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Thursday-- May 16, 2002—Ground Zero Plus 247

Emergency Room--Hall Of Terror
by
Cliff McKenzie
Editor, New York City Combat Correspondent News 
 

        GROUND ZERO, New York City, May 16--I don't watch the Emmy-winning show, ER.  One of the reasons is I didn't believe the constant madness and crisis was real.   I have changed my viewpoint.  Terrorism lives in the Emergency Room at Saint Vincent's Hospital in New York City.  I was its witness.  I affirm its madness.
        I was en route to Ground Zero for my "Crisis of Ordination" confrontation yesterday morning with my sister and wife.   I had insisted on taking along a wheel chair for my sister, who suffers from a multitude of leg and ankle problems.  I was being a Sentinel of Vigilance, ready to protect her weak ankles and legs from the grueling, pounding assault of New York City sidewalks when it happened.
       As I was lifting the wheel chair, a sharp, nauseating pain rocketed through my chest and side.   I felt the punji-tipped pain spears sinking deep into my ribs. I gasped.   I hoped it would pass and we began to walk toward Ground Zero.  Each step I took increased the pain until I had to stop.
       "I have to go to the Emergency Room," I said, holding on to the side of the wheel chair, my breath short, angry that my sister's first day of visiting in New York City from Las Vegas was being spoiled by my sudden painful attack.
       We took the wheel chair back to the apartment and climbed in a cab, directing it to go to Saint Vincent's Hospital.  I tried to joke with my Haitian cab driver who had commented about his own back problems as I gasped and groaned my way into the cab..
       "I was born in March, a Capricorn," he said in a heavy accent.  "I have much bad luck in my life."    When I asked what was the worst thing that happened, he told me that he was one day late in payment on his business and the bank foreclosed, stripping him of his livelihood.   Even though I was in pain, I thought how painful it would be to live in a country where the rights of the citizens were subject to losing one's vocation over a 24-hour-default.  
       "I wish you more good than bad luck," I said, exiting the cab, trying to keep my mind off the excruciating pain stabbing at my chest and side as I moved toward the ER door, assisted by wife and sister.
       Everything went orderly, normal at first.
       The waiting room was about a quarter filled.  Some were moaning.  One guy had a patch over his eye, but otherwise it appeared a regular, simple day of emergency treatment.
       A few months earlier I had been to the ER at Beth Israel with my daughter and her daughter and knew the drill of waiting and waiting, so I was prepared.   I had my carving tools and a piece of wood with me, but had no desire to do anything than wait in pain for the relief the doctors would give me through X-raying and examining me to assure I hadn't done any permanent damage.  At 6-4 and 270 pounds, the last thing I wanted was a slipped disc.  I was hoping for a stripped and injured muscle.
       I signed the admission documents.  I didn't read them.  I can't imagine anyone in an ER state-of-mind taking a microscope to what the words said.  I was lucky to scrawl my name.   They attached a wristband with my name and hospital serial number, my "Band Of ER Courage," and I waited for my name to be called.
       Security at hospitals in New York is like Fort Knox.   Tall, tough-looking guards in green jackets and sour-expressions guard the doors.   There are buzzers and codes on them that have to be punched in.   No cell phones are allowed. 
       I thought it ironic that hospitals have more security than airports.   It seemed a far stretch to imagine a Terrorist walking into an ER with a bomb strapped to his or her chest, but then I was about to learn why that was a major possibility.  
       My name was finally called and I was given security entrance to the bowels of the ER.   Chairs lined the wall where patients sat, and hospital gurneys were butted up at one end of the chairs with patients lying on them, some babbling to themselves others reading a newspaper, some just staring blankly at the ceiling.
       A young woman, a Physicians Assistant, examined me.   She checked my back for disc pain and took my history, then told me they would give me a shot for the pain and take X-rays.   She told me to wait.
       I was sitting on a chair in the ER room.  A woman next to me was telling a social worker about how she was beaten by her husband.  Another woman across the way was bleeding from her nose, some after-effect of an operation.  Blood stained her blouse and she pressed a huge icepack against her nose.   Next to me, on my left, an older black woman who was blind had a huge lump protruding from her jaw, a blocked sebaceous gland, the PA said.   I could see it throbbing on her jaw, as though she had a huge wad of cotton stuffed in her mouth.  Her husband stood Vigilantly with her.
       I sat there for over an hour.  I listened to the madness and disorder of the room.  Nurses yelling at one another.  Doctors arguing.   It seemed every member of the staff was mad, in conflict with one another.    It wasn't like the movies or TV. programs where everyone is harmonized in the madness of the moment, all for one and one for all.  This seemed to be "every-man-for-himself" management.  
      Unable to find any pain reliever medication for me as they fished through a drawer, they told me to go get my X-Rays.   An older woman led me down the cluttered hall. Another nurse told her to tie my hospital robe and they had a huge argument over who was in charge of me.  I stood there between them, wondering if this was a joke or for real.  It was for real.
      "She's always trying to tell me my job," the woman told me.  "I've worked here for thirty years, what does she know."
      I didn't respond.  I shuffled slowly, painfully toward the elevator.
      Again, I waited upstairs for someone to come get me for an X-Ray.   It seemed I was invisible.   Finally my name was called and I groaned and grimaced and made my way behind the large, hulking shaped Jamaican woman who was my X-Ray tech.  She limped as she walked, and I wondered if she had been afflicted with what I had for she seemed to be in more pain than I.  I said nothing.   Jokes seemed inappropriate.
      Because of my size, they cross X-rayed me.   I stood for a series of X-rays of my front and side, and then they had me lie on a table and began to take a series of additional pictures.   Each time I moved the pain shot through me.  I could hear people laughing and joking and telling stories about their lives in the adjoining film processing room.   It seemed that patients were flies on the walls, interposing themselves between the lives of the staff, necessary evils to their existence and conversations.
       I was told to wait for someone to take me back down to the ER.   My X-ray tech shouted to the people at the desk who were talking to one another that I needed an escort.  They said nothing.  I sat for about a half an hour, just about ready to waddle myself to the elevator and go down to the ER solo when someone came by and was told I needed to go back to the ER.  I was worried because my X-rays hadn't been read yet.   It was nearly 2 p.m. and I had arrived at the ER at 11:00 a.m.
      The ER was filled with people when I returned.  There was one chair left.  I eased myself down and leaned back against the wall.  The sounds of moans served as a chorus to the shouts and barking of the nurses and doctors working on people.   I tried not to pay attention to the chaos.  I just wanted my X-rays read, a prescription for the pain, and to leave.
      Then all hell broke loose.
      First, two Port Authority cops entered with a prisoner to get him treatment.  He had a black eye and appeared to bleeding from the head.   He was a huge guy, with thick shoulders and a barrel chest.  The two cops were small and slight.  I figured the prisoner could take them both with one punch.  
      Up to that point I assumed the ER stories on television and the movies were manufactured drama.   The hallway had been quiet, almost sedate.   But now the reality of  madness was unfolding.
      Inside the treatment room a man started cursing the nurses and doctors, refusing to take off his shirt, yelling the "F"-word at everyone and demanding to be released, to exit.   Four security guards rushed into the room. A confrontation was growing.  I was going to stand and peer inside but decided if there was a scuffle I might get bowled over, and add to my injury.  So I just listened as the guards refused to let the man leave and told him they would strip him if he didn't do it himself.
      I was perplexed.   It was as though I were in a jail, and all individual rights had been left at the security door.   Part of me wanted to jump up to the man's defense, but I bit my tongue.   The pain and need for relief overpowered by righteous indignation.
      More people poured into the narrow hallway.  A tall, lanky woman, perhaps in her twenties or early thirties stood bobbing her head, intermittently laughing and then twitching and grumbling.   She was pale and pasty, appearing like a drug addict coming down.  Her sister accompanied her, trying to soothe her.   She was given hospital gowns and told to remove her clothes and wait to be called.
      She and her sister found a seat next to me.  I overhead her conversations with her sister.  She was complaining about the long wait, bobbing in and out of hysterical laughs and depressive anger.   She kept insisting she wanted a cigarette and finally pulled one out.  I thought she was going to light up right there.  She kept saying the "F" word in relation to the hospital, the staff and the long, grueling wait.   Finally she bolted from her chair and rushed out the security door to the entrance where she could smoke.   A doctor yelled at the security guards, all of whom were crowded around the man who wouldn't take off his shirt, that a patient was outside smoking.
       Two guards rushed out the security doors.   The girl was forced back inside.   She told the guards to keep their hands off her and began to scream and kick and swing her fists at them, yelling she wanted to leave, to get the "F" out of there.
       Four guards tried to restrain her.  She thrashed at them, screaming madly at the top of her lungs.  A nurse rushed out with a syringe and long needle and injected her with some tranquilizing drug.   The girl slumped into a rag doll and was dragged back to her seat next to her sister, next to me, her head lolling.
      It wasn't over yet.   The calm had brewed into a storm, far beyond anything I had seen on television or the movies, far more real than fiction could paint.
      Against the wall stood a young Hispanic woman with her mother.  The woman's hands were all twisted into a deformed claw and her fingers twisted and twitched as she stared vacantly about, seemingly unaware of the cacophony around her.
      The sister sitting next to me stood up.  The nurse told the young Hispanic woman to sit down.  Her mother was pressed up against the wall, standing, quietly assuming the position of wallpaper.  I stood and offered the mother my chair next to her daughter.  She graciously accepted.
      It was nearing 3 p.m., five hours since I had arrived.  I wanted the PA to see me, hoping she would read my X-rays and let me leave the Snake pit the hall had become.
      Then Nurse Ratchet, or one that looked like the infamous nurse from One Flew Over The Cuckoo Nest, appeared.   She began to tell other nurses about the paranoid schizophrenic patients in the hall.  She spoke in a loud, coarse Voice, as though the patients were suspended in time, talking about each one and pointing at them as she warned the other nurses to "keep an eye on them."  One she singled out  was the young Hispanic girl with the twitching, twisted hand and vacantly frightened stare just three feet away from her.  I wondered about the ethics of demeaning patients' conditions in front of them and other patients.  I wondered about the Terror the alleged "angels of mercy" were injecting into the mind of the young girl, shoveling more trauma on an already disturbed soul.
       Later, I was to learn her hands were the result of too many psychotropic drugs, a common condition for those who live a drugged existence to counterbalance their terror.
       Then the young black man a few seats to my left yelled at the security guards to let the "F"-ing man who didn't want to take his shirt off leave.   He began to yell at all the ER staff, especially Nurse Ratchet who told him to not use that kind of language.
       He was a well dressed, educated young man who was exasperated.  He began to tell Nurse Ratchet how disorganized and confused the management of the ER room was.
       Taking umbrage, Nurse Ratchet began to defend the ER, and told the man that his attitude was not the kind of attitude that would get him treated in a timely fashion.  He retorted that he had been there for five hours, and had a lacerated eye, and no one had seen him yet and that he was pissed.
       Then he pulled out his cell phone--a violation--and dialed a number.  Nurse Ratchet called security.  The guards rushed at the young man.  "I'm calling the local television station to come down here and film this insanity," the man said.  "This is madness."
        The security guards started to take the phone away and the young man closed it and stuck it in his pocket.  Nurse Ratchet told the young man to stop yelling, which he wasn't, and that if he wanted to be treated he would be nicer.
        I wanted to vomit.  But, more importantly, I wanted to leave.
        Next to the young man was an older woman with Alzheimer's Disease, accompanied by her friend.   The older woman was disoriented.   They had been waiting for over four hours.   The older woman's companion had had enough.  She took her ailing, fragile friend by the hand and tried to coax her up and out.
        "We have to leave," her friend said.  "They are too busy here.  We are not waiting any longer."
        "But...but...I want to stay," the older lady cried..."I don't want to go...I want help..."
       "They can't help you here...they are too busy..." her companion said, her Voice frustrated, the idea of sitting there for hours upon hours more oppressive than the trauma of leaving.
        Finally, my PA appeared with my X-rays.   She put them up on the viewer and I began to ask her questions and then realized she wasn't a doctor, and was probably not yet thirty.   I realized the insanity of me expecting her to know details of my problem, or to read the picture of my lungs.  I still smoke, and wanted the X-rays for a look at my damage, if any, as well as the signs of torn ligaments and muscles.
       I choked off my questions.  Took my prescriptions and left.  I glanced back at the room before I exited the security doors, at the rows of people waiting, at the young Hispanic woman's hands twitching, at the black man's angry face and lacerated eye, at the lolling head of the woman who had been tranquilized, at the security guards lingering near the treatment door where the man who refused to take off his shirt still threatened to erupt.
      That evening I told the story to my wife.  As a hematologist, she had worked in many ER situations.   I was perplexed at the militaristic stripping of people's rights in the ER room, and told her about my siding with the patients who abhorred the treatment of the other patients.
      "That release you signed, Cliff, remember it?"  she queried. 
      "Yes."
      "It gives the hospital total rights over your body.  When you enter an ER, you give up personal rights.  You go under their command, control.   It's like you enter there for help, and when the help is offered and you resist, you lose the right of choice.  Lots of people walk into an ER and then fight the treatment.  So hospitals protect themselves.   They assume you want help or you wouldn't sign a release."
      I thought about it.   It made sense.   But it didn't make sense.
      Years ago my wife had been knocked out by a patient she was drawing blood from--a sheriff who was unconscious and when he awoke to a needle in his arm--slugged my wife and knocked her across the ER room.  It was reflex, not intentional.
      Still, it seemed I had been in a Hall of Terror.   It seemed to me the rights of command over the patients had been exaggerated at their expense.
       I saw no justification for the way in which those people were treated, especially the authoritarian Terrorist attitude taken by the employees.   But this was a Triage treatment center, in the heart of New York City.  What did I expect.
       Still, I thought especially of the young Hispanic woman with the deformed fingers.  I thought of her being driven deeper into her dark inner sanctum by the "angels of Terror" who spoke about her in such demeaning terms.
       On the obverse, I thought of the Alzheimer's patient and her companion, who quietly sat for hours--two old ladies seeking solace--in a world that paid no heed to them, and gave them no solace for their pain.
       As I left with my sister I took a deep breath outside.  I felt like the Birdman of Alcatraz who stepped out of the cold walls of a prison in which all my rights had been exsanguinated, into the warmth of freedom.
       "How'd it go," my sister asked.
       "I'll tell you later," I replied.  "Right now I want to smell freedom."

G0 TO:  May 15--Crisis of Ordination