Robin A. Grant  

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A Long Wait in the ER
The Halifax Commoner

Overcrowding has health experts declaring a national crisis. The QEII Health Sciences Centre refused to let The Commoner spend time in the emergency room last week, but as luck would have it (for us, not for her) reporter Robin Grant had a bad headache.

I tried fighting it with gallons of apple juice and naps under my big comforter, but by the third day, my head hurt so much I could hardly walk. Instead, I was shuffling around, bent at the waist like Tim Conway. Any sudden motion sent sharp, excruciating pains through my head.

On day four, Friday, I woke up, slowly got dressed and called a cab. I'd had enough. I was taking my headache to the emergency department of the QEll.

It's a nasty cab ride. We hit every bump on the road between my apartment on LeMarchant Street and the hospital. I walk through the doors into the emergency and look around, a little dazed, trying to take in my new surroundings. A tall, well dressed older man approaches me and asks very politely, "Are you here to see a doctor?"

He reminds me of a butler. I say yes, and he directs me to a row of chairs on the left, lined up in front of a long, rectangular window. I sit down and a woman comes from behind the glass.

"Are you here to see a doctor?" she asks.

"No," I feel like saying, "I'm here because they kicked me out of Tim Horton's."

She whisks me into the room and tells me to sit down. She is the triage nurse, responsible for prioritizing so-called emergencies. I wonder if she's ever made a big blunder, and think how stressful her job must be. Emergency rooms are a demanding place to work under normal conditions. I can't imagine the pressure the staff feels when the facilities are overcrowded. The triage nurse asks me a few questions, checks my vitals, and sends me to registration.

The registration desk is only about 10 metres away from the triage station. The woman behind the desk barely looks at me. She has a telephone headset on. There is a clear plastic partition between us with a small hole to talk through. I find it unsettling. I imagine the plastic is there to keep germs away. She asks me my name. When I reply, she asks me to please speak up. She checks my information and tells me to take a seat in the waiting room.

Shouldn't be too long, I think. It's 11 a.m. and there are only five other people waiting.

The woman across from me sits wrapped in a white hospital blanket. She has a big glass of water in a Burger King cup and a kidney-shaped basin at her side. She breathes laboriously. She bends down and holds her head in her hands.

"Have you been waiting long?" I ask.

"Since nine o'clock," she answers.

"Do you mind if I ask what brought you here?"

"No," she says, rocking back and forth. "I can't stop vomiting. They don't know what's wrong..."

She goes on to tell me that she's had to come to the ER more than 10 times to get rehydrated since her bouts of nausea began a year ago. She had to spend Christmas Eve here. The ER, she explains, is the only place to get an IV. She looks exhausted.

I rest my head against the wall. Soon the fluorescent lights begin to aggravate my headache. I wonder how long the wait will be. The vinyl arm chairs aren't the most comfortable accommodations for the sick.

I look around the room and notice the expression in everyone's eyes. It's either dull or pained. Except for the man who greeted me when I first came in. He looks almost sprightly. He moves around the room, fixing the magazines into neat piles and collecting any bits of garbage he can find. He smiles at everyone.

I wander to the vending machines to buy some cough drops and bottled water. A man is parked there, sitting hunched over in a wheelchair, drool hanging from his lip, his shoulders heaving softly.

The machines offer only junk food. I ask the woman at the registration desk where I can get some water. She tells me to ask the volunteer to get me some, and points me in the direction of the tall elderly man. He goes off on the mission happily. He returns with a Styrofoam cup filled with water. I enjoy the pride he takes in his work. He seems to genuinely want to help out.

The time passes slowly. Waiting has that effect on time.

Paramedics come and go through the main doors. Whenever the door opens, the cold air creeps into the room and the woman with the blanket pulls it up around her neck. A well dressed middle-aged man comes in and goes straight to the registration desk. He says he thinks his 89-year-old mother has pneumonia. He sits down next to me, still carrying the cold air from outside. It's around 1 p.m.

I ask why he's here and he tells me about his mother. I ask him if he's been here before. He hushes his voice.

"Well, my sister brought my mother in last time," he says. "She still says if she hadn't kept a close eye on things mom wouldn't have pulled through."

I tell him I'm writing a story on the emergency room and ask him what happened. He says he's not interested in talking about any specifics to the media.

"You understand surely," he says.

The woman with the blanket has started coughing. She's holding the basin up to her head and I'm scared she's going to vomit.

A young woman walks in with a knapsack an her back. She's panting hard from the cold outside. She's routed into the triage room and a nurse holds a stethoscope to her back and gets her to breathe in and out. After she registers, she sits down next to me and cheerfully tells me she's having an asthma attack. She explains that she's just coming in for a prescription because she couldn't get in to see a general practitioner. She has piercings in her nose and chin.

An elderly woman is sitting across from me. She's wearing a bright blue blazer and skirt and a high white blouse. An old fashioned broach glitters from her collar. Her demeanour is very dignified. Her eyes are deep and watery, and she swallows a lot as if trying to get rid of a tight lump in her throat.

"This place, this waiting room, it's like a warehouse," she says. "I can remember when they used to be so homely."

I ask her why she's here. She points to her rib cage and says she has a steady, sharp pain. I look around and notice the place is filling up. I check my watch. 2:30 p.m. Across from me an elderly man is grimacing, clutching his left arm.

Suddenly I notice a woman cursing in a throaty voice. She's sitting in a wheelchair. Her hair is matted and her entire appearance is filthy. Her male companion is trying to calm her. He has a heavy moustache and a dirty ball cap. The tongues of his boots hang open. They look like street people. She suddenly crumples into the wheelchair deflated and begins moaning, "I'm dying ... I'm dying..." The dignified elderly woman in the blue suit has begun pacing around the waiting room. She is crying.

The girl with the nose ring stands up, slings her knapsack over her shoulder and turns to me.

"I've had enough," she says, gesturing towards the chaos. "I'll probably end up coming in tonight with a severe asthma attack, but I'm not waiting here all day. Good luck."

It's 4 o'clock. I've been waiting for five hours. An elderly man coughs and the woman with him rubs his legs. He's in a wheelchair and looks incredibly weak. I think of the germs in the room and remember a man with AIDS I interviewed once who told me an emergency room was the worst place for an AIDS patient.

The doors open and paramedics rush in. Cold air bites through us all. The woman with the coughing old man looks bitterly towards the doors. She pushes the man and his wheelchair across the room towards the triage station. I hear the triage nurse tell her, "I'm sorry, ma'am, but you're going to have to go back to the waiting room. We can't do anything about the doors."

The woman doesn't budge, but the nurse persists. Finally she offers some blankets to the woman, who accepts them, covers the old man, and wheels him back to the waiting room.

It's 4:30 p.m. I make my way gingerly to the nursing station, careful not to aggravate my head--or the nurses.

"Is there any way you could tell me how much longer I'll have to wait?" I ask.

I had read the sign on the wall that said those most in need of care were treated first. I could still walk and talk, but I couldn't take much more of the vinyl chairs.

She looks through the charts.

"You're next," she says.

It's at least another hour before I set foot in the ward. I hear later that someone misplaced my file. A cheerful nurse takes me to a room and checks my temperature, blood pressure and pulse again. She asks me some questions about my symptoms. I ask her if the flu season has hit the emergency hard. She says yes, but it's always busy in the ER. She says there aren't enough beds for everyone.

She leaves, telling me a doctor will be in to see me in a while. I curl up on the cot like a cat, grateful to be horizontal. I wake up an hour later, around 6 pm.

Somebody is moaning loudly. The nurses talk to him soothingly, almost jovially, using his name over and over.

"Now we just have to get this down your throat," a nurse says.

I hear a terrible gagging sound.

"It's just going to hurt for a minute, come on now, hang in there."

The man begins to speak but I can't make out what he's saying. The nurses clearly can. Their voices to me sound courageous, like they are guiding him through the ordeal.

I look around the room. There are a bunch of pamphlets on pregnancy, stillbirths and miscarriages. There is a filing cabinet and a table with various swabs and syringes. I pick up a stick that looks like a long, thick toothpick and play with it. I pad quietly out of the room.

The man is talking through something that seems to magnify his voice to the nurses. The nurses are holding up remarkably. One of them, a heavy-set blonde woman in a green uniform, sounds extremely sincere. From the entrance of my room I can see the soles of the man's bare feet and the slope of his belly raised up under the sheet, blocking any view of his face. Blood gushes onto the floor from where his head should be. The room is marked, "Trauma."

I wander around the comer towards the main desk. The staff looks swamped. I can't decide if I admire them or feel sorry for them. I decide I feel both. I suddenly feel a tap at my shoulder. An official looking woman, perhaps the head nurse, demands, "Are you lost?"

I bite my lip. "No," I say, and shuffle back to my room, feeling like I've been sent to the principal's office. I doze off briefly only to wake up to the trauma man's voice again. He's calling for the nurse. He says he wants more pills. The nurse says she's not allowed to give him any more pain medication, that they have to examine his neck first. He keeps asking.

I decide to hoist myself up and look for my doctor. I head for the desk. As I make my way down the corridor I notice a young man leaving the trauma room carrying a mop. His face is terribly pale. He looks like he's about to vomit.

I decide against pestering the nurses about a doctor. Instead I stand back and observe as the doctors, nurses and staff zip by. I notice the blond nurse telling a patient that her shift is over, that she'll have to go.

"Thank you," an old man's voice says. "You've been very kind."

I go back to my room and sit in the chair so I won't fall asleep again. A doctor comes at last. She takes my vitals and asks me the familiar questions. Then she leaves, never to be seen again.

My patience is wearing thin. I wonder if anyone in an ER has ever found someone stiff with rigor mortis in the waiting room.

Finally an older gentleman comes in. He shakes my hand and tells me he's the doctor. He apologizes for the wait. He asks me where I'm from and what I'm studying. He shines a light into my ears and eyes, chatting with me all the while.

He eventually tells me what I had suspected all along: I have a bad sinus infection. He also thoroughly explains the diagnosis. He even draws me a diagram of the sinuses. He goes through every possible drug regimen and finally tells me to use a nasal mist for two days, drink lots of fluids, and get lots of rest. Finally he asks me if I have any questions. I say no, a little breathless. I feel like I just got my medical degree. He apologizes again for the wait and sends me on my way.

I walk through the corridor past the bustling nurses' station into the waiting room. I look at the long faces of some of my comrades. I know the staff are working hard, but I hope none of the patients have to wait as long as I did.

It's 8 p.m.

I've been here nine hours.

I'm going home.