In Connecticut we are in the midst of hospital wars. It is a very competitive market and all of the hospitals fight to attract patients. You can see it on the billboards that line Interstates 91 and 84 with hospitals proclaiming themselves the best at heart care, stroke, trauma care or declaring they are the safest or provide the shortest wait times. It can be seen even in EMS CMEs where medics and EMTs were recently treated to a lavish meal at one of the city’s finest restaurants complete with free valet parking to hear a specialist tout a hospital’s latest capabilities. (The event was subsidized by a vendor). But nowhere is the battle more evident than in the TV commercials where hospitals tout their state of the art technology, their beautiful grounds and rooms, and the attractiveness (and wisdom) of their staffs. It can make going to the hospital look almost like a trip to the Bellagio or some fine hotel with lavish fountains that go off at regular intervals.
Last Tuesday, my last call of a three day tour (I work three consecutive 12-hour days), we are in the triage line with our emotionally disturbed patient, coming on on a police paper. I drove, my partner tecked so I don’t have many of the details other than the young man is hearing voices and occasionally punches himself in the face, but for the most part he has come willingly. No restraints, chemical or physical, were required. We have been in line maybe 20 minutes so we are no longer outside the hospital or in the foyer, but within sight of the triage desks and the patients waiting in chairs and outside the first provider exam rooms. My partner is waiting to give his report. I stand by the head of the stretcher, checking my i-phone for the time. Hopes of getting out early are lost.
An old woman on a nasal cannula sits on a chair outside an exam room and is suddenly yelling at me. “Stop that! Stop that! Do something! Do something!” She looks very angry. I have no idea what she is upset about. No one else seems concerned. Is she just another psychiatric patient hearing voices and talking to herself. “Stop!” she shouts. “Have you no decency! Stop!”
I look at her closely. Her anger is not abating. Then I look at our patient. He had his penis out and is urinating straight up into the air. The golden liquid is arching up , then falling back down splattering on the patient himself. A fountain.
“Do something!” the old woman shouts.
For a moment, I think “What do want me to do? Is this my fault?”
But then I realize, I can probably take some action to alleviate her distress. I grab a sheet from the back of the stretcher and throw it on top of the patient’s offending part. “Knock it off!” I say. He mumbles something incomprehensible, then punches himself in the face one time as if he is admonishing himself for his bad behavior.
The woman is still glowering at me.
“Sorry about that,” I say.
What I really want to say is: “So they left that part out of the commercials.”
It is an hour before we get the patient off our stretcher and leave him in the psych ward where the staff are wrestling with another man and from deep in the bowels of the ward we hear another patient chanting “Bin Laden! Bin Laden! Bin Laden!”
Welcome to the ER.
Clean the stretcher, sanitize the straps. We get out an hour late. The ambulance goes back into service with a new crew, ready to take the citizens of the area to the destination hospital of their choice. Enjoy your stay.