Wednesday, October 9, 2024

Four People ahead of You

I bit the bullet Monday and returned to the emergency room to find out whether I had torn an artery in my neck. I’m not sure how I would have torn it, but I had been experiencing that same weird hollow pain somewhat off-center in my forehead that I experienced only when I had torn arteries in the past. Because of what follows, I won't say which emergency room, but it is associated with a major university.  

The first time I tore arteries, I had been coughing so hard it seemed my lung would come up through my throat. The second time, I had lifted something too heavy and popped a bulge. Lately, I have been wrapping a physical therapy strap around my neck in order to loosen it up. I don’t use a great amount of force, but it is my neck, and there was that peculiar pain showing up like a recurring nightmare.

After ignoring the quarter-sized pain a few days (in which it was plausible to think my COVID shot could have been a contributor), I cleared my afternoon and drove up the hill to where they have neurologists, CT scans, and the Stroke Center. 

The waiting room was busier than I have ever seen it. I thought maybe showing up straight from work in my business clothing might illustrate that I knew what I was talking about. Instead, it encouraged them to push me to the back of the line, over and over again. 

They did the initial blood pressure, fact gathering, and filling of three vials of blood in pretty quick order, then told me to go back to the waiting room, where “the longest wait has been three hours.”

They plopped a wheelchair-bound woman a few feet from me, who joyfully carried on a long conversation in a foreign language with great voice inflection and plenty of laughter. At ten minutes, I noticed she was talking too loudly. At twenty, I started to fantasize about politely interrupting her to ask if I were being too loud for her conversation. At thirty, I considered filming her and putting the video on Facebook as one of those “found this creature in the wild” videos. At forty minutes, I realized that she was not on the phone. She was her own good company. At fifty, an employee came up to her, crouched to her level, and announced, “We are going to drive you home.”

Good, I thought. Ah, but the fun was just beginning. 

As my third hour and phone battery drew to a close (I wasn’t talking on my phone, just reading it), I lifted my eyes in hopes of something happening soon. 

It didn’t. 

The horse pill ibuprofen I’d taken at four-fifteen in the morning started wearing off.  My pain started to climb from the “two” I’d—stupidly, I was starting to realize—announced to the triage staff, to at least a four. Maybe they should know that?

I went to the front desk and told them my pain was rising.

“Where is it?” they asked. 

“In my head,” I reminded them, bringing my hand up to touch the spot of pain. 

It worked!  They pulled me right back behind the door and took my blood pressure again. “Do you still have the cuff we gave you?”

I pulled it out of my lunch bag. Heaven forbid they should charge me for two of them. They announced my blood pressure, normally on the low end, was 148 over 96, and sent me back out to the waiting room. I guess they wanted it higher, and a few more hours of stifling my breathing in their noisy, crowded, germ-infested waiting room was likely to do it.

I should have enjoyed and been amused by the humans out there, but, by then, I was far too crabby. There was the man who either crouched by, vigorously massaged, or practically lay on his tall, pretty wife, when he wasn’t loudly discussing her very private symptoms on a cell phone call to her regular doctor. And there were others. 

A couple of young women came back out of triage and sat down next to me in order to have the most banal conversation I have ever had to listen to. I should have taken notes so I could share it with you, but I was doing my best to shut it out. I remember thinking that I couldn’t believe anyone would ever talk about such worthless details. But here I am. 

Finally, I decided to make the ER a deal. I went back up to the counter. “Hi. I’ve been here four and a half hours. Could you please tell me how close I am?”

“Four people ahead of you.”

“That’s what it was ninety minutes ago.”  I told them, “I realize that my case isn’t urgent enough for me to be here right now. Why don’t I go home and come back in the middle of the night, when you’re less busy?”

“Totally up to you, but we’ll charge you again.”

“Why?  I haven’t been seen.  I’ll keep my bracelet on.”

“We’ll have to start all over again,” another employee told me. 

“You’re going to the throw away my blood?” I heard my voice rising on the last word like a crazy person, but the rest was measured.

“We'll keep your blood, but we’ll charge you again.”

“Why, when you don’t have anywhere for me to sit down, and you’re not moving me forward?  Why can’t I just go wait in bed, then come back at two or three?” I thought my proposal was honestly a win-win for both sides. 

I was told I could wait in my car, and they would phone me.  I readily agreed to that. 

Walking to my car in the parking garage, I totally intended to drive home.  But, as I got closer, I started to rethink that. I plugged in my phone and called my husband. Had a drink of water and munched on my cucumber snack. 

After an hour, I started to worry that they would call my name in the waiting room instead of calling me on the phone, so I walked back in.  I was really starting to resent the professional outfit I’d put on that morning and longed for leggings and a tunic. “Hi,” I said.  “I’ve been waiting in my car for an hour. Where am I on the list now?”

“Let me check. Oh, you’re really close!”

“Okay, I’ll wait in here then.” There were some chairs available. I sat down across from a couple that kept complaining they’d been there four hours. I was at five and a half. I was dismayed when they got called back.  They literally didn’t know how lucky they were. 

A man who looked like those mix-and-match cards kids play with--where you stack up sections of people--was also across the room.  His head looked like a regular old man--short gray hair with a large bald spot on top.  The next layer was a flowing floral blouse, backless.  Next level--men's cargo pants.  Last but not least, hideous glittery sandals (over socks) that no sane woman would ever wear, but that he seemed very proud of.  Bold choice, my man!  He was happy, and that’s all that matters. After making a big deal about seating himself, he played a song so loudly on his phone that a security guard came out from the mysterious backside of the doors we prospective patients had never seen and told him to turn it off.  He negotiated a lower volume, which he increased halfway back up again as soon as the security guard left.  Then, he opened up his huge yellow garbage bag, drew out his supper, and started to eat it.  Someone must have ratted on him, because the security guard came out again and told him to take it to the cafeteria.

"Will I have time?  Will I miss being called?"  Not a chance.

Then, I noticed that a woman talking to staff had been a client of mine. I was wearing a big, paper mask and my readers, and I hoped she wouldn’t notice me.  I can’t acknowledge her unless she talks to me first, and I just didn’t have it in me to deal with anything more than enduring to the end.  But it made me very quiet and still, especially when she came and sat right next to me. I knew that, if they did call me, I would have to state my full name right in front of her.  And then she'd know. I kept my head turned away and played solitaire until my phone battery ran out.

Then, I approached the desk, yet again.  Four people ahead of me. I told them I was going back to my car. 

At six and a half hours, I decided to go in and plead my case again—to a supervisor, maybe. It made so much sense for me to get out of their hair and get my hair out of there that I thought maybe someone with some authority could be reasoned with.  I took two steps and my phone rang. 

“We have a room for you.” 

Great!  Half done. I figured I would probably be allowed to leave the hospital by three a.m.  (It was actually midnight.)

Honestly, by then, I felt like a celebrity who had won some grand prize!  I had a room!  I was walked so far back into the depths of the hospital that I thought maybe it was no longer part of the ER. I went to the bathroom and put on a hospital gown. I told the nurse the chest pocket was ripped at the seam, and what was below it was playing peek-a-boo. “I need another one.”

“They’re all like that,” she explained.  What else.

The nurse was nice, but she scoffed when I told her I had a blood pressure cuff in my lunch bag and she didn't need to use another one. I started to hear a cash register sounding in my head.

When the ER doctor on my case came in, the first thing she said to me after introductions was, “Your face is asymmetrical.”

I started laughing.  Everyone’s is, to some extent. I thought it a hilarious place for her to start.  Of course, she was trying to determine if I’d had a stroke.  She got out her personal cell phone and reversed the camera so it was like a mirror for me.  “See?  Does your face always look like that?”

Before or after seven point five hours of torture?

“See?  This side of your mouth when you smile is not quite as high as that side of your mouth.”

“I just have a permanent smirk on my face.” I honestly could not take this seriously.  I had most definitely not had a stroke.  Yet.

She asked to see my driver’s license, to compare my lopsided-to-her smile with it. 

“I guess you always look like that,” she said. 

She put me through numerous neurology tests, which I expected. When I was able to read through a list of very simple, short sentences, she complained I was passing everything too well. 

I got the long-awaited CT scan, and waited a couple more hours. The ER doc said it didn’t show any damage to my neck arteries. And then she started to propose that I might be coming down with a condition I had never heard of that involved inflammation and blurred vision. 

I didn’t think so. 

“But you said you had blurred vision.”

“No, when you asked if my vision was at all altered, I said I wasn’t sure.  This pain in my forehead makes me feel diminished.”

Even though I was trying to be nice, she got tired of me real fast. “But at your AGE. . .”

I got a little tired of her, too, although I knew she was just doing her job. I really did keep trying to be polite.

She sent someone in to get more blood so she could test for the strange disease she had settled upon. I had more questions. She said she had a responsibility to make sure I didn’t have it, because, if I did and it wasn’t treated, I could experience vision loss.  If I left before the neurologist saw me, it would be against medical advice. 

At that point, I had not eaten for eleven hours, not counting some cucumber slices.  I had taken the huge ibuprofen my husband had run up to slip me, then added to my empty stomach the three Tylenol the ER doc had insisted I take. I told her I was getting nauseated and asked if I could eat something. She agreed to bring me a snack.  I never saw her again.  

My heroic husband left the room to hunt and gather, and came up with two bagels and a brownie, which we shared.

I did want to stay for the neurologist. I wanted to know if he could see any damage to my arteries on the CT scan (he couldn’t), or thought I had the mysterious illness (he didn’t). 

So, too late to make a long story short, there is nothing wrong with me. Except that old, familiar referred pain in my head that no one can explain. (They wrote “migraine” on the discharge papers.) And galloping blood pressure, also not explained. “We expect it to be high in the ER," the neurologist said. (That makes sense.)

And, I feel I have lost my rudder.