This is about what was happening around us in a Level 1 trauma center emergency room, not why we were there.
At 1PM on a Friday the trio of paramedics rolled the gurney up to the sliding door of the emergency room, a level one trauma center of a respected university hospital system.
There was a gurney traffic jam. We are fourth or fifth in line, and at least one other paramedic squad had just rolled into the driveway behind us.
Emergency rooms are overcrowded as many people who lack insurance use them as their primary health care.
A doctor, the hospitalist on duty as we would later learn, and a nurse came down the line of gurneys. This is triage, like in a combat zone. As we would soon learn, it sort of IS a combat zone, a combat zone of life and death made worse by America’s for-profit medical system.
We are given priority. Which is great. Except for one thing: there’s nowhere to go. There are no open beds.
Time and space are collapsing for me. This will be our reality for nearly three days.
Weekends, including Friday, are typically very busy times for emergency departments, most of which are overburdened and over crowded. But by 1PM on a Friday every bed and seats (yes, seats) in this emergency room are full. The two overflow emergency rooms (yes, two) are not yet open because there isn’t enough staff, but I don’t discover that until later.
Outside paramedics are keeping their patients in the ambulances as the gurney traffic jam clears.
After a few minutes we get a bed – in a hallway. We learn we are fortunate. No bed available? You get one of the big medical “easy chairs”, the kind that are often used to deliver intravenous chemo to cancer patients.
We get a “good” hallway bed. It’s right outside the nurse’s station. It’s already numbered with a printed out sign, because this is the ongoing reality in American emergency rooms. All the hallway bed and chair spaces are numbered with a letter and numeral. We are W3.
I can only describe the nursing staff as heroic. But this is their job, all them working three 12 hours shifts per week.
Because of the nature of our medical emergency we get a little extra attention. Our nurse starts the various IV drips and puts in an extra port for drawing blood. He then draws four large vials of blood and sends them to the lab.
Time and space has collapsed, but to me it seems like the nurse is working at near light speeds. We’re not his only patient, of course.
He comes back about half hour later, tells us the results of the blood test and draws four more vials. This process will continue about every 30 minutes for eight hours.
The hospitalist, the same one who did the triage earlier, comes by and checks on things. He’s moving so fast it seems like he’s apparating from one patient to the next.
About 90 minutes in, the first specialist arrives with her Fellow, a doc in his final stages of training, in tow. She has with her another doctor with her who specializes in imaging. They do the imaging and check the general condition of the Patient. She coaches the Fellow in the use of ultrasound, all the while giving me a running account of what we’re seeing and what it means.
She basically tells me if you don’t understand everything happening right now, you soon will.
This is actually very reassuring. They move on, but promise an entire posse of specialist docs will be along on rounds. This is fine because the nurses and doc are not entirely sure what is happening with the Patient, but they are going to find out.
Meanwhile, more and more and more human misery is pouring in.
The plastic folding chair I’ve been sitting in is killing my eight levels of spinal fusion in my back. And I have to pee.
Despite this, I’m reluctant to leave, even for a few minutes, under these circumstances.
This is not our first emergency room rodeo. We’ve ridden the bucking bronco of emergency health issues more than thrice. We’ve spent plenty of quality time hospitals pre- and post-surgery.
We have a rule: Never, never, never, never leave a patient alone for long if you can help it. They need an advocate and a companion. You can’t advocate for yourself if you’re unconscious.
Nurse says he understands my need. Joking, he offers me a plastic urinal, but wisely says better in the bathroom than out here. Patient is stable enough, so go ahead and go, he says.
Up to this point, I’ve only been involuntarily privy to the distress of those in our immediate area. That’s about half a dozen people, mostly stroke, heart and abdominal issues in our area, and a couple of cancer patients with chemo reactions.
But the bathroom is down the hall, maybe 50 feet away. Between me and relief there are several dozen people in various stages of distress ranging from unconscious to screaming. Some of everyone is here, every race and color in diverse Southern California, speaking at least five or six different languages, often with family or friends by their side.
After the trip to the restroom, maybe staying in the folding chair isn’t so bad.
Watching these nurses work to discharge the walking wounded and those who are well enough to go home is like watching Sisyphus rolling his stone uphill. As soon as one patient is out the door there are two more waiting.
At last a squad or specialist docs arrives. Lead doc checks the charts, the blood tests and says he thinks knows what going on. Scrum. Consensus? Time will tell, but time has collapsed for me.
Patient needs a bed in a specialty wing of the hospital. There is no room at the inn, however. For now now.
Friday afternoon has turned into Friday night. Medical Sisyphus is really rocking and rolling.
By now I’m really hungry and overdue for another pit stop. Patient is now asleep.
Now is as good a time as any for a trip to the bathroom and the hospital’s dysfunctional cafeteria. The cafeteria (I’ve eaten here many times in the past) has a habit of closing its grill, mini-pizza oven and deli sandwich station at times of peak demand.
I decide to walk out through the emergency room waiting room to hit the head and obtain nourishment. That means walking the length of the emergency room and observing the full range of the evening’s casualties.
Big mistake.
Not only do I bear witness to a bloody motorcycle accident victim coming through the door, I see dozens of very sick and hurt people in those big medical easy chairs.
When I get to the waiting room it’s worse. Standing room only for maybe 50 sick and hurt people who are “walk ins” and the folks who brought them there, some begging for treatment.
There’s nothing the desk staff can do. Capacity, for the moment, has been reached.
I could have gone out a side door from the emergency room, cutting my walk to the cafeteria in half, but noooooo, I chose this way.
At the hallway bathroom, I see a desperate maintenance crew armed with mops and a wet/dry vacuum throwing towels on a rapidly expanding pool of brown sludge oozing out from under the doors of both the men’s and women’s.
Ok, there’s another bathroom further down the hall. However, this one is festooned with caution tape and blocked off with orange traffic cones. Same thing happened there.
Fortunately, the cafeteria bathroom is functioning, even if the cafeteria itself sort of isn’t.
It’s what most people would consider dinner time. Deli? Closed. Mini pizzas? None. Pizza station closed. Grill? No grilled cheese for you! Closed. The steam table where hot meals are served? Closed. Serve yourself hot food steam table? Empty.
That leaves pans of several dozen of the same packaged sandwich, turkey and Swiss on wheat, the serve yourself salad bar and the four containers with three kinds of soup and one of turkey chili.
Turkey chili it is.
The area with the salad bar, soups and prepacked turkey sandwiches is a big U-shaped stainless steel counter. It looks as though it has been attacked by wild animals and no one noticed.
Standing inside the U-shaped space are two women who, by their uniforms, tell me they are in charge of this area. They’re in a deep conversation and seem to have no recognition of the condition of this area.
Sigh. Eat. Back to the emergency room.
All this walking around the hospital closes my fitness loop on my iPhone.
We get a new nurse. The shift is changing.
New nurse happens to be a charge nurse. She’s good.
Patient in and out of sleep.
Eight hours in we get a corner cubicle with a curtain! HUGE improvement. We are now in bed W7.
We’re next to the positive pressure isolation room. We watch as every single person who goes inside scrubs up, gowns up, doubles their gloves, puts on eye protection and pulls a fresh surgery cap down over their ears.
Yikes! It’s not like we have a choice.
About 10PM, Patient is awake and orders me to go home. I comply.
Saturday morning.
Life has been going on in the outside world. On Friday our small dog was trapped at home. Fortunately he had plenty of food and water. Son was able to come by after work and walked small dog.
Saturday morning I take small dog for an hour walk and then watch some TV while he sits next to me. Small dog likes to sit with humans while they watch the flashing light box.
I’m back at the emergency room about 10AM. We have an EV. Discover the parking garage has chargers. Bonus!
Patient is awake, has had some food. She’s still not all the way with it as she asks me the same set of questions over and over for a few hours. Worrying. Don’t be, says new day shift super nurse. Patient will be fine.
Saturday, at least until the early evening, is a rerun of Friday. ER waiting room crowd is gone, so that’s good. Hallway bathrooms apparently fixed and sanitized. Also good. Cafeteria still dysfunctional. At least consistency is sort of good. I expected nothing more or less.
Still no word on a bed in the specialty ward. Mild frustration.
We learn from another nurse that the ER is the butt end of the supply chain for the hospital. Sometimes nurses have scavenge or steal supplies from other departments.
At lunch I notice the sign for the ER overflow room for the first time. So that’s where all the other casualties went.
Every rich fuck in this town (and there are A LOT of them here) has his and/or her name plastered on hospital buildings, waiting rooms and what have you. The Joe Schmoe Center for Hemorrhoid Studies, etc.
But the emergency room has no name. No one wants to put their name on the most desperate place in the hospital.
We learn that people have come to this emergency room from as far away as Orange County (at least 80 miles), Temecula in Riverside County, (an equal distance to the OC) and even Tijuana and Ensenada,, Mexico, also 80 to 100 more miles away with tRUmp’s hostile border in between and where there’s a four or more hour wait to cross into the US is typical.
Saturday early evening Patient is stable and more with it. I’m ordered to go home. I comply.
I return Sunday AM. This time I enter and get my visitor badge at the main hospital entrance. Cafeteria grill is open this time. I have a breakfast sandwich on a brioche bun. When this place is functioning the food is reasonably good.
I head down the hallway toward the ER. For the first time I notice the sign for ER overflow room #2.
Inside my head Scooby Doo says “uh oh”.
Patient informs me of the horrors that erupted Saturday night that did not abate until about sunup. There’s an actual window in the cubicle.
A tsunami of patients came in with the night. Orderlies brought in more beds. Now where there was one bed in the hallways, now there are two. Doctors and nurses and visitors have to turn sideways to squeeze between the suffering.
I’m reminded of the scene in “Gone With The Wind” where Scarlett O’Hara runs to the Atlanta train yard and the pullback crane shot reveals thousands of wounded confederate soldiers. Only this emergency room is indoors and a lot more sanitary.
Outside the Patient’s cubicle are two very elderly men having nonstop coughing fits.
About 3AM both ER bathrooms ran out of toilet paper, Patient says. The bathrooms still didn’t have any TP when I arrived.
Nurses are optimistic about a room.
It will be a private room in quiet area in a specialty wing. A lot of people from the specialty wing are discharged on Sundays. Or they die. Either way, beds open up.
I stay until early evening. Still no bed. Things seem to be a bit mellower, if you can call it that, in the emergency room. Ebb and flow.
I wake up Monday AM to a text from Patient. About 5AM they moved Patient to the private room in the specialty wing.
Our emergency room hell had ended.