Sunday, August 30, 2009

Emergency Room Revisited

The fundamental problem with democracy, to paraphrase Socrates, is that the vast majority of the population are half-wits and very easily lead against their own best interests. Sophistry plays its part, with entire news networks devoted to disseminating lies to the masses for fun and profit; oddly, no-one ever gets sued for lying. It's constitutionally protected, I imagine.

I really don't know what I find more irritating - the perverse inequities, bureaucratic inefficiencies and manifest injustices of what is laughingly referred to as the American healthcare "system", or the spectacle of slack-jawed, self-righteous, ill-informed old duffers screaming that government needs to stay out of healthcare. Actually, I do know. It's the latter. Essentially it's an analogous societal niche to that which in England can be provoked by a few headlines in The Sun to lynch paediatricians as "pedos", only here The Sun is replaced by an overweight far-right radio talk-show demagogue and the pedos are replaced by anyone who doesn't drive a Ford F-150.

Whatever. For all the horrific expense of the system, I can tell you that the all-American Emergency Room is remarkably similar to good old-fashioned NHS Casualty; an unsettling melange of terror and abject boredom.

Ethan woke the other week around midnight, barking like a sea lion; an awful wheezing cough that caused us to immediately suspect that he's swallowed a toy and had it caught in his throat. I drove him to the ER, which was mercifully quiet. I filled out the paperwork. George Clooney was nowhere to be seen, despite the fact that my contribution to the company healthcare plan alone should be more than enough to ensure that he's on constant stand-by for this kind of situation. Then we wait. Then triage. Then we wait. Then x-rays. Then we wait. Eventually we get to leave the appropriately named waiting room and are ushered into a private room, where we continue to wait. Then a nurse sees us. Then we wait. Then a doctor sees us. Then we wait and wait and wait. Then a nurse sees us again and we are discharged.

On this specific occasion the usual rhythm was disrupted in a positive and surreal way by virtue of the doctor exhibiting a manner remarkably similar to that of Bill Murray, although I fear this was lost on Ethan.

Because Emergency Rooms are prevented by law from turning anyone away regardless of their ability to pay, everyone winds up here, much like Casualty. To discourage anyone but the most desperate, however, the waiting rooms are engineered to be as uncomfortable as possible. Chairs originally designed by the CIA to enforce stress positions on suspected terrorists awaiting interrogation have now found their way into civilian life. By way of contrast, NHS waiting rooms use the prospect of being randomly stabbed by a drunken Scot to deter all but the most virulent bleeders.

Ethan behaved at least as well as might be expected. After three-and-a-half hours he was diagnosed with "croup", given a dose of steroids in a cup of apple juice, and sent home doing a little better. Dad was exhausted but much relieved and spent the next day on a drip coffee drip.

We await the bill, or bills, which will no doubt arrive in due course. Despite having health insurance I will have to pay a co-pay, a percentage and perhaps some other expenses that I will then spend the next x weeks attempting to claw back from two separate excess medical expense accounts, one of which I pay for and one of which I don't. I will not have a clue how any of the numbers have been arrived at. If anything is so conspicuously wrong as to require follow up, I will spend approximately 3 hours on the phone with the insurance company trying to fix it.

It is madness, without doubt, of an institutional nature; and, like it's human analogue, the cure is not covered by any existing plan.


Further evidence that Portland is the West Coast's Royston Vasey can be gleaned from the rear label of this bottle of 'local vodka for local people' (above right).


Poor Pookie's wristband from his recent trip to the ER.


I'm fond of a seed pod and their bizarre alien forms.


Here's a lovely picture of Conker looking gorgeous, because one can never have enough of these.

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