Events: Emergency Room I
Monday, February 18, 2002
Man, I'm glad it's this week and not last week. 'Cause I was having so much fun for a few days there that I don't know if I could have taken much more of it. It got to the point Friday night that it became clear I was so happy I needed to drag myself to an emergency room for some medical care. Phoned a friend, got a recommendation for a good hospital, grabbed a taxi.
A chubby munchkin of a woman met me as I stumbled through the emergency entrance, asking what was up. I thought the answer would be obvious, given my pathetic state. Apparently not. As nicely as I could, I told her I was ailing. She referred me to a small room ringed with what looked like bullet-proof plastic which fronted numerous receptionist stations, all of which were vacant. A woman in another enclosure saw me, came over and said, "Dígame." ("Tell me.") I told her. She asked if I had a health card, I said no. She asked if I had a credit card, I said yes, but not with me. (I'd barely managed to get myself dressed, forgot to put on a belt so that my pants -- never a tight fit to begin with -- were drooping noticeably after three long days of being unable to consume anything but water.) I had some cash with me, when I mentioned that she said she couldn't take money, sternly instructing me to return to the hospital the next morning and proceed directly to the correct office to settle up. I intended to pay, but only after I'd had the weekend to recover from the fun of the past few days. I didn't tell her that -- just said, "Vale" ("Okay"), let her take my passport info., accepted a receipt to present when I returned to pay, then headed to the E.R. desk.
A medical type there said, "Dígame." I diga'd. They nodded, took my name, took my blood pressure, told me it was fine, led me to the nearest waiting room -- there were several, all lined up next to each other. An omen I might have taken note of if I'd been feeling clearer.
Now that I think about it, though, the first one, the one they gently dumped me in -- white linoleum floor, white ceiling, white walls, ugly four-unit modular plastic seats, fluorescent lights -- was a genuine waiting room. A holding pen where you did nothing but enjoy whatever condition had brought you to the E.R. to begin with, watching everyone else do the same. The other waiting areas were all rooms with counters, sinks, storage cabinets (packed with medical supplies), oxygen masks, comfier chairs, and a spartan bed at one end where the occasional individual spent time.
A universal truth, known from earlier times working in an ambulance, rediscovered in the course of this outing: there is nothing quite like an emergency room in a hospital in a large city on Friday and Saturday nights. Emergency rooms see it all anyway -- on a weekend night in a major population center, it's just that much more of a party. All sorts of characters show up, in all sorts of states. It is one lively display.
The first waiting room contained two rows of plastic seats, facing each other, people sitting in them. Nothing else. No tables, no rugs, no TV, nothing on the walls, though one had a large window looking out on the E.R. desk. Nothing to read. No distractions. I slowly, carefully planted myself in one row of seats -- one person occupied each end seat, leaving two open seats, so that I had to sit next to one of the two people. After three or four minutes, the woman I planted myself next to got up, relocated to another part of the room.
An elderly couple sat together in the opposing row of seats, off to my left, in the corner. Normal folk -- the woman small, grey-haired, serious expression, the husband larger with a bit of a stomach, receding hair, expression also serious. Impossible to tell which was the patient until the husband pulled out a large plastic bag, began vomiting and hawking up stuff into it. A 20-something guy sat across from me, wearing sports clothes/sneakers. Not looking like he'd come from a sporting event, just doing the casual thing. (A bunch of people showed up that evening wearing training pants and sweat shirts or training jackets. With sneakers. A popular ensemble.) Nothing visibly wrong with him. Didn't look like he felt ill. No apparent injury. He simply sat quietly, watching the rest of the inmates.
An older man shuffled slowly into the room -- late 70s, cane-assisted, mouth opening and closing. Baggy pants, slack white shirt. Small in stature and build, unshaven, each cheek/ear sporting streaks of scars and discolored skin from serious lesions at an earlier age. Couldn't make out his current complaint either. Maybe he was there for the sensory input of it all. He spent his time shuffling in and out of the room, gazing around. Other inmates came and went. Now and then a nurse materialized, called out a name, an inmate got up, follow her away.
Forty-five minutes into my stay a nurse wheeled an elderly woman into our holding pen, explaining to her that she'd have to wait there until a doctor could see her. The elderly woman replied, "Vale, vale," the nurse took off. Time passed, the new arrival began going "Ayyyy!" every few seconds. Once in a while she'd reach around, place her hand on one side of her lower back for a moment, saying, "Ayyyy!"
An hour and fifteen minutes later, a nurse appeared, called my name. I staggered to my feet, followed her into an examination room.
Tuesday, February 19, 2002
They did not leave me in the examination room American style, waiting ten, fifteen, twenty minutes until a doctor showed. The doctor was there, ready to go -- an attractive, tired-looking Spanish woman, mid- to late-30s. Slender, my height, typically Spanish-featured including dark, moderately-heavy eyebrows, dark hair streaked lighter blonde. She sat at one side of a small writing table, I sat at the other. "Díme," she said (the informal version of "Tell me," pronounced 'dee-may'; "Dígame" = the formal version). I did, or tried to. I had trouble doing anything more complicated than stare blearily ahead, mouth slightly open. She listened, she asked questions, she examined me, she told me I'd need X-rays and a blood analysis, I quickly found myself back out in a waiting room. One of the more comfortable ones this time.
By that point, Madrid was well into Friday night. E.R. traffic had increased, every available seat had been taken, people milled about. Family members and sweethearts hovered around patients. Three or four older, heavy-set men lounged unhappily about, wearing oxygen masks. Folks of all ages and social types waited. At one point the scene became so crowded, so noisy and entertaining that staff members cleared out all non-patients. Uniformed security guards stood conspicuously in the hallway until all intruders were gone and peace had been restored.
With relative tranquility re-established, I became aware that I could hear the elderly woman in the wheelchair from my first holding pen. Having apparently changed ethnic allegiance, now going "Oyyy!" every few seconds.
After a while, a young woman came along, took a blood sample from me. A sizeable blood sample. Back in the days when I did ambulance work -- a madcap six-month stretch of time that provided strange, indelible memories -- I used to be able to watch that kind of thing with no problem. Hell, I could come upon fairly serious carnage without blinking too much. These days I find I don't especially want to watch a needle going into my arm or my blood filling up a vial. So I don't. I watched the other inmates, the medical worker finished up and took off, I found myself waiting more.
A bit later someone ushered me to radiography (radiografía) for two quick X-rays, then ushered me back to my chair. People came and went. A young, thin woman appeared, flung herself down in a chair down at the other end of that waiting enclosure, not happy. She clutched a large plastic bag of stuff, occasionally slipping an inhaler in her mouth and taking a shot, scowling, stressed, complaining loudly that she wasn't getting the attention she wanted. If another inmate listened, she'd talk to them. If everyone ignored her, she'd complain via monologue. She had no intention of keeping her feelings to herself. After a while, disgusted by the lack of medical attention, she took out half a sub sandwich, started in on it. A passing nurse said something to her about food not being allowed in the emergency area, she replied that no one had told her that and if she had to sit and wait for hours she was going to eat, goddammit! The nurse wisely moved along.
By this time, friends and family of patients had begun filtering back in, the level of noise and activity rising to a more entertaining level. And before too long, the sound of a body hitting the floor could be heard from the neighboring waiting area, followed immediately by an alarmed voice calling, "¡Qué alguien venga!" ("Someone please come!") Medical personnel came running from all directions, a gurney showed up a minute or two after, a middle-aged woman already in a hospital gown was gently lifted onto it and taken away. Things quieted down once more.
After a while I got up to stretch my legs, found a more comfortable chair with a view of the hallway. Two hours later, a medical worker approached calling my name. I raised my hand, she came over, immediately started getting out medical equipment, the kind that suggests further blood loss. Looked like she had some papers that might be the results of my blood test, I asked about that. She told me the result of the first test was that they wanted to take another one, then hoovered a tubeful from my other arm and disappeared. That was near midnight. I'd arrived around 7:15.
Nearly two hours later, the doctor I originally dealt with retrieved me and gave me the lowdown. I had a serious lung infection, she said, serious enough that it had impacted my whole system, flu-like. She handed me several pieces of paper, including test reports and one page filled with unreadable scribbling that I was to bring to a pharmacist. She gave me two X-rays as my very own souvenirs and sent me home.
When I stepped outside, I found that the night had turned cold during my 7+ hours indoors. Really cold. The kind you don't often get here. Two passing empty taxis ignored my waving arm, I found myself starting to shake. The third taxi pulled over. I fell into it, saying, "Chueca," he started off. Turned out to be a long ride 'cause the police had cut off access to a number of places and were siphoning all Saturday night traffic through one system of thoroughfares, my taxi driver becoming more upset each time we were turned away from a street that led in a direction he wanted to go. He finally made it a few blocks from here via back streets, we found ourselves trapped in a line of cars behind a garbage truck that worked its slow, halting way up the block. My taxi driver, by this time, was practically foaming with impatience. I paid up, got out, walked the last few blocks home.
Saturday: hit a pharmacy, took care of myself. Existence has been easier since then. Yesterday, Monday, I returned to the hospital to pay for Friday night's fun. At an information desk in the main lobby of the hospital, a woman directed me to a neighboring building. Over there, I followed signs to Facturación (billing/invoicing). A woman there directed me to yet another office. It began to feel like no one knew what to do with someone who actually wanted to give the hospital money. At the next stop, a man in a jacket and tie asked if he could help me, I told him I wanted to pay for a visit to urgencias, explained my situation. I handed him the piece of paper I'd been given on my entry to the hospital, he scanned it, asked me to wait, disappeared off through rows of desks and workers into a small office. A couple of minutes later, he reappeared with another jacket-and-tie type, they headed in my direction, looking mighty serious. On arrival, he told me that because the City of Madrid was in the process of changing the departments that were responsible for hospital billing, they were going to keep it simple and give me the medical care free. My eyebrows shot up in amazement, he smiled. I said, "¿Seguro?" He affirmed it, we shook hands, I bolted.
Outside, a beautiful afternoon was underway. Sunny, chilly, lots of people about. It felt good to be alive and making my way through it all.
Alive, making my way through it all. It surely beats some of the alternatives.