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In which Turbonerd takes his wife to the hospital and experiences two very different responses by the "the greatest health care system in the world."

I'll start this story at the end. My wife is ok. No definite diagnosis, but it's not appendicitis or kidney stones which is what prompted the trip in the first place.

If you've been to an emergency department in the last ten years, you know what happened when we arrived. The triage nurse determined my wife was not in imminent danger of dying, took some basic information, sent us on to get settled in a bed to wait.

The room we were escorted to had two beds in it. My wife was taken to the bed farthest from the door, and told to put on one of those hospital gowns.

We had drawn the "privacy curtain" so I didn't see the next patient come in. The physician assistant came to take her information. She sounded young, late 20s or early 30s. She was there because she was in pain, same as my wife. The PA asked if she wanted medication for the pain. She declined. She said she's been dealing with this pain for months, and it's getting worse, and she wants to get it figured out. She can't stand, can't move without pain, can't sleep. She has kids to take care of and she can't work her job at Wal-Mart because of the pain.

She explains that had her tubes tied in May and almost immediately she started experiencing abdominal pain. She works for Wal-mart, so I'm guessing she doesn't have insurance. She went to a clinic, but they didn't find anything so they suggested she come back on Thursday. An OB/GYN visits on Thursdays. Again, no diagnosis, just more pain meds and the suggestion that Benedryl might help her get to sleep.

Early last month she had a tubal pregnancy, which ruptured. Emergency surgery saved her life. Afterward, more abdominal pain.

She saw the same OB two weeks ago. Still no answers.

The PA asked again if she wanted some pain meds, which she declined again. He explained they would take some blood for tests and do a CAT scan.

Fifteen minutes later, the scan was complete and the tests were back. The doctor came in to explain that they didn't find anything. There's nothing more they can do for her, so she's free to go. Asked again if she wants some pain meds. Declined again.

What she really wanted - and this is the part that KILLS me - is an excuse from work. Because she can't do her job, but can't afford to lose it because of more unexcused absences.

What a country.

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Comment Preferences

  •  Don't look (or listen) behind the curtain (25+ / 0-)

    It'll break your heart.

    Here's the part that makes no sense to me: my wife has MS. She's been disabled, as the Social Security Administration defines it, for the past 15 years. Because of that, she's eligible for Medicare. We have two children still living with us, so she's also eligible for a special state program that takes care of her copays. It's as close to single-payer as you'll see in this country.

    So my question is: Why should my wife be entitled to health care, and this other person not?

    Reforms come from below. No man with four aces howls for a new deal.
    Keystone XL will raise gas prices!

    by Turbonerd on Wed Aug 01, 2012 at 05:51:42 PM PDT

  •  Don't assume there was nothing in the tests. (6+ / 0-)

    If she had no insurance the vision of the test reader becomes very imprecise.

    Education is a progressive discovery of our own ignorance.

    by Horace Boothroyd III on Wed Aug 01, 2012 at 05:58:12 PM PDT

  •  If she had a tubal ligation... (12+ / 0-)

    .... and then an ectopic pregnancy, I would think she has a good case for medical malpractice.

    How horrible that she can't get good OBGYN care to figure out the source of the problem.

    •  amen to that (6+ / 0-)

      How awful is it that this person is trying to be responsible and still gets beaten down in this way. She wanted to get better so she could get back to her crappy Wal-Mart job. That kind of determination deserves a reward, not a brush-off.

      Reforms come from below. No man with four aces howls for a new deal.
      Keystone XL will raise gas prices!

      by Turbonerd on Wed Aug 01, 2012 at 06:20:50 PM PDT

      [ Parent ]

    •  Which is simply another incentive for any other (4+ / 0-)

      doctor to not find anything wrong.  If it's dragged out just a little bit longer, the statute of limitations - which is generally very short for medical malpractice actions - will run, and her rights run out with it.  Few doctors want to be the one to bring malpractice to light.

      "If you trust you are not critical; if you are critical you do not trust" by our own Dauphin

      by gustynpip on Wed Aug 01, 2012 at 07:45:25 PM PDT

      [ Parent ]

    •  but (2+ / 0-)
      Recommended by:
      Turbonerd, Ms Citizen

      But if she can't afford insurance and she works at Wal-Mart, it's pretty likely that she doesn't know any lawyers who would be able to help her with the medical malpractice.  And I'm pretty sure the hospital knows this.

      When my husband was in the hospital last year I made sure to mention my father the lawyer a couple of times, just in case.  Sure, he's retired and his specialty was international law, but they didn't need to know that.

  •  I travel through several hospitals. (10+ / 0-)

    At one, the main focus is getting an "excellent" rating on the patient survey. One of the questions is along the lines of "was your pain adequately controlled".  This is why there is a focus on whether the patient was satisfied vs whether they were actually treated. Stupid idea- patient care is not the same as customer satisfaction, but the results of these surveys will determine a portion of hospital reimbursement. HCAHP, I think is what they are called. Also add in the fact that the patient is uninsured, and the hospital won't receive compensation, they are less likely to run expensive tests to determine what is wrong with this young woman. Their main focus is on keeping up their scores. As if these things aren't bad enough, consider the fact that EDs are short-staffed but receiving more patients as people with no other option end up there. I leave each day sadder than when I came in.

    •  I agree although I would add (6+ / 0-)

      that if she wanted an excuse to not work she should have asked for it. I know they give them out. But the short-staffed overworked ER personnel might not have realized that was what she wanted.

      As you said, the focus these days are on the satisfaction surveys, and who is most satisfied? Someone blissfully drugged.

      "Kiss my ass! This is a holy site...Show some respect." Rick Gorka, Mitt Romney's press spokesman.

      by zesty grapher on Wed Aug 01, 2012 at 06:24:34 PM PDT

      [ Parent ]

      •  she asked several times (4+ / 0-)

        it was the one thing she repeated. Other than that she'd been in pain for over two months, and it had steadily intensified.

        Reforms come from below. No man with four aces howls for a new deal.
        Keystone XL will raise gas prices!

        by Turbonerd on Wed Aug 01, 2012 at 07:04:10 PM PDT

        [ Parent ]

        •  wow in that case I just (1+ / 0-)
          Recommended by:
          Turbonerd

          don't know. I understand our healthcare system is a mess.
          I know I have been lucky. I guess I didn't realize how much. I was out of work for over a year. No insurance. Had three different times where I ended up in the ER and hospital--once for several weeks. Each time I felt like my care was excellent and never for one minute felt mistreated or treated as an inferior because I was uninsured.
          All the more reason we need the ACA for everyone.

          "Kiss my ass! This is a holy site...Show some respect." Rick Gorka, Mitt Romney's press spokesman.

          by zesty grapher on Wed Aug 01, 2012 at 08:56:17 PM PDT

          [ Parent ]

      •  Or someone who can't remember the worst parts. (2+ / 0-)
        Recommended by:
        FloridaSNMOM, Turbonerd

        We've had that issue in my family - someone wanting to give excellent scores when the rest of the family had been struggling to get the hurses and doctors to provide minimally adequate care. Since that person was in bad enough shape to just not remember being That Sick, the only thing that actually went into the score was from the time period of being nearly well enough to discharge.

        Prayers and best wishes to those in Japan.

        by Cassandra Waites on Wed Aug 01, 2012 at 07:56:59 PM PDT

        [ Parent ]

  •  Refusing pain meds (8+ / 0-)

    She probably refused the pain meds for two reasons:
    1) If she has kids to take care of she may be worrying about functioning on the pain meds.
    2) if you have pain they can't find the cause of, and you start accepting pain meds, soon you have a note in your chart labeling you "drug seeking", and then it's harder to actually get a diagnosis because they dismiss your pain every time.

    I had an ER doc try to label me once as Drug seeking/drug user when I was having seizure type activity (uncontrolled muscle tremors/spasms) from thyroid storm, because my EEG came back normal. Fortunately for me, the nurse on staff knew me from my frequent asthma admits and knew better and pointed out the history and the blood work in the chart.  Found out later that my blood work had come back positive for methamphetamines due to strong otc cold meds I was taking for the flu. The nurse had noticed that I had stated I was taking the otc meds on the intake forms.

    "Madness! Total and complete madness! This never would've happened if the humans hadn't started fighting one another!" Londo Mollari

    by FloridaSNMOM on Wed Aug 01, 2012 at 06:43:33 PM PDT

    •  she said at the end that she had to drive herself (5+ / 0-)

      and so taking the pain meds turned out to be a no-go in any case.

      Reforms come from below. No man with four aces howls for a new deal.
      Keystone XL will raise gas prices!

      by Turbonerd on Wed Aug 01, 2012 at 07:03:21 PM PDT

      [ Parent ]

    •  I run into that. (4+ / 0-)

      For one, I have a diagnosis of fibromyalgia, which half the medical community thinks means "made up so she can get narcotics."

      For another, I not only take a narcotic on a daily basis but an amphetamine. And sometimes a benzodiazapine and a muscle relaxant, depending on what's going on.

      This is why I told my mother, no, I am NOT going to the community clinic. The community clinic does not know me. They do not know that I am not a drug seeker or abuser, just a person with certain illnesses that happen to have these medications to treat them. And I strongly suspect that had I gone, they would have tried to take me off the narcotic and put me on an SSRI antidepressant, and take me off the nice cheap amphetamine that works well and put me on a non-amphetamine stimulant med that is expensive as fuck.  And then I would have to go through a two year process of being on these various drugs until they decided, well, gee, the thing that works best is Tramadol and Adderall.

      I already did this and suffered through all the side effects with my doctor. I don't want to do it again. I just want my meds.  The rest of the doctoring I need involves surgery.

      When you come to find how essential the comfort of a well-kept home is to the bodily strength and good conditions, to a sound mind and spirit, and useful days, you will reverence the good housekeeper as I do above artist or poet, beauty or genius.

      by Alexandra Lynch on Wed Aug 01, 2012 at 07:43:59 PM PDT

      [ Parent ]

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