A Geriatric Night in the Emergency Room.

There was hardly anyone in the emergency room that night. We sat in the sparsely occupied emergency department that looked like a bus station at 3 a.m. waiting for the triage nurse to assess my wife. It was six o'clock an I guess everyone was having their supper, including the staff. My wife had fallen down the basement steps and for all they knew could have been hemorrhaging to death. Still, after only half an hour or so sitting dazed in the wheelchair, someone came out to triage her. The girl looked about sixteen and I asked her if she was the triage nurse. No, she said. She was the student triage nurse. She did a good job. She asked the routine questions that I won't bore you with right now and then politely vanished into the night without further comment.
Ah, good, I thought. My wife will soon be seen by the Doctor. We sat and sat. An occasional patient drifted in, otherwise nothing seemed to be happening apart from an occasional patient drifting out. Not like any emergency department I had worked in, and I had worked in quite a few. We hadn't had any supper so I bought an exorbitantly priced bag of potato chips from a vending machine. After that my wife needed a drink (I needed one too, but not of water!). I found a water-vending machine. A small bottle of water cost only $2.95. (A similar sized bottle in Costco is 25c! ) Outrageous - in a hospital yet!!
After only an hour we were called out of the waiting area to have the whole history taken again by the triage nurse as well as a cursory medical examination. This was the real one, not the student! We were ushered back into the waiting room as the triage nurse had identified that my wife was still alive!! The same few patients were still sitting there - none looking as though they needed an emergency room. It was approaching nine pm, my wife and I were getting restless and irritated.   "I'm leaving here and going home if I'm not seen by nine pm." said my poor battered bruised wife who was now exhausted by being in a sitting position for three hours. She had once several years earlier been in the same ER following a severe accident resulting in facial fractures and had insisted on leaving after waiting many hours before being seen, regardless of the consequences. At least on that occasion the ER had been very busy. On this night there was nothing happening apart from an occasional patient drifting in and out.
At about one minute to nine we were again called into the assessment area. This time the young man who assessed her was the medical student. The history and medical examination protocol was again followed. After only a further hour my wife was seen and examined again, this time by the medical resident. After this she (the resident) assured us we would be seen shortly by the Emergency Room Physician. By now my wife was lying on a gurney in a cubicle in the ER, three of the four walls of which were a thin curtain, so that every word of the discussions taking place in the bubble on either side of us seeped through the drapes. So much for the alleged respect for privacy that we hear so much about!
Less than an hour later, the ER Physician appeared in person. He was a pleasant man in his middle forties. The history and physical examination were, of course, repeated once again but this time concise and to the point.
"Looks like she is alright, but we better do a CT scan and a few X rays. Accidents like this kill old people," he said, not unkindly.
So, after shuffling around at home for a day and sitting in a wheelchair in emergency for several hours the patient was placed on a rigid fracture board and neck collar, so as not to transect her spinal cord, while the X rays were performed. In terms of subjective suffering that's when the acute phase began. The scan and x rays took about an hour but she had to remain immobilized until the results were available and interpreted, which involved another hour. Those two hours were by far the worst part of the whole experience, both because of the acute discomfort of the hard board and immobilization and some temporary but very frightening visual disorientation and vertigo. Eventually the ER physician came back with the good news the CT scan and x rays showed no brain damage or fractures.  
At twelve thirty am, six and a half hours after our arrival, we were on our way home. We knew the game had changed, permanently.

Come back here for further episodes of 'geriatric adventures' in the near future .