1. Through the Emergency Doors
Heading down to emergency is no easy matter. The time is of the utmost importance if you have a couple of hours to play with. Arriving on a weekday evening around 7 pm is not recommended since all slips and falls and construction accidents and pending stitches and the odd fierce flu is sitting there in the emergency waiting room, moaning about how long it is taking and peering through the mystery doors as they swing open and close again. Depending on the hospital and the length of its halls around “emerg” don’t be surprised to see the elderly, hooked to ECGs and remaining relatively quiet, parked waiting for admittance to what is only the first stage of a tiring evening. Arriving on Friday or Saturday night near midnight is out of the question because barfight stragglers and anyone arrested who has gotten hurt in the process stares at you as you sign in, and continues yelling at the Police Officers who nabbed them and the Nurses who firmly remind the inebriated to stop singing that 70’s Rock classic and no you can’t smoke in here.
I prefer to try and hold out til the am hours from about 3 through 10 in the morning. I call it, after rush hour. The midnight shift! Having said that let me describe the usual circumstances that have me dialing a cab and packing a bag. My liver is in a state of chronic weakness bordering on failure and my body does not carry a strong immune system because of it. I am awaiting transplant, which means I am on a list with hundreds of others with similar liver dysfunctions, and things have to get worse, for me to get better. If I catch a cold, virus or bacteria, it is full blown in about 6 hours and more than once I have had the symptoms of an upper respiratory virus and am developing pneumonia and have fluid in a lung. The tip- off is my appetite which disappears under a rug somewhere. A half hour later I feel exceptionally tired, beyond the usual lethargy of my present state and then comes the inevitable…the first time that I feel cold in a relatively warm room. I meander to the vanity and take my temperature knowing it will already be around 100 degrees F. It is. Each ear is always different by about half a degree so I mix it up for the next hour and watch it climb every ten minutes…100.5, 101,101.5…here we go. I think about what day it is and what time it is and plan my arrival if I can. Wednesday 10 pm, hold out for 2-3 hours, try, try. I lie down and pretend to sleep as the headache arrives on time. I cannot take any typical over the counter remedies for a fever since my liver doesn’t tolerate any Tylenol or similar concoctions. Temperature, 102.5. Hold on. Now 103.1…make the call, here we go. I text my sister and head out to wait for the ten minute cab. It is now about 1 am , not bad, 9 people in the waiting room, promising. I sign in and am called to examine vitals and talk about my temperature. Not long after they run my card I am called by a nurse and ushered in to an isolated room for more vitals and blood tests and typically an I.V. inserted. By now I am dehydrated and my temperature is being relayed to me in metric …”39.4, pretty high”.
It’s time to lie back and let the routine commence. An emergency Doctor or resident will visit and hear me out and realise that I am pre-transplant which warrants a call to that department because they will want to see me and take over once I’m hydrated. If there are any unusual symptoms besides a high white blood cell count they will admit me to the Transplant Wing and monitor me from there. Oh yeah, lying back, I am alone again, in hospital for the 100th time in 4 years, probably more, hooked to a bag of saline and possibly antibiotics, regretting the clothes I decided to wear tonight and wondering if they leave the brightest fluorescent lights on every time they leave the room just to irritate me. The nurses as always are a welcome voice and man or woman young or old, they are kind of like having your Mom in the room making sure you’re ok and letting you know that you are cared for without saying a word. I usually weather this part of the process alone and if I am admitted for a stay I have visitors then.
There is a giving up, or a giving away of privacy in hospital. Undressing and dressing is not an issue and quickly the idea of delivering a urine sample is no embarrassing matter. Throwing up is completely acceptable and sometimes encouraged. Feeling uncomfortable is the norm so adjust quickly, I tell myself on arrival, and allow for the rough moments and the relaxing opportunities if they come. In the X-Ray room taking three pictures of my chest to monitor pneumonia I have to stand up, sit down, stand up again, turn to your left, a little closer, now sit down and wait…oh, one more from the front , arms up, ok you’re done. I can barely stand or hold up my head while this happens. Back in the wheelchair, back to your room. Checking for hospital infections that travel fast and are of great concern these days, the nurse tells me ( as if I don’t know) I have to insert this swab through your nose and touch the back of your throat…Oh sure, go ahead, I can weather that, relax relax oh! I let the staff give me all the information and try not to say “I know”, too much, when they explain procedures or tell me the schedule. Something always surprises me on each visit so I listen carefully and I learn and I remember my experiences so that next time, it will be a little bit easier. Discomfort is just a state of mind. Soon I will be stabilised and sent home with anti-biotic prescriptions, or I will be admitted and end up upstairs in a more comfortable bed with suitable lighting and a meal schedule! Then I will phone or text my daughter and tell her what happened and what I am expecting, at least for the next 12 hours. Finally I just hunker down and do what I’m supposed to do there… be sick, and assume the position of patient… in my “semi-private room”.