Emergency Room Essay

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And every nurse’s shrug seemed to say, “Women cry—what can you do?

”Nationwide, men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain.

Once, hobbled by a training injury in the days before a marathon, she limped across the finish line anyway.

So when I saw Rachel collapse on our bed, her hands grasping and ungrasping like an infant’s, I called the ambulance.

Most hospitals use the Emergency Severity Index, a five-level system that categorizes patients on a scale from “resuscitate” (treat immediately) to “non-urgent” (treat within two to 24 hours). Rachel was nearly crucified with pain, her arms gripping the metal rails blanched-knuckle tight.

I flagged down the first nurse I could.“My wife,” I said. Something’s wrong, you have to see her.”“She’ll have to wait her turn,” she said.I found myself pleading, uselessly, for that kind of special treatment. R., a square room with maybe 30 beds pushed up against three walls. His visit was so brief it didn’t register that he was the person overseeing Rachel’s care.I kept having the strange impulse to take out my phone and call 911, as if that might transport us back to an urgent, responsive world where emergencies exist. She hardly noticed when the attending physician came and visited her bed; I almost missed him, too. Around , someone came with an inverted vial and began to strap a tourniquet around Rachel’s trembling arm.By then, Rachel was writhing so uncontrollably that the nurse couldn’t get her reading. She’d be fine, I convinced myself, if I could only get her something for the pain.She sighed and put down her squeezebox.“You’ll have to sit still, or we’ll just have to start over,” she said. But during an emergency, established codes evaporate—this is why ambulances can run red lights and drive on the wrong side of the road. I later learned that at Brooklyn Hospital Center, where we were, the average wait was nearly three times as long, an hour and 49 minutes. Everyone we encountered worked to assure me this was an emergency. By 10 a.m., Rachel’s cot had moved into the “red zone” of the E.A more careful examiner would have seen the need for gynecological evaluation; later, doctors told us that Rachel’s swollen ovary was likely palpable through the surface of her skin.But this particular ER, like many in the United States, had no attending OB-GYN.I felt like I could bend iron, tear nylon, through the 10-minute ambulance ride and as we entered the windowless basement hallways of the hospital. The intake line was long—a row of cots stretched down the darkened hall. Shaking, she got herself between the sheets, lay down, and officially became a patient.Emergency-room patients are supposed to be immediately assessed and treated according to the urgency of their condition.In an interview included in her book She was talking about Rachel.“That to me felt like this deeply personal and deeply upsetting embodiment of what was at stake,” she said.

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