Tuesday, April 16, 2013
I recently had a medical emergency that required me to go to the emergency room. From that visit many things highlighted to me the recent conversation about affordable and quality health care. As someone with comprehensive medical coverage and living with HIV I never had to give a thought to the services I received. Although I was aware of the issue of uninsured people, in the best way I knew how, I could only relate through their telling. My experience was an eye opening experience that showed the many levels of inequalities of healthcare. But it also gave me a perspective as a man with HIV, visiting the local ER. As a disclaimer I acknowledge all emergency rooms are a waiting room and none claim to offer Four Seasons type service but I do feel there is a difference in how private and city run emergency rooms operate.
My episode began when I sat down for dinner. I knew the moment I swallowed the steak that I was in trouble as it quickly became lodged in my esophagus. This had happened many times before with others warnings me to take small bites. Previous incidents didn’t result in any drastic action so when it happened I felt it would resolve itself. Yet this felt different as no matter what I attempted it just wasn't going down. Despite the efforts of doing a self-Heimlich, drinking a diet Coke which usually helps and according to Google, consuming a table spoon of white vinegar, it simply was not dislodging. So the night was spent with the inability to drink water and swallow food. You would think I would have immediately went to the hospital but knowing how emergency rooms operate and it being late I simply didn’t want to spend a night in a room waiting to be seen. Besides I was sure that during my sleep it would go down by itself.
Having gone 12 hours without food and water I couldn’t even take my HIV medication as it would come right back up. I was out of it and in no mood to take the two subway trains to a reputable emergency room located 45 minutes from the house. I was also feeling cheap and didn’t want to spend money on a cab. I just wanted a quick fix and chose to take myself to the city run hospital that was only 15 minutes away. This hospital is known for bandaging the shooting victims of the inner city and pushing them out to be shot again. Based on it’s location it’s the only medical facility for nearby residents and those without health insurance. It’s because of its close proximity I made my way to it.
While waiting my turn I overheard one man looking for a refill on his Prezista prescription, a HIV medication. My ears pricked up as I wondered to myself what makes that an emergency. Soon after, two guys who were showing each other a lot of public display of affection exclaimed loudly they were there to get some ‘crazy pills’. I assumed that it was a derogatory slang for mental health medications which is no joking matter. In fact I was surprised on how opened many were about their reason for coming in. In their public share it was evident that most of their conditions could have been covered with a regular clinic visit but that’s hard to do if you don’t have insurance. Yet without insurance this may have been their only option. A quick adding of the numbers saw that for those who opposed affordable health care, tax payers are paying double to send someone to the emergency room than they would have sending a person to a regular doctor visit.
My interesting interaction moment came during the intake process. As I was explaining to the nurse why I was there, she asked about any other medical conditions. When I informed her I was HIV positive she immediately grabbed her pen and wrote down a name of a doctor. She informed me to go to YouTube and watch this doctor’s videos as he had a cure for HIV. I was shocked that here she was pushing a voodoo doctor on me while I'm trying to see a real doctor. What was also disturbing was the irresponsibility of this medical representative and basically someone who should have known better, passing along misinformation of a disease that is already misunderstood by others. And the scary realization was knowing it was highly unlikely that I was the first she shared this information with and the realization there may have been follow- through on others with this information. It left me wondering how many others have delayed their care with hopes to getting a quick cure for their HIV.I was too weak to challenge the information she provided at that time and reminded myself to call the hospital when I was feeling better.
Despite the interaction with her it was assuring to hear the hospital offering people waiting, the opportunities to receive a HIV test. The discouragement came when two people hearing the word laughed and loudly state, "Nobody wants to hear about the ‘Monster' a term I hadn't heard for a while but reaffirmed the stigma HIV had attached to it. With all these HIV reference in one sitting I thought someone must have known I blogged about HIV and I was getting punked.
Thankfully I made it past the waiting room and moved to the next room of purgatory as my waiting continued. I would get excited when I would see nurses come in but be deflated as they were in there to grab medical supplies. I laughed as I realized that I was placed in a medical closet. My self-advocacy skills were not effective as each nurse were tone deaf to my asking when I would be seen. I did see one nurse and after asking about my HIV status he ignored the fact I was dehydrated but found the time to give me HIV 101 lessons. In my delirium I wanted to say I’ve had HIV longer than your medical profession but knew I was at their mercy.
In my delirium I had texted Joel who rushed down there. When he got there he had this shell-shocked look. I thought it was about my situation but it was more about passing the detectives who were standing outside the room of a guy who was shot. It was nice to have him help cure the loneliness but him being there had another unexpected benefit. Whereas my previous requests for service were unheeded, Joel simply made one request and like that the flood gates of comfort came rushing in. I have to add that Joel is white and I strongly believe that his race changed my level of service. In an instance the missing nurses and doctors suddenly came flooding, stumbling over each other with one of the attending nurses giving me movie star treatment. Instantly I was given a nice fluffy pillow along with a comfortable blanket and the side railings of my bed were raised to make a comfortable bed. I even was even bought Ginger Ale which didn't help me as I couldn't drink it but nonetheless it came with a package of services that was once denied.
Even Joel noticed the attentiveness and it was shocking to see the inequality. But sadly I think it’s the reality for many. Living with HIV and no health insurance is a scary thought. The good news was despite no coverage people were seeking care but receiving it in a piecemeal fashion. There are health programs like ADAP but even those programs are getting stretched with long waiting lists or hung up in current budget debates. It was sad knowing based on this small card in my wallet I had access to a regular physician, specialist and dare I say a less chaotic medical setting. The issue of health care is real and each day many including my brethren living with HIV are on the unbalanced side of accessible care. The emergency room was just a small sliver of that disparity. We may not want to vocalize it but there is a huge difference when you have health insurance.
They ended up not fixing the problem and I had to go to my private hospital and the service was like night and day. I was seen in a timely fashion, received an IV for my inability to drink water and a team of doctors removed the piece of steak. I was able to get that type of service because I had health insurance. My little episode showed how important it is to lend my voice to the fight for affordable and quality health care for all. And for that nurse who referred me to YouTube, in case you are reading this, I reported you so hopefully you will be talked to and sadly it may be business as usual.