Slipping Through the Safety Net
Plastic bag in hand, ready for any bilious torrent produced by the next round of respiratory fits. I couldn’t tell if her moaning was due to the racking cough which shook the two chairs she had pushed together to make a bed or to the moonshoe protecting her tibia from trauma. Please don’t puke, please don’t put me in a situation where I’ll have to decide whether it’s more polite to pretend I haven’t noticed or to find some way of fetching water. The self-service malady station offered tissues and barf bags and hygienic hand gel but no cups. I should spray my neighbor down with the provided antiseptic.
I never would have taken the seat, alone against the wall of an examination room, had I know the woman was retching. She waited for the raging drunk falling out of a wheelchair to lurch after a pregnant woman and her young daughter, leaving the sanitation kiosk unguarded. The drunk’s sudden departure alarmed reception and a stray nurse who debated going after him until they became distracted by the viscous black fluid he had left to seep through his former seat and onto the floor. A call to maintenance was interrupted by a girl in pajamas who was angry at having her pathetic groans ignored. Yes, you’ll be seen after the gaping head wound who swears he’s not drunk but can’t remember his name, the guy with chest pains, the woman who can’t walk on her own, the five or six people who sleep here when it’s too cold and wet on the street.
These people aren’t sick, the triage doctor told me after I waved away her apologies for the wait, they just think they are. Her bitterness clashed with the spunky hair and Chuck Taylors, and with her adoration of the little girl who had hit the panic button. A SWAT team burst into the lobby all body armor and light weaponry, peering through windows and signaling each other across the room. Little girls are cuties. I’m tired of telling the staff I’m not a junkie.
Shift change introduced a bubblegum chewing nurse who had added flair to her scrubs and prattled on about how she preferred working the emergency room over sitting with patients in the other wing. Years of discipline kept reception and the other nurses from stabbing her in the face. A guy from maintenance showed up with Lysol and stood silently while he was berated for taking an hour to arrive. He sprayed the wheelchair down and wiped liquefied excrement up with paper towels which he threw into the uncovered trashcan next to my seat. I left moonshoe to deal with the stench and followed a nurse into the bowels of the Legacy Emmanuel.
Blue-lit washed out decay. This isn’t a fucking hospital, it’s an overstaffed data center. Doctors and nurses slumbered before outdated computers, ignoring me as I tripped and dodged through their ranks to my own private torture chamber. Middle management flitted through the hallways on Segway terminals to make sure no one was playing solitaire. No eye contact, no talking. I was shown into a surplus Soviet veterinary clinic choked with canisters of combustible gas, miles of tubing and cables, spigots and diodes pressure valves and tetanus. The nurse told me that it was the first day they were using this wing of the hospital. That explained the raw spackle and exposed wiring which led me from the front door to the emergency room.
The attached bathroom was being used as a storage closet and had a sign taped over the toilet forbidding use. I was pointed to an unmarked door and a nearby computer drone warned that there was no lock. There wasn’t a toilet seat either, or paper towel dispenser or any attempts made to brighten the beige tiles. I ignored the sliver of soap collecting staph in a pool of scum and tried to ignore the drain in the center of the floor for when maintenance hosed blood off the walls.
A new nurse invited me to watch television and I wished I had thought to bring some VHS tapes with me. I tried to settle in by pacing and looking at terrifying medical posters or staring out the window at passing cars before but was interrupted by one of the Segway caste. We talked about my being uninsured and she issued third generation copies of payment plans and sworn affidavits to my state of impoverishment. I rifled through the paperwork. I succumbed to the allure of basic cable. When the doctor finally arrived she told me it was okay to leave it on while she examined the abscess with had brought me to the hospital. No, I’m not a junkie. No, I don’t have any known communicable diseases. Yes, I met with the financial department. She lowered a face shield and commenced with the needles and the scalpels.
Internet printouts of things I already knew, a couple antibiotics to tide me over until I could get to a pharmacy the next day, surgical gauze packed into my arm. Don’t go slow, pull it out quick like taking off a bandaid. Charming parting gifts but the real treat arrived later in the mail. An itemized hospital bill required a call, a customer service agent to tell me to collect pay stubs and bank statements and where to mail the evidence of being broke. That was expected, but not the second bill from Northwest Acute Care. Ten years ago Legacy Emmanuel spun off a second billing department. Nurses, maintenance, reception, the emergency room power was all paid by the hospital. Doctors, who had administrative power over lesser medical professionals while on duty, were paid by an outside company which needed money for computers and mailing bills and taking confused phone calls from me.
Here is the life of the uninsured in American. People are afraid that Obamacare will lead them into a bureaucratic gulag and substandard medicine, but that dysfunctional system already exists. It’s already the problem, and it’s an administrative one. The problem with health care in America isn’t the doctors or the nurses or the technology and know-how, it’s in how money gets shuttled from department A to department Z, how costs dictated by the market prevent lowlifes slipping through the safety net from seeking early treatment, and then flooding emergency rooms when problems explode into infected abscesses. We’re millions strong and we’re wasting everyone’s time and hard work because there’s no other option.
I really don’t know what would have been different had all the provisions of Obamacare already kicked in. If I can’t afford to buy insurance on my own I can’t afford to be penalized. If you try to fix a system by making concessions to the corporations who profit off a market where 100% of people require care, there will not be changes to that system. You either recognize that profiting off the well-being and health of people is illogical and amoral or you send me, pregnant women with young daughters, gaping head wounds, chest pains, moonshoes and whiners in pajamas to die in the street.
I could have given a fake name and address when I registered with reception. But I want to support public hospitals as much as I can. It’s not the fault of the nurses, the doctors, the maintenance guy, the SWAT team or even the people who answer the phone when I’m confused that health care costs so much in America. It’s executive boards and financial wizards and stock analysts and layers of bureaucracy.
It’s reason enough to throw up my hands and say fuck it. You get nothing from me.