Sunday, September 30, 2012

Obamacare Rules!

David's Ehrenstein's new book!
 Here's a brief section from my book Early Plastic that demonstrates what can happen if one relies on emergency rooms, as per Mitt Romney's "solution" to the nation's health problems, in lieu of having some form of medical insurance. Only by a fluke (the E.R. mistakenly believing that D had insurance) did David manage to survive a stroke that put him in the hands of ER personnel whose sub rosa instructions were clearly to get such---let's face it---deadbeats off of their hands at all cost. Just make sure they had a pulse when you slid the gurney in the ambulance for the pitstop at "County" on the way to Potter's Field.

 CHAPTER TWENTY-FOUR: That's Where We Came In
"Chief Complaint/History of Present Illness:
This 49-year-old, David Ehrenstein, was presented to the Emergency Room at Midway Hospital on 12-28-96 complaining of headache and weakness. The patient's blood pressure in the Emergency Room was 207/126, and a head CT showed a large intracranial hemorrhage originating just adjacent to and extending into, and nearly completely filling the right lateral ventricle. The patient was admitted to the Intensive Care Unit where. . ."
    This thing that happened to David, my significant other of nearly the last thirty years [now nearly fifty---2012] wasn't what I had in mind as a dynamite finish to this book. Two days after Christmas '96, and I had just been laid off from my job as a film researcher. To postpone telling David the bad news, I almost stopped on the way home to check out a new video store in the neighborhood. But I would rather be with David than aimlessly eyeballing empty video boxes. I got back behind the wheel of my beloved and beat-up three-decades-old VW and continued home.
   Pulling up in front of the house a few minutes later, something was wrong: David was supposed to have been home all day working on his book, yet it was six o'clock and mail still had not been taken in. Without even grabbing the accumulated post, I ran up the hallway stairs two at a time. All over the house wet towels lay scattered about. In his bedroom I found David lying prostrate, nearly unconscious and unable to respond to my entreaties to tell me what was wrong. He could only moan: "Leave me alone. I'll be be all right." Bullshit! I called 911, the paramedics quickly arrived, and after a cursory examination, David was diagnosed as suffering from nothing more serious than a "viral infection." Odd! He didn't even have a fever. They prescribed bed rest, liquids, aspirin, and departed.
    An hour later, David was somewhat more responsive, but I remained unsatisfied with the diagnosis: how could you have a viral infection but no fever? Our friend and neighbor Sharon Butler and I were somehow able to get him down the stairs and into the car. We took him to a nearby emergency room where he lay the next two hours almost entirely unresponsive in a chair. At last a doctor summoned us back to an examining room. Again, the diagnosis was the same as an hour earlier.
       "But how can you have a viral infection without a fever?," I pleaded
with the physician.
       "It happens sometimes."
       "Oh.. .."
As with the paramedics, aspirin (the worst thing that you could have given him it turned out) and bed rest were prescribed. We went home where it was a nightmare. David mostly moaned and cried out for something to kill the pain. Fortunately, for no particular reason, I gave him Tylenol instead of aspirin. Instinctively, I applied cold compresses. Later I learned that the "burning" of ice effects a kind of deflective and competitive false pain, which helps cancel out the real pain.
   Something had been not quite right with David for at least a week. He'd chalked it up to having eaten a "bad burrito" at a Mexican fast food place. "Does your stomach hurt?," I'd asked.
"A bad burrito could only give you food poisoning," I nagged. "Leave me alone. "
I let the subject drop.
     Sunup found David no better. And again I shoehorned him into the VW. Because it was close, we went to the same emergency facility. This time, however, all it took for a different doctor was a cursory exam before he hazarded that David clearly did not have a viral infection but was most likely suffering from something much worse. A half-hour later after a rush cat scan, the doctor's worst fears were confirmed: David had suffered a cerebral hemorrhage. Much later, I learned that he had been knowingly sent home the night before with diastolic blood pressure of over 200. That's nearly twice what it should be. Months later, by the time I found out, it was too late to file a malpractice suit in doctor-friendly California.
  "WHAT DO YOU MEAN HE DOESN'T HAVE HEALTH INSUR­ANCE?" The hospital's chief neurosurgeon's voice rang out from across the ER facility where David and a dozen others lay scattered about on gurneys. He stomped toward me.
"You've committed fraud allowing your friend there to be admitted to the hospital under false pretenses!" he pointed at David and ranted. "Do you have any idea how much the kind of operation he needs costs?"
"What operation?" I wondered to myself.
He stormed off.
        Ordinarily my impulse would have been to shout at the retreating doctor, "If I had known we weren't wanted here we wouldn't have come in the first place, we'll take our business elsewhere!" Instead I kept my cool and didn't give him an opening to toss us out bag and baggage. A few minutes later David was admitted to the hospital's neuro intensive care unit. Midway Hospital is one of the most expensive private hospitals in the city. Early on, I had twice informed personnel there that David had no health insurance (most free-lance writers don't!): still he was allowed to continue along the Hippocratic conveyor belt. And by the time the ER had uncovered the serious nature of his illness, it was too late for them to legally dump him the way they'd tried to the night before.
    I've always been a strong believer in E.M Forster's axiom that in the process of dealing with and embracing the daily "seen," there is little or no time left for dealing with the "unseen." But I contemplate those few minutes that I hadn't spent perusing the video store the night of David's (as we came to call it) "incident." It could have meant the difference between life and death for him. All those years David and I spent worrying about the inevitability of AIDS laying waste to one or the both of us. Instead, he had suffered a bomb in the brain. That's what killed my father fifty years earlier before he'd even hit the ground in front of me.
    Even though "Profit Before Patients," is Midway Hospital's motto, after stabilizing medically uninsured patients, its policy is to ship them off to a public facility post haste. But it was an especially busy time of year, what with the traditional Christmas upswing in driveby shootings in Los Angeles, the city where the future comes to die. There was not a single bed available in the L.A. County hospital system. They were stuck with David. 



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