Lump (22)

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“At Kaiser Permanente we put our Emergency Room at the BACK of the hospital, with almost no sidewalks, so if you get hit by a car you can get almost immediate attention.  Because WE CARE!”

EMERGENCY

She overdid it during the weekend, and now she is in the Emergency Room and I am trying to figure out what I did wrong.

It was her birthday.  There was a party.  It wasn’t very big as parties go.  But we stayed perhaps too long.  And we tired her out too much.  And now she is shaky and fatigued and bleeding (BLEEDING!) and in the Emergency Room.

Because it’s really an emergency.

The Emergency Room is different than the infusion center.  Here she lies on a bed instead of sitting  in a chair.  Here the machines go “meemee” and “pip” and “boop”.  Here the nurses are a bit more rushed.  Here there are people who are really screwed up.  There’s someone facing a gall bladder operation, another with acute appendicitis, and a third who had to be rushed in by paramedics due to diabetic coma.

And there’s even less privacy.  I thought the infusion cubicles were small. but here I not only have to sit on one of the hideously uncomfortable chairs but I have to do so with a blood pressure gauge lying atop my head.  And because everyone in the emergency room is a serious case, and serious cases need discussion and information and planning and consultation, I can hear what’s wrong with everyone.  I can follow the progress of their treatment, and hear the consultations that they have with nurses and doctors and surgeons, follow issues like their insurance and attempts to get in touch with loved ones (the person with appendicitis is high as a kite on painkillers, and can’t remember important things like cell phone unlock codes needed to find work numbers for members of the family).  At one point a patient is brought in who has had a major psychological break.  Surrounded by parents and siblings, wearing piss-soaked clothes, the eyes dead and shattered by something internal that no one else can see or touch or measure.  The family is really good, really supportive, and I feel like I have no right to be even tangentially a part of their drama and tragedy, but there I am, sitting in a chair with a blood pressure gauge dangling on my head, unable to get away, to give them the privacy that they need and deserve in a time of crisis.

And they, of course, can no more give she and I privacy than we can give it to them.  They’ve been giving her fluids – nearly 200 units – and she has to use the restroom.  But the patient with the psychological break has to use the bathroom to change out of those piss soaked clothes and clean up and the family wins the race to the one restroom in the emergency room, so we have to wait while they get her cleaned up.  It’s an uncomfortable few minutes, she fidgeting on the bed in increasing desperation, me trying to figure out if there is anything I can do to help either party – which of course there isn’t but that doesn’t stop me from trying to figure it out.  I’m actually on the verge of asking for a bedpan when the patient finally comes out of the bathroom like a robot, wrapped in a blanket and hugged close by a supportive family member, and the whole group is led off by a kindly nurse to another part of the hospital.

She is into the bathroom like a hound coursing after a rabbit.

All in all we spend an afternoon at the Emergency Room.  We get there around 12:30 and leave just a bit before 5:00.  During that time she receives her fluids, gets several blood draws, and receives a pelvic CT scan.  Her lactic acid count is initially high, and that is almost cause to admit her to the hospital overnight, but it comes down in later tests.  The CT scan eventually reveals a small abscess, which may or may not have ruptured earlier.  Antibiotics were prescribed and administered.

During that time I fret.  Really there isn’t much to do but fret, sitting in a cubicle for five hours with someone who feels awful surrounded by other people who feel awful.  She notices me fretting a couple of times so I try to stop.  But I still fret.  Even though it turns out to be nothing too serious, I still fret.  Five hours waiting for a diagnosis surrounded by people with serious problems do that to me.

But at least I learn something.

This probably won’t be our last visit to Emergency.  We got off easy on this one.  There was none of that really dramatic stuff you see on TV emergency rooms.  No spurting blood.  No screaming drug addicts taking hostages.  No very serious ER doctors wielding paddles and yelling “CLEAR!”.  No gunshot wounds or gang fights, no tracheotomies using a pen or  or patients being delivered by helicopter from horrible auto accidents.  More importantly, no admittance personnel trying to find her a room, no consultations with surgeons or anesthesiologists.  No emergency prep or discussion of long term treatment options or hospice care or  any of the very horrible, very real stuff that can happen when things are serious enough to go to the emergency room.

I don’t do well in unfamiliar environments.  I get nervous and fretful and anxious.  I think that most people do.  And it gets worse for me in high pressure situations – again I don’t think this is uncommon – to the point that I may start being less effective and less supportive than I should be.

So for me this was a good test run, if you will.  I became familiar with the ER at the hospital, so I can find my way around now.  I know what to expect and where the bathroom is and how to get the attention of a nurse and how to get back in if I have to leave (and a special shout out to the security guard who was really nice and friendly and helped me find her again when I got back from the pharmacy and got lost).  And maybe these are all little things, but little things count.  Little things can be important in times of crisis.  And now I know a lot more than I did last time, so next time I will be better prepared.

I can’t say that I am happy about going to the ER, I’m certainly not happy that she needed to go, and certainly not pleased with the idea that she will likely have to go again – or I will because you never know.  But I learn the lessons I can from the situation that I’m in, and I try to use them to improve.  Which is what I can do.

2 thoughts on “Lump (22)”

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