Escape from the Emergency Room

By James J. Gormley

I realized one day that I had a medical "situation," a male concern I had wondered about for a couple of months, yet had dealt with via the time-honored male tradition of "avoidance"-- if I pretend everything's okay, the problem will go away -- not exactly the best approach.

Scared about cancer, I sat down with my wife. We resolved to speak with a physician friend the next day, which I did. I was told: "Get thee to an emergency room," in no uncertain terms.

Wracked with fear, I stepped into an emergency room in the Bronx, where I live, and I was shocked. Before me were hundreds of people waiting to be called -- victims of a world without a family doctor, statistics at the periphery of an HMO universe.

There was no hope in this room. Only desperation. Only sickness. Only pain. The room was dark and filthy, the staff looked shell-shocked, and the triage "window" was a l-inch-thick bulletproof barrier.

My heart sank. I felt a ball of worry in the pit of my stomach. I telephoned my car-service friend, Marvin, and asked him to pick me up and drive me to a hospital in Manhattan, one regarded as one of the finest medical institutions in the world.

When the cab drove in along the graceful, flower-lined driveway, I thought that I was pulling up to a Hamptons dinner party, not to a place of X-rays and blood. There were only a couple of people waiting in the immaculate, "elegant" waiting room. I thought, "Now I'll be safe. Now I'm in good hands. "

Or not? The triage nurse ignored most of my questions, and I wound up in a room within the bowels of the E.R. Freezing in a hospital gown, I was examined by a surgeon who was compassionate yet overworked. He informed me that I would need ultrasound testing, and that a urologist would have to see me.

After he left, a nurse ordered me to vacate the room, since they needed it for an "eye injury." I painfully climbed down (without a step-stool) and found myself, ignominiously, having to climb up onto a stretcher in the hallway.

About 2 hours went by before transporters came to bring me to ultrasound. When I was brought back to the E.R., I was deposited in a wheelchair and forgotten.

When my meal arrived (for which I had to practically beg), the urologist intern showed up: 7 hours after I arrived, 4 hours after the ultrasound. He was very vague, and just didn't seem to care. He promised to give me the names of three urological surgeons, and sent me back to the nurse's station, where I waited another hour for my discharge instructions, which I could barely read.

When asked by one of the night-shift nurses, "Who was your nurse?," I told her that I had no idea -- that no one (except for the surgeon) had bothered to give me a name, or ask me if I was okay, or if I needed a sip of water ... anything at all.

When I sit back, and try to process what this experience taught me, I'm left with this thought: It represents the very worst and the very best of what's horribly wrong and allegedly right about mainstream medicine today. It's high-tech but "low-heart," the apex of empirical skill yet the nadir of compassionate medicine.

In 1975, Ashley Montagu said, "One goes through [...] medical school and one's internship learning little, or nothing, about goodness, but a good deal about success."

Pity that goodness needs to be taught, and sad that this is a definition of success.

Is it any wonder that holistic medicine holds the key?