THE REAL E.R.: THE END?
HEART-ACHES & HEART-ATTACKS
WHAT TO DO IN EITHER CASE
Don't Let Them Die Alone
Early this morning, I noticed a small crowd gathered around my neighbor's van in his driveway next door. His wife and two of his employees were standing next to the van. The front passenger door was open. My neighbor's wife, a gruff old Korean lady of 75 was trying to get a response out of her husband, who was lying back in the passenger's seat, which was tilted halfway down toward the back seat.
My neighbor, an easy-going local Chinese man of 80, was pale and disoriented, and seemed to be having trouble moving or speaking. His workers had assumed he was asleep, but his eyes were open and he was trying to speak. I asked him if he was all right, and he just looked at me without responding. He was cold and clammy, I realized when I felt his forehead. He mumbled "No" when I asked him if he was having chest pains, and again when I asked him if his head hurt. He was breathing OK and he had a pulse.
It didn't look like a heart attack, but I'm no cardiologist. It might have been a stroke, which meant that the clock was ticking. If he got treatment right away, he might be all right. If we delayed, he might end up dead or disabled. Since he was already in the van, I decided to take him straight to the hospital emergency room. I knew I could get him there faster than they could get to him. He would be better off in the hospital than in the back of ambulance in half an hour. I fastened his seat belt, tilted his seat upright and got into the driver's seat. We made it to the hospital in less than fifteen minutes. Those NYC cab-driver skills come in handy, sometimes.
I kept him talking on the way in. He had difficulty speaking, and he wasn't making much sense, but at least I knew his heart and lungs and brain were functioning as long as he kept trying to talk. I pulled into the emergency room drop-off zone and told him to wait there, I'd be right back. He was fortunate to have good health insurance, so we were able to go to a good private hospital where he had received treatment for heart problems before, according to his wife.
There was no line or group of seated people waiting. In fact, there were no seats. I just went right up to the admitting desk and explained the problem and asked for a wheel chair. The admitting person pointed one out, and asked the security guard to help me. We wheeled the chair outside to the van and managed to get my neighbor into it, with some difficulty. He was barely able to move, but he got out of the van and into the chair with our help.
I thanked the security guard and promised to move the van as soon as I got my neighbor to a doctor. I wheeled the old guy into the admitting area, and they opened the door to the emergency room. These places are high-security now: All the entries are locked and guarded and/ or under video surveillance. Given the events of the last few days, and the proliferation of right-wing gun-nuts and other maniacs, I guess that's a good thing.
Some nurses took my neighbor, JD, let's call him, straight to an exam bed. They got him up on the bed and loosened his trousers, removing his shirt and giving him a gown. He was unable to sign their paperwork or answer their questions. I told them I was his son-in-law, in case they required consent for treatment. I was then able to stay with him and give the medico's enough information to identify him and pull up his records on their computer. I told them what I knew of his trouble today and his previous ailments. They put an oxygen line in his nose and took his blood pressure. A young doctor came over and I gave him the run-down. The nurses attached tape-like sensors to JD's chest and abdomen and then attached wires to them. This gave them a read-out on a monitor. Then we had to wait for a more senior doctor to check out the data.
In the meantime, they took JD into another room for some more tests. I told him I would move the van and call his wife to let her know he had arrived at the hospital and seemed to be doing a little better. His speech was coming back and his eyes looked more focused. Mrs. JD was glad to hear this when I called her, and I promised to stay with her husband, and call her back when I knew more.
When I went back inside, they buzzed me in and I found JD back in his bed in the curtained exam area. He greeted me and we talked as the nurses continued to check him out. They brought in a portable X-ray machine, moved everybody out of the area, then zapped JD. That was a bit weird, but they gotta do what they gotta do.
Once the big rolling radiation source was gone, I went back to JD's bedside. He seemed more awake and alert, and we talked for a while. He wanted me to return the van to his workers, so they could get back to business. But he obviously didn't want me to leave. I stayed for well over another hour, waiting to see what the results of his tests would be, and whether they would be admitting him for the night.
The senior doctor came over and said they weren't quite sure what the problem was yet, so they were going to admit JD and have his cardiologist check him out. With his primo insurance, it was deluxe service all the way. I envied him. Almost.
I was about to leave, when JD started rambling on about his experiences in the Korean War, when he had met his bride-to-be. We talked about the frozen Chosin and Inchon and artillery barrages of half a century ago. Then he got onto the subject of veterans cemeteries. He said that the Korean government would pay Americans' travel expenses if they wanted to come to Korea and visit the graves of fallen American soldiers. This led to his recollections of some stories about the vast American veterans' graveyards in France. He started tearing up, and became quite agitated. I was concerned that he might be working himself into a stroke or a heart attack, so I tried to talk him down. I can be quite boring when I need to. No, really.
It took a while, but his attack of nostagia subsided. Then he was embarrassed that he had cried in front of me. He asked me not to tell anyone I had seen him cry, and I promised not to. He was really ashamed. I told him that it would be shameful if a person, especially a veteran who had lost friends in combat, were not emotional about it. He thanked me, but I had to keep promising him that I wouldn't tell anyone. Sad. Strange.
Here, he might be dead by morning, but his gravest concern was not to be seen as weak or emotional by people who were not even close to him, his employees. I thought that this might be his last wish, so I kept reassuring him that no one would ever know, it was already forgotten. Thank Gawd the senior doctor showed up again, or I might never have been able to get JD off the subject of tears, and leave him safely with his care-givers.
All of this must have consumed almost four hours. It was almost noon by the time I left JD, somewhat cheered up by a funny story I managed to extract from my own military history. Well, a Marine never leaves a man to die, anyway, so I stayed until I felt the old man would make it. I only wished someone would have done the same for me when I had my heart attack last month. We are not made to die alone.
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