"The Doctor Will See You Now" Series:
Introduction:
I am one of thousands of Registration Admission Coordinators that work in Emergency Rooms (ER’s) across America. We are the front-line staff that register the patient information required for every ER chart. All that really means is that if you want to be seen by a doctor, you first gotta’ go through me. My name is Gaylene Thomas and as a sixty-three year old, middle class, divorcee (four times now); I‘ve been around and seen a lot. I don’t consider myself jaded, but at this juncture of my life; maybe cautiously pessimistic would be a fair description.
The following stories are anecdotal observations that I’ve made of the dramatic changes that ER’s (and the landscape of local communities) have seen in the past decade. The characters in the following stories are simply that: characters. However, each was inspired by a true event and actual patients.
The hospital I work for is Grace Tender Healing (GTH, for simplicity’s sake, or Gate To Hell, as we have deservedly named it). GTH is located in Oakdale, Texas, an acutely urbanized city tucked along the fringe of Southern Houston. We are a medium-sized hospital with 123 inpatient beds and 16 ER beds available. Our hospital is primarily known for our teams of highly skilled Osteopathic physicians who operate our Level II Trauma Center. We are also an esteemed teaching hospital, offering fellowships in leading-edge trauma treatment, closely rivaling Houston’s elite Texas Medical Center.
In the early 1960’s, our complex was the local center of quality healthcare in a low-key residential area built toward the end of the previous decade. The neighborhood was a mix of 65 hour-a-week working families with blue-collar backgrounds, laboring in the oil industry that dotted the Gulf Coast or working in one of a dozen nearby chemical plants. The community’s standard of pride was demonstrated in the maintenance of their small homes and prized grassy front lawns.
However, GTH now finds itself discreetly nestled along a busy drug corridor skirting the impoverished, multicultural enclaves that have seeped like sludge from the Southwestern boundary of Houston. The edge of town where GTH huddles in Oakdale offers drugs, gangs, prostitution, violence and abuse enough for all. At the end of my shift I have never missed a security escort to my car, even though the parking lot is well lit and littered with emergency phones along the way. The avenue where the hospital is located reflects the neighbors... and their “hood.” Beginning at the main avenue, the majority of the houses are one and two room clap board shanties. Front yards often mimic grassless fenced cages, dotted with pit bull terriers and other aggressive dogs pacing their territory with steely defiance. The driveways are graveled rut-ridden pathways to security barred doors. The popular businesses in the immediate area are the two liquor stores which flank the neighborhood, Tatts for Brats (a tattoo parlor), a drinking establishment named the Cuddle Puddle and a McDonald's on a popular corner next to a car wash. The car wash is a converging site where gangs of young men hang out daily, smoking blunts and most likely swapping manic stories about how to keep ahead of the cops. There's not a Wal-Mart or other similar chain store in the neighborhood. I can only imagine what their market analysis of this area rendered.
ER staff administers to a multitude all healthcare situations and are the intimate hands-on providers attending to a range of illnesses, often to a marginalized population of the human blemish, and I mean that literally, as there’s an entire subculture of people “existing” that often becomes invisible, as we pass by.
Our hospital and one other a few miles east of us share the intense neighborhood drama, including knifings, gun shot wounds, brutal beatings, overdoses and attempted suicides. These are the patients that ER’s are designed to treat; seriously ill patients. This is the type of drama that originally drew me to this type of work fifteen years ago. O.K., that and…divorce number three practically left me homeless, so I had to find a job; but really… I do love drama. But things have changed for ER’s through the years. It’s my personal observance that ER's in America, have for the most part become the free clinics for the local inhabitants that are unwilling (as opposed to unable) to pay for medical treatment. We're a busy ER and I work the 3-11pm shift. We treat an average of 140 patients daily on our shift alone. More often then not, we now treat more abscesses, earaches, sore throats, scrappy dog bites, and outrageous human bites, as well as a myriad of other infirmities, which, in many cases, could easily be treated in home or at one of the dozen free clinics nearby and/or are accessible on the bus route.
Don’t get me wrong, GTH gets action day in and day out, but it’s our after-dinner crowd on the weekends that are the real show stoppers. This first story depicts one recent account of initial patient contact, in:
“Are You One?”
"Juan… Guttenez?" I hesitantly hollered out into a crammed ER waiting room. A young man clad in grease-stained jeans and a sullied t-shirt got up and, with a slight limp, walked my way, then with eyebrows furrowed, stopped and looked around. I hollered again, "Uh, Juan Godinez!" The young man smiled, then continued walking toward me. "Are you Juan?" I asked as he approached me, knowing there were probably three other men named Juan in the waiting room. But I knew I had the right one. The slip I was reading was the patient sign-in sheet. Juan had illegibly scrawled his name across the top and wrote that today's visit was for a "bad eye." Yes, I was confident I had the right Juan. The young caramel-colored man in front of me had a good-sized gash across his right eyebrow that could just be made out through the heavy dark hair that fell across his forehead, with an eye that was on the verge of swelling shut. Remnants of blood from an apparent scuffle looked dried and crusty. Based on the eye’s outer overall color and swelling, I guessed the injury to be several hours old. "Whoa, friend, that is a bad eye. ” I said, “My name’s Gaylene, follow me and I'll get you registered to see the doctor." This sympathetic response fulfilled one of my job requirements.
"Thanks," he muttered softly as his dusty, tattered shoes shuffled across the polished floor, following me into my private cubicle for registration.
"Please get out your ID and any insurance you want us to file, then have a seat," I said, giving him my customary acknowledgement that we were commencing the registration process.
"I don't got ID or insurance ma’am," Juan stated pleasantly, without hesitation or hint of any accent.
I began to register the young man, as is our standard, asking for his social security number (which he had), address and other identifying questions. Then as customary, toward the end, I stopped and looked up with an inquisitive smile to ask, "O.K. so what happened?"
Juan became animated as he protested his plight, "I got robbed. You know, I was just walking down the street and some guy jumped me; then robbed me." His demeanor, along with my previous fifteen years of hearing incredible, near improbable stories, gave me a hint that this might not be the entire story. I thought, really? I mean, even in this neighborhood with a high crime rate, rarely does anyone from the “hood” get jumped for no reason; there’s almost always a reason.
"So, what you are telling me is that, out of nowhere, some guy just robbed you? Is that what you're telling me?" I reiterated, resolved that I wouldn’t roll my eyes in total disbelief of a story I had heard a thousand times before. He knew I wasn't buying what he was selling.
"O.K., O.K., well that's not what really happened, but I did get robbed," emphasizing the word robbed as if pleading with me to believe him. I pursed my lips and silently waited to hear the rest of his story. (Remember I told you, I’m not jaded, just cautiously reserved. Yes, I know I used the word pessimistic, but reserved fits here too)
"Yeah well, what I meant was I just wanted to buy some shit, ya know." I grimaced. "Oh sorry. But let me tell ya, I was just talking to this dude on the corner ya' know and I told him how much I could pay for some shi..stuff. And we made a deal, you know what I mean, we had a deal." I continued to quietly listen. "So he takes my money and then bamm, he pops me in the face. Get that, he pops me one!" His gestures became exaggerated, as he punched the air, but continued, "I said to him, hey whadcha' do that for man, I just gave you my money! And bamm, he punched me again and f'ing knocks me down!"
It was difficult to remain serious as he relived his most recent skirmish, but I managed.
He continued, "And that's how I got this," he dramatically pointed to the red and bluing bulge protruding from his eye socket.
He seemed to be toward the end of his current dramatic life story, so it seemed appropriate for me to give the expected response, "Bummer."
To which he replied, "Yeah man, I mean what the hell is this country comin' to when you can't even buy shi...I mean stuff without getting beat up and robbed?"
The doctor will see you now.
