No Time For These Small Details In Emergency

dublin | rights, freedoms and repression | feature Friday August 05, 2005 12:33 by tobie* - WSM (pers cap)

There is nothing like a knock on the head to wake you up and make you reevaluate the things around you. Sitting here with a bump on my left temple that is as stubborn as ever and refuses to go away . I can only sit back and think about the severity of the health care system here in Ireland. I must admit I'm coming from a completely biased perspective, someone who grew up with a public health care system, but here it is anyways.

The night of my accident, I lie in bed disoriented, in pain and confused. I have heard nothing but horror stories about emergency departments, not that this is something specific to Ireland, but none the less it turned me away from taking the leap and heading down to my local A & E. I lie there wondering "what do I do instead?" I know that I've given myself a right shake up but I'm a bit too disorientated to make any clear decisions. I actually phoned emergency to see if it's right thing to go into them. They basically say if it can wait till Monday go to my doctor and get him/her to write me a letter for an x-ray. My mate the nurse says this is a case for liability since you should never push off anything that is related to a head injury. and the thing is I know all this but I'm so banged up I can't seem to make even this simple decision. The nightmare stories paralyze me and I do nothing. Days go by and my pain stays constant and my fear builds up. I talk to a mate who is a nurse and she sends me straight to the clinic down the street . . . actually the third clinic I phoned since the other two couldn't give me appointments for a few days.

A few hours and forty five euros later I'm sent to the hospital . . . to emergency where I could and should have been four days earlier. Emergency said go to the doctor, but the doctor says he couldn't send me straight to the x-rays and skip the day in emergency because I would not get the results for days and as a result would not get any medication for days. Only through emergency would I get the tests I need done and get to see a doctor that will tell me the story and write any prescriptions that I might need.

The next eight hours were an eye opener - I get to emergency excited that there are very few people there - assuming that I made the right decision about coming during the middle of the day on a week day and not the middle of the night on a weekend. Yet the promise of seeing a nurse with-in 15 minutes drags on to at least 30 minutes and her promise of 1-2 hours after that turns into 3 hours. Not to mention that I called the hospital once again to see what the story was with money. I had a letter from my doctor, but he was sending me to emergency, how much would I have to pay. After what my mate how heard all the 15 minutes of transferring of calls said if you didn't have brain damage before that call you would know, they tell me I will have to pay €40 . . . yet huge signs all over emergency say €55 . . . so I'm at €100 before medication . . .

I get my x-ray results relatively quickly and am told that in a door way that I didn't fracture my skull but they want to do a CT scan just in case . . . that’s all the consultation I get 20 seconds in a door way . . . the next 3 1/2 hours start to get interesting. I realize that I have not been offered any pain killers and at the rate they are going all the pharmacies will be closed when I get out and this great plan of my doctors for same day results and prescriptions is just bollox . . . so I start to chat with people.

The guy next to me is from Pakistan, he has been here four years, came here alone and has never looked back, he likes it here . . . His story is that the past month he has pains in his legs from the knees up on both sides and a fever . He gets weak walking and has been near collapsing frequently. Half the reason he is here is to figure out what is wrong with him, but the other half is to get a doctors note. You see he works as a security guard and his boss won't give him a day off due to sickness, says he needs a doctor’s note. So here he is on his one day off in the weak spending at least 8 hours in emergency waiting for results of blood tests and a note so he might have a chance to rest and get better. Still with all this he is all smiles with tears behind his eyes demanding that I share his crisps with him.

Two women chat around us and sometimes to us about all this "bollox". They are both here for about the same thing, there stomachs are in bits, kidney infections, and a list of unanswered for complaints. Both arms have been brutalized from blood tests. One says how she has never done drugs in her life but between the blood tests and hours of crying leading to blood shot eyes she looks like a right junkie and I would say they are treating her likewise. They both came in three to four hours before me and I left them there. Several times the junkie looking one asks when she will get the results of her urine samples and for a cup of tea but hours pass with neither. At first it seems that only those who are bad enough off to have a bed get sandwiches and tea. It is a slap in the face to the four of us when this elderly woman is told to sit with us is given tea and biscuits.

Hours pass and finally it is time for my scan, a steward takes me this time. Which is handy since the last time they told me to follow the blue line which due to years of fading had disappeared about 50 meters along my journey and I had to ask many over worked nurses who seem to only know their specific department the way.

I get talking to the steward, at first he is stand-offish, I don't know what it was that opened him up, perhaps that I mentioned that in the book "Hard Work" that the woman’s first job was a hospital steward or the fact that he suddenly realized I was Canadian but he started talking and when I got stewarded back to my seat he was right as rain. He says that his job and his job description are no where near each other, he does so much more. He complains that the government decisions on health expenditure is all wrong, they spend money on all the wrong things, that it is clear that those who make the decisions on money are not on the floor, he figures that he could do a better job. He ponders the public health care system in Canada and can't place why there is nothing like that here. Our time together ends as he is off with someone else.

This time this guy who I say sitting just off from us in a wheel chair is dragged off and the one and only chair is left in emergency. When this guy waddles back with his X-rays I notice that they are of his knee . . . you would think that they would want to put as little strain as possible on his knee but comfort didn't seem part of the plan, not enough time for that. I witness people in some undignified moments and this is a Tuesday afternoon I can only imagine a saturday night.

This one guy in full view of me with no curtain pulled continuously pukes; he is given a bag eventually. No drip in his arm to hydrate him, actually tea like everyone else which may be comforting but dehydrates you and surprise surprise he pukes after his first sip . . . when he is calling for help many walk by too busy to take notice of this guy with little liquid left in his body.

I would have to say the best moment was this old man with his shirt open exposing several suction cups attached to his chest, as his bed is dragged by me I gave him a sympathy smile he gives me a shrug hands turned up as if to say what can you do? . . .

The four of us who were told to sit together, moved around due to a police investigation look out for each other. We get each others names and when a nurse is looking for someone but they are outside we let the nurse know so they don’t miss their turn like we had seen happen to so many others who had not organized themselves like us. Its survival of the fittest in there which is not saying much since we are all in emergency.

So on my eight hour a doctor finally comes to say I can go home again its 30 seconds in a doorway. No brain damage, take paracetamol every few hours and give this to your doctor who he says I should see tomorrow. No time to talk, my doctor will explain the story to me and the hell is over.

I leave after 8 hours to be told take paracetamol for my headache!

I open the confidential letter to my doctor to find out the true story. . . I was right I did have a concussion. And the diagnosis now is that I have post concussion syndrome. It takes a call to my bro for him to look on line and tell me what that is and what I should expect and how to get better . . . there is no time for these small details in emergency.