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The ER Is No Place for the Sick and Dying

15 Oct 2012

written by Carolyn

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Mitt Romney said recently that people don’t die at home in their apartments because they don’t have health insurance. In Mitt’s world, people who are on death’s door are whisked off to magical places called hospital emergency rooms, where they receive the finest in life-saving treatment, regardless of whether or not they have medical insurance. Romney’s understanding of emergency rooms seems to have been formed by television shows like Medical Center and ER.

Of course, Mitt Romney has been wealthy and privileged his entire life. I wonder if Mitt knows what it is like to need health insurance, much less to need it and not have it. I doubt Romney even has health insurance now. If he has it, he can afford to the best quality health insurance money can buy. If he doesn’t have it, he is wealthy enough to self-insure. He can easily afford the finest in medical care for any condition he or his family may ever suffer – including airlifting in specialists, if needed.

And then there’s the rest of us.

Even for those of us with health insurance, getting emergency medical treatment in an ER is far from guaranteed. One summer when I was home from college, I began experiencing sharp pains in my lower back. My mother correctly guessed that whatever was wrong with me was kidney-related. Her own mother died of kidney failure in childbirth, so she felt kidney issues were not to be taken lightly. She insisted that I go to the ER, instead of waiting the next morning to see a doctor.

I waited in the ER of Detroit’s Henry Ford Hospital for close to nine hours. The gunshot victims took priority – and until you actually witness it for yourself, it is hard to fathom the number of gunshot and stabbing victims that come into an urban trauma center like HFH. I was young and not in obvious distress. “You’re still here?” the nurses asked, like they expected me to give up and go home.

Finally, a nurse walked over to me.

“Ok, honey, can you pee for me?”

“Do you mean you would like a urine sample?”

The nurse seemed taken aback that I, then a young black female, knew those words.

When I was finally seen by a doctor, he was more interested in my unemployment status than my medical complaints.

“Are you on welfare?”

“No. I’m a student.”

“Oh. Where, Wayne County Community?”

“University of  Michigan.”

“Dearborn?”

“Ann. Arbor.”

He looked at me as if I were a unicorn. A young black woman who claimed to be a U-M Ann Arbor student? In Detroit? “Then what are you doing here?”

“My parents live in Detroit. I’m living with them for the summer.”

After learning that I was, in fact, a student at the University of Michigan home on summer break, the doctor began discussing the results of my urine and blood work as if I were a medical student. “Your creatinine levels are extremely elevated, which is a clear sign of acute nephritis, your kidneys are only functioning at about 20% of capacity….” Although I was practically last in line to be seen, my condition was in fact an emergency. I walked out with a prescription for Prednisone and a complete lack of respect for ER staff who assume all black patients are welfare cases and talk down to them accordingly.

Twenty years later, when my elderly mother was the ER patient, the results were not much different. My mother had come to New York for a visit, and began vomiting violently after eating a small snack. “It’s just indigestion,” she claimed. I called 911 anyway. The medics arrived, took an EKG reading, and gave her a nitroglycerin tablet. That was when I learned that heart attack symptoms often present like indigestion in women. My mother was rushed to the emergency room at St. Luke’s Roosevelt Hospital. I rode with her in the back of the ambulance.

Like Romney, I expected that once my seventy-plus mother arrived in the ER by ambulance and was announced as a heart attack patient, things would move quickly from there.

I was wrong.

Mom was put on a gurney, hooked up to an IV, and wheeled into an open area behind a curtain.

Where she lay. And lay.

I stopped every person I saw in scrubs. “Excuse me. My mother is having a heart attack. Is anyone going to see her soon?”

“I’ll talk to the attending. But we’re very busy tonight. There have been a few gunshot victims brought in.”

“She’s having a heart attack.”

“I’ll see if I can get someone over here.”

After about an hour of this, I started getting even more nervous and scared. I knew people suffering a heart attack had a very small window – less than two hours – to get treatment before too much heart muscle was lost. My mother was approaching the two-hour window.

I went to the desk and asked if they could get a doctor over to see my mother, who was having a heart attack, right away. The guy at the desk – whether he was a nurse or an intern, I do not know – made some crack about my mother and sex. I can’t recall the specific nature of the crack, but he may have insinuated that Mom suffered her heart attack during sex.

Whatever he said was enough to make Polite Carolyn recede into the darkness. I was not about to let my mother die on a gurney in the ER. I went off. I blacked out. I can’t remember what I said, but it involved lots of cursing, screaming, and threats that centered around the fact that I practice law for a living.

Mitt Romney said people who are having a heart attack are rushed to the ER and get treated right away, even if they don’t have insurance.

My mother was rushed to the ER in an ambulance. She had gold standard health insurance – a Blue Cross/Blue Shield plan that paid for everything, without a co-pay. Her insurance was the equivalent of getting sick while being named Mitt Romney.

Yet I am convinced that she never would have been seen with the urgency her condition demanded if I had not been there with her and caused a scene.

I embarrassed my mother. “You didn’t have to act like that,” she said.

“Mom, they were ignoring you.” I felt like, just as they had with me when I was in college, the ER staff assumed my mother was just another indigent black lady, someone they could get to after the fiftyeleventh gunshot victim. This time, I knew better than to sit back and assume my mother’s case would be treated as the emergency it was.

Once the attending came over, things did move quickly. Suddenly, I was being given papers to sign authorizing them to take her up to the catherization lab, where they would confirm whether or not my mother’s arteries were blocked and, if so, insert stents to open them back up.

My mother survived that night, and lived for another five years, until she died from heart disease in 2009. I don’t think Mitt Romney knows that situations like mine and my mother’s are unfortunately all too common – and we are the people with insurance. I’ve heard worse stories from relatives who lacked insurance. When you arrive in the ER and are uninsured, unless your head or chest has been blown open by a bullet, you are given the bare minimum treatment and dismissed – yes, in some cases, to die at home.

Arguments about the cost implications of ER care – and Romney’s own past acknowledgment of those costs – have been made elsewhere. I wanted to focus, not on the cost, but on the quality of ER care. If you arrive in a trauma center and you are not dead or damn near dead, your chances of getting seen quickly are as good as your chances of winning the Lotto. Someone should explain this to Romney before he repeats his claim that people don’t die in their apartments due to lack of health insurance. The uninsured don’t always die at home. Sometimes, they die in the ER, waiting to be seen.


3 Comments on The ER Is No Place for the Sick and Dying

  1. Sally Moore

    I wish this was an exception but it is in fact the rule. I’ve been to HFH and I’ve left untreated and quite ill. Thanks for putting it in perspective because this is so real

  2. Carolyn

    Sally, my family used to take my mom to the HFH in West Bloomfield because the one in Detroit is so bad. Even still, even going to the ‘burbs is no guarantee. But like I said, NYC hospitals aren’t really any better. You have to go with an advocate.

  3. Ellen at Defenestrated Feet

    Man, I loved this post! You put so clearly into words the feelings and uncertainty that were lingering in my brain after hearing Romney’s statement.

    I was all “no way that can be right…”

    But as a Canadian, I really don’t know first-hand how things are down there. So thank you for putting a stories and real people behind those feelings.


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