One Night in the ER
Confronted by pain, perspective and a man named Bill
G’day!
This story is part 2 of one I wrote a few days ago called Seeing the Signs. I highly recommend you go back and read it before checking this one out. In any case, thanks for reading! Goodonya.
Whatever I expected the emergency department to be like late on a Friday afternoon, it was worse.
I was sitting in chair at the Royal Melbourne Hospital across from a man named Bill who smelled like a wet ashtray.
We were in a hallway lined with chairs - the temporary waiting room while the regular one was being renovated. The sound of jackhammers echoed from just beyond the wall.
It was 4:30 p.m., and this was not the place I envisioned going for happy hour. On one hand, there are lots of drugs available, but good luck getting served - muscling your way up to the nurse’s station will only succeed in drawing the attention of the ever present security guards. The industrial metal rock music sucked, and the crowd is generally pretty sick, and not in a good way like when my teenage boys use the word. “It’s time for dinner,” I’ll say to them, to which they respond, “Sick.” I interpret that as being a good thing. It’s also possible that they are insulting my cooking.
On the positive side there were lots of nurses in scrubs cruising around the place, but they all seemed preoccupied with others. Story of my life.
I didn’t want to be there, kept telling myself that I shouldn’t be there, unlike a poor fellow like Bill. He had shuffled in a few moments ago, his wild beard and weatherbeaten face making him look like a fisherman who had just come off the boat after 18 hard days and nights at sea. He had a damp looking sleeping bag slung over his shoulder, and when the nurse asked him what hurt, he mumbled “everything”.
I wasn’t like Bill. I didn’t have the outward appearance of someone who was cooked, but I belonged in the ER just as much as anyone there.
The last day had been a whirlwind, starting off with feeling a random pain in my left calf the previous afternoon. I saw my doctor in the morning, got an ultrasound just after lunch and was suprised with the news that I had a blood clot in my leg. I went back to my doctor, who was bewildered by the fact that I had stopped to see her when I had a blood clot, and she sent me to the hospital.
Before kicking me out the door, my doctor told me I was at risk of a pulmonary embolism, which is when the clot breaks free and finds its way to your lungs, leading to all kinds of bad things.
So while I didn’t want to be in the ER on a Friday afternoon, I also didn’t want to wreck pizza night at home by coughing up blood on the couch.
Maybe, then, riding my bike to the ER wasn’t the best choice.
Pumping your legs, elevating the heart rate and getting your blood moving seems like the perfect way to dislodge a clot and send it hurtling into your lungs.
I didn’t care, though. Biking made sense in a strange way. If I downplayed the seriousness of things, making my trip to the ER into no big deal, maybe it would actually turn out that way.
So I told my wife Katie not to worry about it and rode only using my right leg - what my friends and I used to call ‘punk rocking’ - all the way to the hospital.
Now sitting in the ER, I wasn’t feeling very punk rock.
Just then one of the nurses came up to me and snapped me out of my funk. The sticker on her arm said ‘ER Concierge’. This was promising. The person to lead me to my suite, where after a quick vein cleaning and maybe some room service I could be on my way. She leaned in close.
“There might be some drama in a bit, so can I ask you find a seat in the other room?” she asked. This made me glance across the hallway to where Bill was mumbling to himself. They were going to ask him to move along and didn’t know how he’d react.
Walking a bit further down the hallway and a larger space opened up to reveal the real temporary waiting room: a former four-person room that was now crammed with 30 people. I glumly took a seat next to a bearded guy in sweat pants.
I had been feeling sorry for myself, but sitting down next to 30 other sick people made me feel worse. For as much as I thought I shouldn’t be in the ER, I knew there was something wrong with me, knew I needed to be there. This is where I belonged, amongst the sick and damaged, which was hard to admit.
I looked around the room, wondering what was wrong with everyone else. A name tag system would be helpful. A ‘Hi! My name is Steve, and I almost cut my finger off at work’ type of thing. Most people were wearing masks. Some were sleeping. A couple wheelchairs. A lady in a bathrobe. Crutches, beanie, tattoos and a hijab, though not all on the same person. On the front of one guy’s shirt was a cartoon of a bowl filled with noodles and smiling kittens. Noodles and kitties, fun and weird at the same time.
A lady with a bandage on her arm was hogging two seats in the corner while working on her laptop. A Big Issue salesman, not there for business, sat next to her.
Even though it was hard to determine the different ailments around the room, one thing was clear: None of these people wanted to be there either, and why would you? I can think of few places grimmer on a Friday night in Melbourne.
When I had been sitting near the entrance, an older man came in. He was very neatly dressed, his hair well coiffed, looked like he could have been going out on the town for a bite to eat. He spoke to the triage nurse in a very calm and matter-of-fact way about how he had been having chest pains. It seemed like something my father would do - get a quick shave in, comb his hair, and put on a blazer before going to the emergency room.
It struck me that, like the man with chest pains, a lot of the people here had put some thought and preparation into the fact that they were coming to the emergency room. Some brought bags full of clothes and food, others books and water, and another stopped to grab the needlepoint she’d been working on. If you have time to pack for your trip to the emergency room, it isn’t much of an emergency, is it? The ER seems to have become less about emergencies, and more of a doctor’s office for all, no appointment necessary.
For all, except for Bill. Not long after I moved seats, two burly looking security guards appeared and the next thing you know, Bill was back out on the street. I guessed that he was homeless and periodically stopped in to the ER for lack of somewhere else to go.
I wanted to move along as well. As I understood it, they treat people in the emergency room in order of priority: who is the sickest? The well kept man with chest pains had not waited long. For all the embolisms and strokes and life threatening issues that ChatGPT described to me related to blood clots, I thought I would be up there on the list.
Instead I was wasting away with Ice Pack, Crutches, and a girl with a bandage on her finger.
Finger Bandage then left to get X-rays, along with Tattoo and Beanie. It was bad timing for Tattoo, because his wife had just showed up with a box of donuts. Those three were replaced by The Operator, who had been talking non stop on her phone since sitting down, and Knock Off Drinks.
Knock Off was a handsome young guy in navy dress pants and a crisp white button down who looked like he had just come from work. Or maybe from actual knock off drinks. But his glazed look said that he had either been up all night or had been whacked on the head, because his eyes were dead. He stared blankly into space like he didn’t know where he was and might keel over.
It wasn’t long before a nurse called his name and he shuffled tentatively into an adjacent room.
Seeing Knock Off get quick service pushed my self pity into grumpiness. Don’t they know that sitting for long periods makes these blood clots worse?
It had been about two hours since I’d sat down when a nurse called my name. Nurse Nancy, according to her name tag. I went into the treatment room and sat down in a chair. She stuck a port in my arm and started drawing blood.
Nancy was young and chirpy. She asked fun questions like “Do you know what your blood type is?” and laughed when I told her it was A-negative, negative because it wasn’t very useful. My new chair was vastly more comfortable than the ones in the waiting room, and the ER Concierge had given me a cup of water. This was progress.
After finishing with my blood, Nancy hooked me up to an EKG machine. This involved sticking around ten patches to my chest, and then connecting what looked like tiny jumper cables to each patch.
“Is your heart rate normally so low?” she asked. It was bumping around at 50 beats per minute. It is, I told her, but I couldn’t remember exactly how low. As I was thinkinb about it, there was some commotion.
Some people came in the door quickly, whisking their way into the cubicle next to mine. I heard one of the nurses say to the person, “just sit down here and we’ll see if we can stop the bleeding.” It was the first actual emergency I’d seen in the emergency room.
As I sat back down in the waiting room, bummed by Nancy’s estimate of at least an hour to get the blood test results, I was still thinking about my heart rate. Is that a problem, something else to add to the list? I was on high alert right now, keenly aware of every little pain, splutter, and kink in the neck, thinking they might be another sign of impending doom. I had lost trust in my once predictable body.
I looked up to see Knock Off getting ready to leave. The ER had taken its toll on him. His shirt was no longer crisp, the top button was undone and it was half untucked. I imagined that I was looking as crumpled as him. I first saw the doctor at around 10 a.m. in the morning, and it was now near 7.
I decided to head to the bathroom and have a look at myself. I found it down a hallway, and the little indicator on the door was green. I pulled the door open to come face to face with an old woman sitting on the can. “Ahh!” she groaned holding her hand up, while another woman who was in there with her said ”Hey!”. The door slammed shut. The indicator spun around a couple times and landed on red.
One truth about the ER is the waiting. Unless you’ve got chest pains, you’re bleeding profusely, or you’re carrying one of your fingers in a plastic bag, you will spend time in the waiting room. So, many of the people there were not alone.
Katie had offered to take me to the ER or meet me there, but I had stoically told her to not bother. It was another way to downplay the situation and not cause a stir.
It’s silly. I knew I was lucky enough to have good people as family and friends that would happily come blow their Friday night and sit in the waiting room with me, and that it would have vastly improved the situation.
But I didn’t bother. I was intent on grinding through it alone. And then my son Oscar arrived.
On instructions from his mother, he had ridden his bike to the hospital to bring me a power bank for my dying phone. I met him outside the ER on a section of the footpath covered in cigarette butts.
I stripped off my mask and gave him a big hug.
As we walked across the road to 7-Eleven, I told him how I had spent my day. I bought a candy bar for him and a joyless chicken sandwich for myself, and we stood around talking for a while longer in the smoking area.
Then I realised that an hour had nearly passed since I’d had my blood taken, and I did not want to miss my name being called. So I gave Oscar another hug, pointed him in the direction of home, and watched as he rode away into the icy wind.
A man and two kids walked in and sat across from me. It was unclear who amongst them was sick. The little one was maybe 8 years old. His knees were all banged up and dirty, like he had just come from a footy game. After sitting down, he immediately ripped the strings off his mask and started trying to put it back together again. Seemed fine to me.
The other boy was 10 or 11 and looked bewildered. He was wide eyed, looking slowly around the room at all the people in different states of injury and sickness, not knowing what to make of it all. He looked at a girl with a bloody bandage on her chin and then glanced at his dad for guidance. His gaze landed on me but he looked away quickly once he saw me looking back like a weirdo. I’m broken on the inside, kid, I thought.
I could understand how he was feeling. The room was filled with people at their most vulnerable, which is bewildering, something that confronts you. Vulnerable like the big strong bloke in the corner grimacing weakly, or the guy in a blue stocking cap who just vomited in front of everyone. Into a bag, fortunately. The girl who came with Kitty Noodle Soup vacillated between staring grimly at the floor and silently sobbing.
I felt sorry for all the people I’d been sitting with all night, even as my calf throbbed. I was also calm, calmer than I had been all night. It was almost like we were communing there in the waiting room, and there was something slightly comforting about it, all of us sitting and being broken together. Maybe being there wasn’t so bad.
Then the nurse called my name. I got out of there as fast as I could.
My doctor was friendly and efficient. After hearing my story, checking me over, and reviewing the results of the blood tests, she told me I could go.
I was given a prescription for a heavy dose of blood thinners which would help to clear up the clot, after which I would start the process of figuring out what caused it.
“What else?” I asked her. Surely there was something. Sleep with one eye open, take up swimming, stop drinking so much, don’t ride your bike home… something. She saw the concern remaining on my face, so came and stood by my side.
“Keep an eye on yourself. If you start having chest pains, or develop a cough, or if the pain moves up above your knee, then come back and see us,” she said with a smile, like a waiter inviting me to dine with them again soon.
As I walked out through the waiting room, I saw Bill sitting near the door. He had returned, driven inside by the rain.
I had no intention of coming back.
I'm sorry you had to go through this ordeal, but hopefully the thinners worked their magic. After all you wrote this piece and are still kicking :) The word carnival came to mind as you were describing the colorful ER guests... but also empaty, as we are all fragile, on the inside and out. Great piece!