by Kyle Dudley
My experience with the health care system of New Orleans.
|I recently moved back home to New Orleans from California following an extended stay that could be described as a ‘working holiday’. After the week and a half and 3200 mi of driving (side trip to CO), I arrived in N.O. mentally exhausted, spiritually drained, physically atrophied, and visually desensitized. When I finally pulled into my driveway, I was ready to vacate my belongings from my car as fast as possible, have room service (my new housemates) bring me a heavenly shrimp po-boy from Parkway Tavern down the street, maybe hurl up a few foamy stories from the froth of my trip, and then subtly slink off into a few days hibernation and disappear temporarily into my room somehow, unquestioned and undisturbed.
Naturally, my New Orleans honeymoon came to a crashing halt without much warning around the time of my one-week anniversary. I had a tooth that had long ago cracked and decided that this was its time to shine, and that it was going to blow like Mt. St. Helen whether I was on board for its big moment or not. With a little bit of pain and a lot of grotesque, albeit certainly temporary, maxillofacial deformity, the damned thing was threatening to put the coitus interuptus on my new city swag, so I knew I had to do ‘something’, and probably ‘soon’, before I got a ‘very serious infection’. Before I even had time to take a bite into the po-boy of my dreams, my (4) + (5) pre-molar/molar re: previous neglect, which had been developing this subcutaneous infection stage left of my face, decided to swell to the size of de Rozier’s hot-air balloon and sky-lifted me down Tulane Ave. to University Hospital for a visit to the ER.
At 3:07PM CDT, after several minutes of guide-less and confused meandering through construction work on Tulane Ave. followed by yet more addled wandering through the sprawling, disorienting ILH/LSU Health medical campus, I finally was directed to the entrance of the ER where I was asked to input my information into the kiosk at the nurses desk. I hadn’t been to an ER in Louisiana in close to 10 years, so I was very impressed to see that the technology was upgraded, alleviating the desk nurses from the task of handing you a clipboard to fill out your name, date of birth, and possibly social security number. Quips aside, this does create efficiency down the line by interconnecting the various parties involved that you will visit during the experience. I liked the kiosk, honestly, and it did represent to me a technological advancement for the City of New Orleans and our ability to conduct business in the modern world.
What I didn’t like was the 13.5 hour wait that followed. I was lucky enough to not be in much pain, and though I personally was only cosmetically disfigured (seriously, think Anthony Hopkins’ in Elephant Man), it did appear that I was unmistakeably getting worse by the hour. I was concerned, but I knew that I would ultimately be fine, and since I’d had abscesses before, I knew that my symptoms were more or less fairly standard (though my eye was beginning to swell shut). I pride myself in my ability to remain tranquil in the face of peril, but to be fair, I was in Candyland compared to some of my waiting room-mates. There were people who were genuinely suffering, and my heart went out to them. Not to the dope-heads stumbling through the door with yellowed-eyes and XXL t-shirts on 135 lbs frames looking for a ‘scrip, or to the mid-pubescent boyfriend and his underage teenage gf with a ‘tummy ache’ who was likely 4-5 days late (Note: pregnancy tests are available at your local CVS, Rite Aid, Walgreens, etc.), nor to the junkies who had taken all of their methadone for the week in one day and were already dope sick, or for the hypochondriacs describing some wacked out, statistically improbable disease they had from spending too much time on WebMD. I did however feel for the man I sat next to for 6 of those 13.5 hours whom I had arrived just 15 minutes before, who was, and I might be going out on a limb here, but appeared to be going into some form of renal failure; or to the construction worker whose foot was run over by his co-worker who was howling like a large, possibly human-related (geologically speaking) mammalian species not quite human. Death wasn’t knocking on my chamber door, but my face was still puffing up slowly, and it did set me aback when during a trip to the loo that I noticed the inside lining of my cheek was beginning to resemble one of those stringy-connectedy-10-bubble-long bubbles kids magically maintain connected to the purple wand.
When I walked in the door, the nurse had initially said to expect about a 4 hour wait to see the triage* nurse. Miles beyond that checkpoint (approx. 7.5-8hrs in), my renally failing friend had decided that he had taken all that he could handle, and to put it simply, he lost it. I could hear him gurgling at first to his mother and wife, and before long it erupted into a scene that without soundtrack or context resembled Peter Finch’s breakdown in Network. He began shouting that we should all rise up, and take down this system, and this was fucking bullshit what they were making us go through, and can’t you see we’re all in pain over here, and why don’t they have more god-damn nurses, and why are the nurses so god-damn annoyed when I just want to know roughly how long its going to be, and that he’d sworn he’d seen 12 people that signed in after him go see the triage lady already and how come they were already were brought in towards the doctors, and you’re telling him that he has to drive back to Baton Rouge after all this bullshit and there is still a chance he might not even be seen tonight?
In a final fit of frustration, he concluded his epilogue to the still room by confiding to us that that son-of-a-bitch Jindal needs to be shot. After a few moments of an awkward silence, he naturally began to sedate and chill-out. He returned to his seat and progressively tapered off his ranting, and the room returned to normal. Within minutes the room was business as usual but the outburst was not forgotten. He voiced the frustrated feeling we were all experiencing, and though his hostility was obviously misdirected, he did have some valid points, and no one was looking to punish him for that.
Now, I just moved back to New Orleans, and Louisiana for that matter, so I am personally out-of-the-loop of the greater politics that are at play with the state of Health and Hospitals. Certainly no one needs to be shot, but politics aside, from a purely objective standpoint, it’s no matter if it’s Jindal or Blanco or Regis and Kathy Lee or fucking Strahan* in charge, the fact of the matter is that the status of staffing in University Hospital is piss poor. The nurses are asked to handle Herculian tasks, playing the role of Nurses, Administrative Assistants, Social Workers, Psychologists, Ring-Leaders, and probably a slew of other roles that are called for on nights that I don’t happen to be in the ER waiting room. Maybe add Flight Attendant to that list, as well, as related to the ‘Everyone-remain-calm-while-(insert a crisis)-is going down’ that I’m sure flairs up semi-regularly. To be fair, on the night that I was present, only 4 NOPD officers came mad-dashing through the ER once, and the desk nurses appeared utterly nonplussed, so I’m assuming that this was a good night.
What follows is a brief time-line of ‘The time after I made contact with the Lifeforms in the Monochromatic Jumpers’:
At a sanguine 11:36pm CDT (approx. 8.5 hrs in): I finally met with the triage nurse who informed me that there was only one patient currently ahead of me in the ‘Dentists Chair’, and that she would keep an eye out and fast-track me as long as no one else had a more serious dental issue that succeeded me in line. Suggested wait time approx. 0.25-0.50 hr.
12.59am CDT (approx. 1.5 hrs later): Prev. triage nurse stepped back into the waiting room and called my name, and I was escorted to a room.
1:31am CDT (approx. 0.5 hrs later): I was greeted by the first of a tandem of general MD’s and residents who all came to the same conclusion that yes, my mouth looked like shit, and yea, I probably need some anti-biotics and to have the puffy, bubbly caldron of puss lining my gums lysed and drained.
2:25am CDT (approx. 1 hr later): Dr. Young Guy comes in with Dr. Young Girl, they assess the situation, tell me to open up my beak, shoot me up with some lido, and make an incision in the inside of my mouth with a sterilized exact-o knife. A few seconds of aspiration, the clink of a few beers in celebration, perhaps a small orgy or two, and the beast was slain, my face deflated, and they had saved the day. Total duration, approx. 7-9 minutes.
4:22am CDT. (approx. 2hrs later): Four-twenty-fucking-two and another-fucking-two-hours-later. This, I didn’t understand. I kept cool for the first hour of this assumed final waiting period and for lack of any other entertainment enjoyed my free 2x Norco 5mg buzz, but as it rounded to near hour two following a ‘surgery’ my niece* could’ve performed, the pills started to wear off, and the party was over, and at this point I was full-fledged batshit, and I was ready to take what was left of the exhausted, lifeless husk that remained of me and go home, get in my bed, and hopefully not see the inside an ER until the waning, senescent years of my post-convalescent life.
But it was this two-hour capper to round things off that sealed the deal for me. It was 13 and a half hours after I had checked in, my mind was deteriorated to mush, and I’m certain that without the moderate amount of prodding and pressure I put on the ER floor nurses that it could’ve easily reached 14 or even 15 hrs. The MD’s were all average/above-average in their services rendered towards me, and sure they were friendly and light and re-assuring and all that good, but there is something else that lingers here that still doesn’t add up to me in the entirety of this whole process. If what this boiled down to was professionalism and good old fashioned protect-your-ass-ism, I could totally understand that. Working thoroughly and making sure patients get as close to A+ care that you can offer is without a doubt the most important thing that a hospital has to guarantee. No, owes. But the inefficiency at every step of the process, the unapologetic attitudes, and the helplessness that is induced upon those in their time of need is inexcusable. LSU Health does a lot of great things, on the back end; it provides sliding-scale pay options for affordable care for those in financial and physical need. I appreciate that. I also understand that naturally the nature of its very existence is institutional codification, which begrudgingly excuses the deficient and Byzantine in some regard. But from the enterprise of one person with a minor medical emergency fighting to get through the system and looking to get care in a timely manner, the overall quality of the beginning-to-end process is just hard to even believe shitty.
And as I write this, I’m at home, and I am out of that building, and I’ve done my time. I got my what I went there for, got on my way and was able to live another day. It wasn’t the third world. It wasn’t Darfur. I get that. But after an ordeal of that magnitude, for something so relatively minor, I can’t help but think about the faces who remained in that waiting room. The ones that I avoided looking at as I broken-down and defeated and down-right fucking exhaustedly walked passed as I weary-eyed and limply floated down the hall. As I staggered out of the double doors out onto Perdido Street, into the weak-tea darkness of what was left of that diminishing previous night, all I was left to think about was that with all of the money and talented people this state has, why does it have to be this way, and will there ever come a time in New Orleans when no one has to drudge through such unnecessarily miserable hoops just to preserve the well-being of their livelihoods.
*A triage nurse is the nurse you see who evaluates the severity of your condition, and determines the priority of patients needs. In my observations, they more or less treated everyones severity exactly the same.
*I haven’t seen much in the way of daytime television in years, but at this point in time it had not been brought to my cultural awareness that Michael ’6’5, 225 lbs’ Strahan is now a daytime talk-show host.
Yet another of the perks of spending an entire day in a hospital waiting room.
*I do not have a niece, but I am certain that if I did that she could have performed this procedure using a Duracell headlamp, a butter knife and a handmirror.