.  Couldn't I just get an x-ray later?  I didn't really have a life-threatening condition, did I?  I'm always the guy who goes to the doctor complaining of pain and finds out he's just fine. 

When I walked in, I had to talk to security first.  Then I checked in at the front desk.  I'd never been in an ER in my entire life.  But, it looked like I expected.  The room was filled with a lot of people.  I walked toward the back and found a seat.  

Some people to my right were using sign language to communicate.  Some people were in wheelchairs.  One woman was pacing the length of the room back and forth.  Some people were talking.  A lot of people were using their smartphones to make calls, listen to music, or do other tasks.  What did people do before smartphones?  Did they bring a book to the ER?  

I got called over fairly quickly.  But it was misleading.  They were simply checking my vitals and asking me what was wrong.  Is this called triage?  Well, I'm guessing they decided my condition was not severe.  The nurse told me I could return to the waiting room.  

I have a friend who had been a paramedic in the military.  She told me that military triage differed from civilian triage.  The goals of combat medicine are to return the greatest number of soldiers to combat, and then to preserve life.  Historically, military triage placed the highest value on soldiers who could be returned quickly to the battle lines, so the highest priority wounded were those who could be patched up and returned to duty. 

I returned to my seat figuring I was in for a long night.  I heard others complaining about the wait.  Some gave up and went home of their own volition.  Some had been waiting for hours and I had just arrived so I knew I was going to be there for hours.  I too thought of leaving but decided to wait for at least a little while.  

A man was soon wheeled next to my seat.  He had infection in a foot he'd injured previously.  He was tired, hungry, and in pain.  His ride had left so he was hoping to be admitted otherwise he wasn't sure how he'd get home.  A little later he found out he'd be admitted but it might take a while before a bed was available.  So, he had to sit and wait.  

An elderly woman was also waiting for a bed to become available.  She was tired and in tears at times.  She had her daughter with her for a while.  But her daughter finally left because she had to work in the morning and it was getting late.  Another woman was having eye hemorrhages which sounded really scary but might not be as bad as it sounds.  She may have had other issues like high blood pressure as well.  I think both of these woman were former employees of the hospital but they still had to wait like everyone else. 

Two daughters had been waiting with their father for hours.  He was in a wheelchair and was getting uncomfortable.  Eventually the daughters got some blankets from an aide and tried to get some sleep.  

A heavy-set gentleman was in a wheelchair.  I think he'd arrived by ambulance much earlier.  I think he called a relative or friend and asked for a ride, but they declined to help him.  He was afraid there would be no taxis available when he was allowed to go home.  A pretty young woman recognized him and said hello.  He had driven a taxicab years earlier it seems and she remembered him.  I think it brightened his day a bit to be remembered and acknowledged by someone. 

An elderly woman with chest pains eventually left.  She was tired of waiting.  A young man rested his head on his girlfriend's shoulder.  People would walk to the desk at times to complain or ask where they were on the list.  Occasionally the nurses or aides were confronted.  I simply accepted the fact that there were only a finite number of doctors and beds available.  

The young man and his girlfriend finally gave up and left.  He declared he'd rather die than come back to that hospital.  I don't believe he or his girlfriend had insurance although I think she was going to have insurance in the near future.  She asked for a referral of some sort for her boyfriend before they left.  Obviously, she didn't want to see him die although she understood his frustration with waiting so long.  

I too got frustrated.  I even got angry seeing ambulances pulling up figuring that would make my wait time even longer.  Then I'd feel guilty about such mean thoughts and say a prayer. 

Eventually they called me back.  I was escorted to a small room and a curtain was pulled after I was seated.  I could hear the nurses chatting about their work schedules and personal problems.  I was right there behind the curtain.  Surely, they knew I could hear them.  I wasn't bothered by their talking.  I found it interesting.  They were working in this chaotic place of life and death and yet seemed to be taking it all in stride.  They were chatting away just like employees do in most work situations.  I found it kind of amusing actually.  I guess doctors and nurses are people too.  

Eventually the curtain was pulled back and a beautiful brunette woman dressed in black scrubs walked in and sat next to me.  She had compassion in her green eyes and in her voice.  She told me she was a physician assistant and would be helping me.  She apologized for my long wait and asked me what had brought me in.  I told her about my doctor's visit the prior day and the phone call I'd received.  

"Are you in pain?"  she asked.

"No," I answered feeling like an Idiot.  Why AM I here?

She asked if she could feel my abdomen.  I gave my permission, and she gingerly touched my abdomen and asked if I had any pain or tenderness.  I again told her I felt fine.  I wasn't in pain.  I wasn't experiencing nausea.  We discussed bowel movements and laxatives.  I enjoy talking to beautiful female doctors about my bowel movements.  😊  I told her I had a history involving anorexia.  I told her they actually use a fairly liberal amount of laxatives on the eating disorder unit though that might seem strange.  

I was about to blurt out, "Okay, I get it.  My young general practitioner jumped the gun and got overzealous.  I have wasted my time being here and now I'm wasting yours.  I'll just be going now."  

I think she explained that she was questioning me so that if a CT scan was done she'd know what to be looking for.  She soon left my side.  I think she went to look at my abdominal x-ray from the previous day. 

One of my father's cousins had to visit the ER once because he fell on a beer bottle at a party leading to a lacerated rear end.  He went to the ER and a doctor looked at the cut in his butt crack and said they needed to call in a specialist.  Greg was lying down on his stomach when a beautiful female doctor looking like the actress Nicole Kidman walked into the room. 

Greg looked up and in a defeated tone said, "Oh God!  Do you want to look at my butt too?" 

"I sure do," she said. 

I, however, continued to wait. 

Soon a male doctor appeared.  What happened to the beautiful female?  You might think I am sounding sexist.  I'm sorry but she was pretty, and I wasn't dead.  Yes, she was definitely intelligent, talented, and professional.  This man was evidently a staff doctor and mentioned he'd spoken with the green-eyed beauty about my situation.  Well, he referred to her by her name, but you know what I mean.  He asked me the same questions she had and also felt my abdomen.  They both may have asked me about certain bowel ailments which I assured them I did not have diagnoses for. 

"Well, your doctor was concerned that you might have an obstruction in your colon.  But I really doubt that is the case here," he said.

I thought he was going to suggest I simply go home but he said, "Well, let's do the CT scan just to be sure." 

A nurse came in and said she was going to insert an IV into my arm.

"Why do I need an IV?" I asked.  I was kind of scared they planned on putting me out for the procedure.  

"The IV is so a contrast agent can be injected into you which helps the x-ray show up better," she replied.  I got the feeling that she got tired of answering questions from guys like me all day. 

I knew what contrast material was.  I'd had contrast used in an MRI x-ray many years earlier.  I still didn't like the idea of contrast material being put in my body.  But I didn't feel like I was in a position to back out now.  

The x-ray technician came and escorted me to the x-ray area.  He told me how to position myself.  The x-ray itself was really simple and not frightening or painful at all.  It was done quickly.  When he spoke to me over a speaker telling me to hold my breath and then later that I could breathe again it was a bit strange.  I recently heard a comedian comment on how we're told x-rays are safe and yet the technician always leaves the room and hides and sometimes they shield you with a lead apron.  Ha!  I'm glad the technician warned me that I might experience a reaction from the contrast agent like feeling a warmth from head to toe and feeling like going to the bathroom.  That's exactly what happened although the sensation passed quickly. 

As he was walking me back to the waiting room, he asked me where I was from.  I told him how I'd originally grown up in northeast Iowa.  It turned out he had as well.  Small world as the saying goes. 

My waiting, of course, was still not over.  I had to wait for the physicians to look at the x-ray results and consult with me one last time.  By this time I think it was around 4:00 AM.  The ER was basically deserted.  One patient other than myself may have been in the waiting room.  Security personal were still around.  One security officer was rounding up stray wheelchairs.  Two housekeeping people had arrived and were emptying trash cans and sweeping.  

I was standing a lot at this point because I was tired of sitting and wanted to go home.  I stood and watched the news on one of the two televisions in the waiting room.  There was a story about actor Fred Savage being fired from a show for misconduct.  And an escaped inmate and a corrections officer who had been missing were apprehended by police. 

Finally, a nurse called my name again.  She took me to an area where I sat on a small couch or loveseat of some sort.  The green-eyed physician assistant came over and sat beside me.  She told me the good news was that there was no bowel obstruction or anything seriously wrong.  That should have made me happy, but it only convinced me all the more that I'd wasted my time and theirs by coming to the ER.  

She did tell me that I had something called an ileus.  When your colon can't move to push food and waste out of your body, it's called ileus.  She said that it would take care of itself and was nothing to be concerned about.  Ileus can become serious at times and most often occurs after abdominal surgery.  Nonetheless, she said I would be fine.  She said I should cut back on laxatives even though I was clearly constipated.  She said I should follow-up with a colonoscopy in the near future because of this situation although mainly because of my age.  I'm not exactly a young man anymore. 

"Come back here if you feel nauseous, vomit, can't eat or can't have bowel movements," she said. 

"Come back here to the ER?" I asked as I motioned to the room we were in.  I was thinking I will never go to the ER again unless I'm in an ambulance. 

We exchanged "goodbyes" and I headed to the check-out area.  I was concerned about my car which I'd left in a parking ramp because I wasn't sure about parking when I'd arrived.  A nice young man at the desk told me not to worry and handed me a parking voucher.  I went to my car and used the voucher and thanked God when the gate lifted and I drove out of the parking ramp.

When I got home, I took some medication and ate a quick bite and climbed into to bed around 5:30 AM.  I went to work later that afternoon.

Well, I've now had the experience of visiting the emergency room.  Yes, I understand the importance of emergency rooms.  Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention.  In some countries, emergency departments have become important entry points for those without other means of access to medical care.

I had a lot of time to observe people in pain and a lot of time to think while waiting in the ER.  I now believe we should have universal healthcare.  Not that I was ever really against it.  How do we as a country pay for it?  I don't know.  But, I have a better appreciation of the need for healthcare.  If someone's only option is to visit the ER and it involves waiting for hours then they might simply walk out and take their chances.