One Patient’s Experience in an Emergency Room

This is the experience of one patient, who spent an entire day in the emergency room at Parkland Memorial Hospital in Dallas:

I welcomed 2008 in a new city with a new job. Unfortunately, I woke up New Year's Day with an intense and debilitating pain in my abdomen. Because I was weeks shy of being insured by my new employer, I tried to ride out the increasingly painful cramping to the best of my ability. Even though my stomach was bizarrely misshapen and distended, and I felt shooting pains ricocheting through my body, I held out for two full days before I sought emergency care.

I went to the county hospital, because I was fearful of incurring private hospital costs. After paying to park (at a hospital?), I still had to hobble a mile to the ER. In the maze of hallways, I was stopped once by a hurried doctor who gave me his phone number and then again by a man who wanted change to buy a cheeseburger. "Chaos" is a word that doesn't come close to describing the labyrinth of the "free" hospital.

The waiting room was like one of Dante's levels of Hell. Patients were piled on top of one another like sardines. They did not check in with an actual hospital staff member, but through an electronic kiosk instead. Most of the ER patients arrived by bus or by foot, and nearly all of them were incapable of checking themselves in through a computer. So I ended up spending a great deal of time showing non-English speakers and those who were not computer literate how to enter their names and illnesses into the queue. There were no human staff to be found, save for the two frazzled triage nurses who would appear on occasion from beyond mystery curtains.

My fellow sick patients were, in a word, depressing. I watched toothless ghosts of humans shuffle in from the street pulling shopping carts behind them, standing for 10 minutes in front of a computer trying to figure out how to be helped. It reminded me of being in a foreign country and trying to order food, but not knowing where or how to begin. We sat wherever we could. The woman in the chair next to me was accompanied by her worldly possessions, all neatly folded in a laundry hamper. She was having three separate schizophrenic conversations, out loud, with people who did not exist. A mentally handicapped man wearing a Santa hat was also talking out loud, excitedly ranting about nonsensical subjects while twitching. The woman across from me had 6 children in tow, all tethered together by a rope – a human leash that she would yank when one offspring would try to wander off. A man who had eaten the protective foil covering off a condiment bottle came in, sat down, and threw up on himself. People who couldn't walk came in on scooters and in wheelchairs, bumping into chairs and corners and people. There were bleeding day workers, blood and tragedy in every seat. It was a room of the battered and downtrodden, pressed together like cattle. It was an adult day care more than a hospital.

And then there was me.  I waited, and waited. I was repeatedly bumped for someone whose condition was more severe or for someone more obnoxious. There were gunshot victims. A drug overdose patient was rolled into the ER and abandoned. At one point I tried to flirt my way into triage. An hour later I got hateful with the nurses but was told "pain is not an emergency here."

As the day turned into night, the waiting room became standing room only and women and children were huddled on the cold linoleum floor. People were hacking. A little Vietnamese woman kept spitting up green stuff into her handkerchief and a homeless man was sleeping, essentially, across my feet. He woke up once to cough, and slung spittle across my shoe before the police prodded him back onto the streets. A couple of women were discussing how the wait to see a doctor could take 2-3 days. One of them took a portable television out of her bag and a can of Vienna sausages, and she settled in to watch Wheel of Fortune while eating her potted meat dinner. She had come prepared to sit in an ER for days! Many of these people weren't ill, but lonely. Many of them weren't sick, but lost and cold. Some of them were in pain, but left unhelped. It was more of a shelter than a place to seek care for people truly in need of medical care.

Every hour on the hour, two armed guards brought prisoners through metal detectors and into the ER. In shackles and striped outfits, the prisoners were sent to the nurses to get their vitals taken, jumping in line ahead of everyone who had been waiting. The handicapped man in the Santa hat had a seizure and was hauled screaming from the floor by the police. A woman having a mental breakdown came in screaming, ranting, crying and threatening suicide. A woman who was at least 90-years-old needed to use the restroom and was crying, but no one (because there was no staff around) could help her. She defecated on herself in her wheelchair. There was a lot of crying.

After 8 hours, I could take it no longer. I was in pain, the worst of my life, but couldn't stand the wall-to-wall poverty, sadness, and system abuse. I lived in Sicily for two years and once went to a public hospital for the birth of a friend's baby. At the time I thought their hospital was so chaotic that I was blessed to have health care in a civilized nation. But the Dallas county hospital was far worse than my experience at a second world facility on an island north of Africa.

I ended up going to a private hospital, where I checked in and was hooked up to an IV within 30 minutes of arrival. My ailment turned out to be 200 cc's of blood that had emptied into my abdomen because of a very dangerous ruptured cyst. I'll be paying off the $10,000 bill for eternity.  But any more time without medical care could have had severe repercussions.

A month after my experience, the county hospital sent me a bill! For my 8 hour wait, without once seeing a doctor, they wanted $200. I laughed and laughed. Then threw it away.

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