Reclined partially on a gurney in the Emergency Department’s busy hallway of a hospital in the center of NY State, I suddenly heard a woman’s voice selling newspapers. Great, I thought, I can buy a newspaper! I can complete that simple transaction, having my pocketbook and a strong enough voice to speak with. I called to her.
“Not the New York Times?” I asked, spying only two local papers.
“No,” she said, “we don’t carry that.”
“Okay,” I said, grateful to interact with her as a regular person, and I bought both local papers. I had to fumble to get her money, my right arm propped up in a flexed position since I had a broken elbow, or rather both fractured and displaced end knuckles (epicondyles) of the upper arm bone (humerus) that make up the elbow.
Agency, that was my personal need now. I may be an emergency patient, and I might not even read the two local papers, but here I was with current newspapers, an accomplishment.
The previous two hours with the ambulance crew had been spent being told what to do. “Don’t move,” they commanded me until the two men splinted my elbow. The taller one asked me basic questions about my identity, and finally, a question I could not answer, “Which hospital do you want to go to?” I had been attending a yoga retreat, and I didn’t know the local area. Apparently, we were equidistant between two hospitals, and recalling my days long ago as a volunteer Emergency Medical Technician (EMT) on our community ambulance, I knew they could not direct business to a particular hospital. Fortunately, one of the hospitals had the word, “Regional,” in its name, and I tentatively chose that. “That one’s very busy,” I was told, as if to be sure I wouldn’t be upset to discover that. “Busy?” I replied, “that’s the one I want!” but chose not to use my energy to explain to him that busy ED’s have a lot of practice in what they do, tend to have better and newer equipment, and tend to attract more skilled physicians as they’re often affiliated with medical schools and fellowship programs, so the staff teaches, as well. A generalization, but I wanted the busy one.
Now I had what I asked for. The ED was quite busy – and perhaps my situation so stable – that I was parked in the hallway with many others rather than given a bay with curtains pulled around me. Grateful to be where I could see everything going on and hail a passing attendant, if necessary, I was reassured to be in this busy place that reminded me of my years of medical training. Still, I was not the one in the white coat writing the orders; I was the one on the gurney with her elbow propped up.
Suddenly, I became much more aware of the pain. The pain was throbbing and sharp at the same time. When I first spoke to the ED doc, I asked if I could have something for the pain. “Not yet,” he replied, “we have to figure out what’s going on first. We’ll get an X-Ray as soon as they can get to you, and when I review it, I can give you pain killers.” I nodded, thinking, I understand that in cases of possible appendicitis, where there are other possibilities, but sheesh, I just fell off a ramp in my scooter onto my arm. Now it’s swollen, painful, and the lower arm won’t move when I tell it to. What else besides a break are you considering?” Fortunately, soon I had my X-Ray, some painkillers, and the pain lessened.
The ED doctor told me I had a broken elbow; he said he’d spoken with my husband who was on his way with our older son from our home in Maryland. I had a vague memory of speaking with my husband while in the back of the ambulance and reassuring him that I was fine, but that I would be unable to drive my van back home, so we needed an extra driver. Relieved that I was talking about the car, Neal said that our older son, Max, could come with him for the car. My immediate needs were cared for, and I could settle back on the gurney. Soon, however, I noticed an EMT walking through the ED to restock his ambulance, and this EMT was carrying a cold pack. “What a good idea,” I thought, having watched the swelling spread down my forearm to my hand and increase around my elbow over the past two hours. I promptly asked a passing nurse if I could please have an ice pack. She alerted the physician who came over for me to repeat my request. “Oh, sure,” he said rather nonchalantly, adding that a cold pack was a good idea, reinforcing my conviction of needing to look out for oneself in the health care maze. “Good idea? That’s what your job is!” I thought uncharitably, comforting myself that I’d succeeded in doing what was necessary to get the icepack. A sense of agency, again, if not as normal as buying a newspaper every day, surely would be more helpful to my broken bones and torn soft tissues.
Soon three white jacket-clad young people with a middle-aged physician introduced themselves as the Trauma Team and said I would be admitted to their service when a bed upstairs was available. Surgery would be the next morning with Dr. Toro who would see me before surgery. They’d reviewed the X-rays, and indeed, my arm was broken at the elbow. They ordered a CT of my elbow to be done before I went upstairs, to help guide Dr. Toro in surgery tomorrow morning.
Subsequently, attendants came to take me upstairs. “How about the CT?” I asked. “Oh, I think you’ve had all your X-rays,” came the reply. (The ED doc had humored me and ordered an X-Ray of my upper arm as I still had sharp pain there. Apparently, referred pain from my elbow caused the upper arm pain, and possibly this extra trip to Radiology had confused the attendants about my CT.) After checking, the attendant took me back to Radiology for the CT. Again, I was grateful to have caught their oversight and not needed to come back downstairs later that night after getting settled in my room.
I reflected that when I first arrived at the hospital and bought those newspapers, I wasn’t sure I could pull it off, but it was the first in a string of events where I had to speak up for myself. The experiences in the ED helped me realize that even when we’re feeling vulnerable, like with an increasingly swollen lower arm while lying in a gurney in the hall of an ED, we can still speak up and be strong, or strong enough!