I'll preface this with a few bits of background information about myself, since this is about me and all:
- I'm diabetic. Insulin-dependent, juvenile onset when I was in about fourth grade. I'm very capable of handling my disease.
- I have no health insurance -- I'm unemployed (for the moment, and even the seasonal employer doesn't offer insurance), and the state health plan prioritizes women, children, etc. before single, white males.
I don't know if you remember, but about a week ago, the entire freakin' country got snowed in. Up here in Portland, it's uncommon enough to get a faint dusting of white powder that melts before noon that a few inches on the road threw the city into a full-on panic and shutdown mode. The news had their STORM TEAM 12 out reporting that in fact, snow was still on the ground and people were still having trouble driving.
Now, I don't drive. It's the bus for me, mostly because it's cheaper, but also because I despise driving. I can also pretend I'm doing it for the environment. The closest Wal-Mart is about an hour and a half away by bus.
No. I'm not going to not go to Wal-Mart for insulin. You know why? They sell it for $19.98 a bottle. Do you know how much a "regular" pharmacy does it for? The cheapest I've found is $29.99. That's $10. When you're unemployed, $10 is a hell of a lot of money. Especially when you need something to survive. So all you "Wal-Mart is evil!" people can fuck off. When things I need to live are affordable at my local organic co-op, I'll go there. Anyway.
The closest Wal-Mart is an hour and a half away by bus. Monday I was planning to head out, but the snow had pretty much everything shut down. The buses were running, but not on hills, and chained, and slow as all hell. I opted to just wait a day or two -- I still had enough left for that. Tueday came and went, same deal.
Wednesday, I managed to get out to Wal-Mart after about a four hour journey on the bus, to find that the pharmacy wasn't open "due to snow". I checked the pharmacy for snow, and the aisles around it, in case I had missed it.
Here's something neat about diabetes: Insulin? Over the counter. You might be asking why I'm going to a pharmacy. See, it's refrigerated. And apparently the only fridge in all of Wal-Mart is located behind the pharmacy counter, and is only opened at the beck and call of the pharmacy workers. I'm sure there's laws that don't bother distinguishing over-the-counter "need to be cool" drugs from say, vials of pure morphine, so I'm shit out of luck if the pharmacy is closed.
By Thursday morning, at around 7a, I took the last bits of insulin I had, checked my wallet, and looked at my last $20. I called Wal-Mart -- pharmacy still closed. I called around to the others in the area, same deal. One store was even closed entirely. This really pissed me off, as the roads were fine. They were slushy. But Portland was still flipping out. The buses were still chained, and happily tearing up the pavement with their chains driving around.
I got on the bus, and headed down to the local hospital, because, well, I needed insulin, and the ER is always open. Now, without insurance, an ER visit is usually super-expensive ordeal. Unless, of course, you give some fake information. I'm not saying I did, just that it might be a good way to pretend we have a national health care plan.
I was the only guy in the waiting room when I got there about noon (time without insulin: 5 hours), told the triage nurse -- who was amazingly nice -- the situation, and told her I needed: a bottle of novolin 70/30, a shot, and maybe something to eat. She said she'd get me fixed right up, took my blood sugar (a whopping 439 -- that's bad), and told me to go wait.
I found out later, a bunch of assmunches had sledding accidents and otherwise were amazingly retarded because HOLY CRAP SNOW. And the hospital was short-staffed because HOLY CRAP SNOW. I asked the triage nurse (because I was still the only guy waiting) after about an hour if I could go to the "ambulatory care" wing, where people with stupid problems go, sit, wait, get their pat on the head, a prescription, and a "call me in the morning."
I figured, "Hell, I know how to handle a little high blood sugar, I've been doing it for decades. I probably know how to do it better than the doctors here." She said, "Nope, sorry, your blood sugar is too high." I blinked.
I was told, "They'll need to put an IV in and give you fluids--" I held up the bottle of water I was drinking, which she ignored. "--and give you some insulin." I said, "Yes, that's what I need, a shot and a bottle and then I can go away and you don't have to clean a bed for me."
I told her I intended fully to refuse to have an IV put in, and she just told me to go wait.
I completely understand the whole triage thing -- people that are bleeding, about to die, etc. get priority. I didn't realize it also meant that people with chronic conditions get to wait forever while their symptoms slowly get worse. At the 6 hour mark, I asked the new triage nurse, now with a full waiting room, what's going on, and she said the hospital was full, and they only had about two beds for ER patients.
I pointed out, maybe the ambulatory thing would be good for me. You know, that no bed, quick fix, etc. thing. By this time, my I was experiencing some of the less pleasant symptoms of high blood sugar -- a faint nausea, my stomach kind of hurt, my joints were aching, and my vision was starting to get a little fuzzy in the distance. Cotton mouth, a headache, pissing every 20 minutes or so, and of course, the accompanying dehydration. I told the nurse this, and she told me to go wait.
At the 8 hour mark, I felt faint, couldn't concentrate, and was amazingly emotional. There's a symptom I haven't had in a long time, which meant things were getting pretty bad.
I'm a tough guy -- or dead inside. Either way, I don't cry much. I watched as some guy with a broken leg got wheeled in, triaged, and sent back immediately. That did it. At that point, I was convinced they were going to let me collapse and die. I found the image of them having to wheel me back after letting me rot for 12 hours on a bed mildly entertaining -- payback! I starting snickering. Then I realized, that'd be me nearly dead, and I started crying. Of course, they might just be doing this so they can charge me for more stuff, and a cried a little more, then I realized that whole fake name thing, and giggled.
Looking back, I can't connect with myself or what I was feeling then. But for some reason, I got amazingly pissed off at the situation, stood up, told the triage nurse when she came out, "Fuck you! Fuck you! Fuck you and I hope your burn!" stomped out, pulled out a pocket knife, cut off the little ID bracelet, hurled it at the registration lady, and stomped outside. I was furious. A small part of me realized I was doing something frightfully stupid, but I was far too enraged to bother listening to reason. I was going to make that triage nurse pay. The best I could come up with was to.. complain to her boss!
I stomped around the hospital, snarling, and went to the main entrance where the info / customer service etc. desk was, put on my best "I am so upset but not at you" smile, tried to tell the lady there what was going on, and two words in, broke into sobs again. At that point, I was just confused. What the fuck? I don't cry. I excused myself around the corner, grabbed a box of tissues, and attempted to compose myself. I'm sure I sounded like a crazy man, alternating between sobs, laughs, and growls. The lady was nice enough to follow me, and ask who she could call for me -- patience services, a chaplain, etc. I just nodded "yes" at the patience services and she suggested I have a seat and wait.
I guess they're used to dealing with crazy, sobbing, laughing, growling people. I managed to get myself under control, and she told me the patient services person was out until tomorrow (snow), and that a chaplain was filling in for her, and introduces the chaplain. I told the chaplain what was going on, and she was nice enough to go down to the ER and get me back in line, waiting.
At about the 11 hour mark -- that's 11 hours without insulin -- they finally called me, and did exactly what I wanted: Gave me a shot, gave me a bottle, and even a prescription for more insulin. They tried for the IV, I said no, but maybe something to eat -- they got me a sandwich and a bottle of water (which I devoured, I'd not eaten since 7a, and once the insulin hit my system, I was instantly hungry).
I went around, apologizing to the various people -- especially the triage nurse and the lady I hurled the ID bracelet thing at. I told them about the whole "amazingly emotional" bit, and told them even so, that's no excuse for me behaving like a child. They seemed taken aback.
I suppose the point to this long, drawn out tale is this: I don't have insurance. This is what I had to go through because I don't. It was nobody's fault (except maybe mine), and yet, it still should never have happened.