Its 2:30 in the morning and I am typing quite slowly due to the blood gas monitor on my left index finger. I was admitted to the University of Iowa hospital via the emergency room about twelve hours ago and I’m currently residing on a neurology floor.
I must say the shine has come off Iowa Care in the last twelve hours. I’m pretty much out of money and as I described yesterday I’m going at this on the down low, staying in the city’s homeless shelter ay 331 North Gilbert until I can secure an inexpensive place to stay.
I’ve learned one lesson this day; if you’re homeless you don’t count, you don’t count even less than any other corporate slave who has outlived their usefulness.
(UPDATE: I don't want you guys to think I am blowing my own horn - my name comes from a diary nyceve wrote about me before I created this userid to chronicle my experiences, so the One Brave Kossack was her idea :-)
UPDATE2: please don't ride to my rescue - there are two others here who are sick/hurt and in the same boat. Concentrate on changing the system.)
UPDATE3: Got out of the shelter, details below)
I had a fairly typical homeless guy day. The shelter noises started around 5:00 AM and I was up and out the door by 7:00. If you’ve never been a resident of such a place you owe it to yourself to make the trip and find out in a direct, personal way what the hopeless and discarded look like before breakfast.
I rattled around the neighborhood for an hour or so, hunting up breakfast and then rejoining the unwashed masses in the common room. One neighbor has kindly left their wireless open so I have good service there. A resident struck up a conversation with me – D., a black man a few years older than me, walking with a bad limp which I later learned was due to an on the job injury with Tyson Chicken. They fired him three weeks after the event and apparently very carefully gamed him to block him from collecting unemployment or workman’s comp.
D. and I collected one other fellow with an entertaining case of schizoaffective disorder to serve as our guide since we’re both from out of town and then we set out to make the rounds. I got a pair of swimming trunks at Goodwill, the pawn shop wasn’t open so early, and then we made our way to a Methodist church that runs a program for homeless adults out of their basement. Again I got amazingly lucky with a snappy wireless link being available in the space. I’m going to office there for the duration of my stay.
We wiled away the afternoon, D. and I, with him getting around much better using my Leki trekking pole for a cane. I had a little money so we hit a junk shop and I got him a cane he could keep after seeing how much it helped him. We lucked out for lunch – as what I have seems to be resolvable I’ve started looking for more projects and an executive with a community driven wireless access business who approached me last month on a project in the area agreed to buy us both lunch. I can strongly recommend a place called The Cottage if you’re ever here in Iowa City – lunch was delicious.
3:00 PM came and we’d run out of stuff to get into so we made our way back to the shelter. I got the most curious physical sensations so I said my goodbyes. My ability to speak largely slipped away in the five minutes it took to make my way to the emergency room from the shelter.
Since I was presenting with stroke symptoms they hustled me straight through to the ER ... where the insults and disinterest in my wellbeing began.
This is a busy teaching hospital so I of course got the pretty would be nurse who looked scarcely older than my fifth grade son when it came time to get a blood draw and IV. Two messy bleeders later a matronly woman twice her size installed the IV and drew four vials in a few seconds. You have to expect this experience at a teaching hospital. Things went downhill from there.
I was going in and out of being able to speak. A puzzled second year resident tried out her unsteady diagnostic skills at a time where I could speak, then went off in search of a neurologist. A few moments later some exciting new trouble came over me – I was on the verge of passing out, I could barely speak, and I pulled the call cord. The doctor in charge appeared instead of the resident and I tried to convey that I was having trouble. I said "Can’t talk ... something changed." She said "You sound fine to me." This went back and forth a few times and I was pretty well amazed by the attitude I was getting. They wouldn’t get the resident who’d heard me able to speak articulately a few minutes earlier, and instead this so called doctor insisted "You sound fine to me." I was fine ... because my diagnosis was "homeless".
I finally got a cat scan and a chat with a nice young neurologist, then they dispatched me to this neurology ward.
The disinterested doctor’s twin sister is one of the floor nurses up here. I was wheeled in and they seemed quite put out that a shelter resident would have a car with a packed bag in it. Me calling my mom to tell her I was here? Not at all important – "You can NOT use that cell phone here." I gave up on the bedside local calls only phone, not wanting to trouble mom with a collect call. I’ve never felt such disinterest from a nurse in my life.
The security guy arrived and began taking the information about my car. The nurse assured him right off the bat that I’d be discharged tomorrow. This is VERY telling as they’d not even checked me in yet. Getting the feeling that the indigent are treated differently?
The whole scene changed when I responded to the guard: "It’s a gray 2007 Nissan Versa and I don’t want my laptop freezing out there overnight." You could have knocked nurse disinterested down with a feather. Once he was gone I started in on her – "Who is responsible for my overall care plan?" "No, I’m not having a stroke, this is a symptom of something else." Finally and most tellingly this little gem popped out of her mouth:
"What company do you work for?"
My turn to be prey to a passing feather. Rather than describing exactly what I do I told her I used to have my own engineering company ... before I got sick.
Things improved a bit after that but I’m left with the feeling that there is some sort of formal policy of delaying, dodging, and denying treatment where possible when the patient is covered by Iowa Care. Assuming I survive this perhaps we’re going to have to dig a little further into this matter and see if a FOIA action will turn up written proof.
An hour has got by me here, picking at this keyboard with one handicapped index finger and tomorrow is a new day on the homeless front – I believe the outside temperature is an honest zero and the wind chill will have it down into the -20F range.
I'm still a little bit amazed. I'm educated, articulate, rather cute as far as forty somethings go, and the attitude has been pretty much astonishing. I've taken the least cost path to the only method I have for obtaining health care and its been very clearly communicated to me by numerous people that I am crazy. I can only imagine the suffering of those who lack the education and temperament to compel the system to perform its intended role of the health care provider of last resort.