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A Visit to an American Hospital Emergency Room

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“We have no destiny assigned us:

Nothing is certain but the body; we plan

To better ourselves; the hospitals alone remind us

Of the equality of man.”

― W.H. Auden, Selected Poems

Nothing is more silent, more suggestive to a human being of their own imminent death than going to a Hospital  Emergency Room. Nothing is so severe with the finality of this  confrontation as how the German language puts it — Der Tod ist der Tod. I have been to many Hospital  Emergency Rooms in the United States, some of them profoundly efficient and caring while others crass and incompetent in atmosphere —-- the medical staff inept and unprofessional, medical equipment that did not function, all of which could have led to a potentially lethal misdiagnosis of any patient who had come into that medical facility.  It is easy for any historian, as I am in my occupation, to make general summations about the medical world or medical care in his or her own country, and therefore, I will only give a sliver of what could be deemed the National Character of American medical care in the USA. I know full well that thousands of Americans are not given access to vital health care and who therefore die in the hospital waiting room itself while  waiting to be admitted to a Hospital  Emergency Room, or who choose to die at home, because they did not have funds to see a doctor let alone go to a hospital. Thousands of Americans choose to hemorrhage from different parts of their body, or waste away from cancer instead going to that final destination called a “Hospital  Emergency Room” where they at least could have been easier for them to accept demise with sedatives or painkillers to ease that exit into death.

Recently, in the late evening hours, just before Midnight, I had to walk through deep snow to the  Emergency Room. Both my ears were clogged with wax, which had suddenly become painful. I knew instinctively I had better not wait until morning,  in case of infection, so I decided to arise from the comfort of my living-room couch, where I had been resting, and begin to prepare myself to venture out into the raging snow storm in below-zero temperatures. Violent gusts of wind were blowing swaths of snow everywhere on the streets, obscuring the walkways past apartment houses and private homes.  After putting on my warm winter coat, deerskin gloves and snow boots, I opened my front door and proceeded to walk down the streets towards the hospital. several blocks away.

Running daily, as well as being a former marathoner, a soccer <football> coach, a basketball referee, an Army veteran and trained enlisted soldier, I had grown used to physical and psychological adversity, so I was not afraid of the snowstorm, and after all, there are worse things to confront in this world than heavy snow in chilly northern Vermont late at night..   

After slogging through the high snow and ice on the streets and enduring the battering winds,  I was relieved to reach the Hospital  Emergency Room. Once inside, I encountered a small woman wearing a white uniform, who apparently was not a nurse and did not even ask what was wrong with me. She just first took my name and then begin to type my response with her keyboard attached to her stationary computer. When I told her my condition, she simply smiled and said curtly and with an expression somewhere between a wide grin and a grimace, “A nurse will be with you shortly!” She did not even inform me where to sit, or even ask me if I was in any kind of pain. I looked over at an alcove with many  rows of chairs, and I walked over to the area, asking the woman at the desk if this was the proper place to sit, and she replied with a socially insane look — “Yes!”  Then about two minutes later or less, an actual nurse walked out of a room across the aisle from me and motioned to me to follow her.         

Two nurses were in the room. One  seemed very bored. She was almost nondescript, except for that harsh look I have seen on the faces of many Vermont women through the years. The other nurse, brunette and comely, smiled at me in an affable way that for a moment  or two made me feel cautiously comfortable. Coolly, and with a clipped voice, the first nurse asked  me to blink my eyes, hold out my arms and hands, and did I feel dizzy.  Finally, she looked at one of my ears and agreed in a nonchalant manner, yes, I did have wax in my left ear. 

What then transpired was astounding on that  cold winter night in January.  

The first nurse picked-up an automated electronic temperature scanner, which could also be applied manually as an oral temperature instrument, and proceeded to scan my forehead to gauge my temperature. Then she looked at me with alarm, exclaiming “Your temperature is registering  88 degrees, way below normal! Are you cold?” I politely replied quietly and with a sense of stoicism “No.”  She then proceeded to take my temperature again only this time by inserting the thermometer- instrument into my mouth, and again it registered as an exceptionally low temperature.  “Are you sure, you are not cold? It says your body temperature is way below normal!” Again, I said “No” but starting to feel a bit panicky from listening to her demands about was I cold, I maintained,  “I don’t have a temperature, I feel normal!’  Then the other nurse came towards me, as I sat in a chair, admitting casually, “Maybe there's  a problem with the machine, let me take your temperature this way, under the arm," She, like the other nurse, got the same scary results, Both seemed terrified my body temperature was so low. It seems that they did not take into account my walking that distance outdoors in sub-zero weather at Midnight  to get to the hospital.  Maybe they were wondering if I was already a dead man among them, who can say?

And, since I am a senior citizen,  apparently it was odd to them I was able to walk to the hospital on my own late at night rather than coming by car.  I could have told them  how as a boy growing up in Kansas,  I endured many blizzards and snowstorms. I could have told them how I read enough Russian literature to learn not to panic in such severe weather, because in Russian literature, older people are accustomed to  hardships in wintertime. I could have told them about the Soviet soldiers who fought outside the gates of Moscow in 1941 in hardened snow to halt the German fascist troops who were attempting to take the Soviet capital. Or I could have told the two nurses about the thousands of French troops who fled the city of Moscow with Napoleon, and how they died in frozen disarray or went mad in the packed snow on the plains of Russia, while their Emperor escaped by a comfortable sleigh to Paris. I could have said, Please, use a little common sense, understanding  my temperature would of course go down, as I walked a long way in the frigid snow. But I did not, since staying calm in a socially insane society is everything.  

Finally, I saw their doctor who was very professional with me and examined my ears and pronounced that  indeed there was wax accumulated in both ears. (The wax buildup had been just starting to break up when I began to feel uncomfortable at home.)  Then the doctor asked a young and lively nurse, as well an assistant nurse,  a large and very spirited, African American, to wash my ears out with a syringe and warm water.  They both worked together and completely cleaned out each of my ears. What I liked about this encounter was watching the young white nurse and the equally young African American working together, which gave me a little peace of mind. The doctor then came back into the room and asked me if I was cold, and for the tenth time I said, "No, I had just walked here  in the cold and snow! I may be a senior citizen, but I am used to walking or running everywhere I go.” She then asked to take my temperature again and this time it was 96.7, much closer to normal. Clearly, I was alive!  Everyone was shocked that at my age, I had walked to the hospital in freezing weather and heavy snow. I said that I was used to such a life, an existence going places under my own power, not depending on others. Not all is equal in life, and this applies to those who live in peace or die in war, especially in hospitals. As the  German novelist Erich Maria Remarque once wrote, “A man cannot realize that above such shattered bodies there are still human faces in which life goes its daily round. And this is only one hospital, a single station; there are hundreds of thousands in Germany, hundreds of thousands in France, hundreds of thousands in Russia. How senseless is everything that can ever be written, done, or thought, when such things are possible. It must be all lies and of no account when the culture of a thousand years could not prevent this stream of blood being poured out, these torture chambers in their hundreds of thousands. A hospital alone shows what war is.”

This is true even in peacetime — when one is confronted with ageism, when the nurses and doctors are shocked a man in his seventies would dare walk alone in the snow to the hospital at midnight in subzero temperatures. And yet, in a way, what transpired was comical, witnessing the bungling of the nurses, in a hospital, their machines for gauging a temperature, machines that probably did not work. All this, also deplorable. 

Upon hearing my American Emergency Room experience, a nurse friend of my acquaintance, involved in nursing for 30 years, declared, "Today's nurses rely totally on medical machines to take care of a patient, without looking directly at them. Most patients complain that the nurses spend more time with the computer than talking with them. By ignoring the physical appearance of the patient, and not asking questions concerning their immediate concerns, that is how there can be a misdiagnosed. The American medical system is focused on monetary value instead of patient value."

To die in a hospital alone is the most egregious of deaths, and as I sat on a small bed with clean white sheets in that small  Emergency Room waiting for the doctor, I looked up at all the medical equipment used for saving a life, and I felt a stark sense of loneliness, utter loneliness.  Then I thought of how the great American novelist Sinclair Lewis died alone in a Hospital  Emergency Room — alone in Rome. This is what happens when you have no one in your life, no spouse, no partner, not even a pet — you die alone.   And yes, there are many, many things to think about, when you enter an  Emergency Room in America.

Author: Luis Lázaro Tijerina