On Hospital Advocacy, Part 1.

posted in: Rant, Sicky, Tips 6
A friend, indeed.
The one on the left is bleeding profusely.

When I went to the ER on Thursday, I went by myself. When I went to the ER on Saturday, I had an advocate. The difference between the two visits was stark. I’ve been to an emergency room alone before and I’ve gone in plenty of times with a friend or family member, too, but never in such short succession. Comparing the trips closely showed me plainly how one has to do these things:

You must have an advocate at the hospital.

If you are a solo person considering driving yourself to an ER tonight (or any night in the future), I urge you to call someone to go with you; at the very least, ask someone to meet you there. Of course, if your arm is hanging off or you’ve got visibly spreading flesh-eating bacteria working its way across your chest, you will probably get through the door with a minimum of hassle. I’m talking to the people out there who struggle with internal problems (e.g., possible appendicitis, possible internal flesh-eating bacteria, fissures, Crohn’s, etc.) because without someone to vouch for you, you are light years away from the care you assume you’ll get in a room created for the express purpose of dealing with people in emergency health situations.

Note: If you’re a person who doesn’t have a soul on earth to call, my advice would be to get to the ER tonight however you have to, get the hell out, and set about making some friends first thing tomorrow morning. Book clubs are good, online dating works well, and if you’re a quilter, run to your nearest guild and join the next sew-a-long. Any of these strategies will yield people clamoring to take you to the hospital before you know it. 

On both trips, I was in identical straits. Pure agony. Any human being who took one look at me (and how could you miss me, howling like that) could see that this was a woman in trouble. Was I foaming at the mouth? Well, no. But I was flagging. And while I understand totally the need for proper identification and at least a cursory examination of a person before IVs and medications are flung around hither and thither, Thursday’s experience reminded me that the collective brain of the ER has been removed and a skeptical, bureaucratic, Policy And Procedures Manual has been wedged in its place. This is not news, I realize, but my shock and indignation is fresh, so it feels like news.

Additional Note: I’m sure there are at least a handful of folks reading who are now or have been professionals in the medical field. I owe my life to a number of you, first of all, and don’t think I don’t know it. I see the problem(s) I’m talking about having less to do with individuals and more with the medical industrial complex. Indeed, it is the lack of individuality and specificity in the system that does damage.

The nurse was working the night shift. I get it. That sucks. And we all have bad days. But she began from a place of inhumanity. She came past my curtain and asked quite casually, “What seems to be the problem today?” (I’m writhing on the bed at this point.) She almost snorted when I told her I needed a certain kind of pain medicine — I’m allergic to morphine — and when I refused a CT scan I felt a freshet of loathing from Little Miss Ratchett. I know roughly when a CT scan of my abdomen is needed and when it is not; it would’ve been useless to do one at that time, given my symptoms and my traveler status, most especially because my pain had yet to be treated. (It appears that hospitals do far more CT scans than they need to**, primarily because they can bill for them. To be fair, this over-scanning has something to do with protection from litigious customers, but I felt my hospital was being either lazy or thick with their order. Not that I said so at the time.)

Halfway through my time there, as I’m trying to explain my entire medical history again, somehow, and get what I need to feel better, I realized how silly it was to be there alone. It was my fault. My stoicism was ill-conceived. The nurse might’ve been a jerk, but I looked up some stats and it appears that fiending drug addicts make frequent trips to emergency rooms all the time, looking for a fix. Here I was, a woman by herself, from out of state, with no visible injuries, crazy eyes, and an increasingly petulant attitude (see: refusing CT scan), begging for pain medicine. If a junkie could pull off looking/sounding like me that night, that junkie would be pretty amazing. But I hear they’ll do anything, so maybe the nurse was right to be so totally unhelpful. I tried to get in touch with someone from the quilt show to speak with the hospital, but when I couldn’t make contact and feared waking up the whole team, I gave up. Not being able to call for backup did not help my case.

I left with the bare minimum of relief and went away, 10% better in one regard, 30% worse in others.

Tomorrow, the second visit, and the wonder of compassion, advocacy, and my friend Marlene.

**Between 2000 and 2010, the National Center for Health Statistics showed the use of advanced imaging scans— CT or MRI—increased to 17% from 5% of all emergency-room visits. A Push For Less Testing in Wall Street Journal, Feb. 23, 2014.

 

6 Responses

  1. Gay Barrett
    | Reply

    Mar, I have been “beating the drum” for advocacy for years. My family thinks that I am beyond nutty to hang out in the hospital with them all day. It isn’t because I have no faith in the medical field. It is because I know that the medical care team has multitudes of patients and I have one mom, dad, sister, etc etc etc. And if something is missed, I consider myself part of that solution. Honestly, who knows my mom, dad, sister, etc etc etc like I do. The medical team doesn’t. They know the sick version. I know the normal mom, dad, sister, etc etc etc. Soooooooooooooooo,, yeah an advocate is vital. Just tonight on our local news stations, they continually flashed video of a lady who didn’t speak English yet needed medical attention. But, they need family to decide. This story has a happy ending-her son was reunited with her. The sadness is that her story is probably repeated in ER’s through the land without the video and the reunion.

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