This story is possible because of three errors. Yesterday I had the good fortune to smash my toe into another piece of furniture (yes, gentle reader, and the singular is not an accident, this is a common pass-time around Chez Shit-Storm). This is the first of our errors. Today, the bruising and swelling became even more impressive than the last installment -- it looked like my toe had been tie died in a long thin bright red and blue strip down its length. It didn't really hurt, but I thought I would call the "talk to a nurse" number on the back of my insurance card to let someone talk me out of going to an ER. Instead, she agreed that it might be broken and told me that I should seek help.
The second mistake of our story, and I am assuming it is a mistake, is that she referred me to the county hospital. Were I nefariously minded, I might imagine that she did so because she anticipated that no health care would actually be delivered there, or at least that billing would never be accomplished. She would have been right on both counts.
The final mistake in our story is that I took her up on it, rather than seek help at the closer private ER. I'm not new in town, but still new enough to forget the name of the indigent hospital -- and that's where I went.
However prepared you are intellectually for the depth of inequality in health care in the United States, it is always dramatically more forceful up close. I walked in, tapped in my chief complaint to the TRIAGE-O-MATIC 3000 computer screen and then sat down for the next three hours to chat with: 1) a plainly homeless woman who could not have weighed 75 pounds, sitting on and off with her head in her hands weeping -- she had been there 13 hours 2) an autoworker who had ripped the web of his hand off in a work accident, and could feel and see the tendons move against his bone -- he had been there 12 hours, 3) a very friendly, hyper woman of limited intellectual faculties sporting a rapidly ballooning poisoning bug bite on her arm the size of a fucking baseball, who had covered the bite all day at work for fear of being fired --she had only been there four hours and left in frustration without being triaged, 4) a spectacularly good natured christian AA guy, who taught the hyper bite victim Sudoku, and compared notes on his own rather impressive spider bite -- he had been there 11 hours, 5) a family that had been there 10 hours, and approached the desk to learn that they expected them to be there 12 hours more. A group of amputees crutched around and looked for seating, which they didn't find. Nurses emerged every 30 minnutes or so and wandered around calling names, most of whom had already left in frustration. I saw nobody at all around me called for treatment. After 3 hours, I was triaged by a nurse, who said my toe was probably broken, but also probably not a priority for her. I told her I had insurance, and she suggested I go "anywhere but here." I obliged, and headed to the private ER.
Parking for private ER seemed frustrating, but that was only because there was an expectation that you would valet. There was exactly one person in the waiting room, reading a book and smiling at me. The three staff at the desk promptly entreated me to approach and told me a nurse would be with me in just a minute. This was literally true, I timed it. The ER was perfectly clean, modern furniture, out of freakin, you know, Danish office furniture land. There were three aquariums.
The nurse immediately looked at my foot and ordered an X-Ray. He escorted me to a room immediately at the conclusion of this intake visit, before which he did not make me fill out any paperwork. To reiterate, the transition between the visit to the triage nurse and the trip to the doctor-room was upwards of 12 MOTHER FUCKING HOURS for the guy whose tendons were poking out of his skin at the indigi-care palace. At HospitalCorp. TM, I waited a scandalous 7 minutes before a young doctor entered with a team of two medical professionals in tow. He waited patiently as I explained my concern about going to India with a broken foot this Friday, and confirmed the order for the X-Ray. There was another scandalous wait of 3-5 minutes as the staff tried to figure out how to code toe X-Ray on the computer. An orderly came by and insisted on transporting me by wheel-chair, even though I said I could walk. The X-Rays were immediately performed, and evaluated within about five minutes.
One fact I forgot to mention: driving away from the first hospital toward the second, I passed the spider bite woman, walking down the roadside to nowhere, untreated.