ER Wait, Illegal Aliens, and Units

As an older person, going to an ER room in Northern Virginia (NoVA) is an exercise in costly futility unless you are on death’s door or are prepared to wait for endless hours while younger people are being treated for colds, high fever, bleeding fingers and toes, and other accidents which occur in the exercise of our daily human lives.

Few Americans know or care that the Affordable Care Act of 2010 or Obamacare had labeled those over a certain age as “units.” If patients are young, they probably think themselves immortal - they would never get old, therefore such “unit” labeling does not apply to them. The stark realization hits you like a ton of bricks - you have become an older “unit” that can be ignored because government formulas deemed your utility to society too close to zero.

Most hospitals in northern Virginia post on electronic boards the number of minutes a patient must wait before they are triaged and/or seen in an ER. That may appear comforting and caring about one’s health and time until you actually set foot in the ER and reality replaces clever and deceptive advertising.

I had to go to our local NoVA ER this week. After the initial data and insurance screening, triage, and waiting for three hours to be placed in a room and to be seen, I decided to leave.

The waiting room, triaged by two people speaking English with heavy accents, kept getting more crowded with illegal aliens who did not speak English and required a translator in their respective dialects. Over and over I heard the question, “Do you speak English,” and calls made over the loudspeaker to a phone translator or to a hospital employee who spoke that language. It was a veritable tower of Babel.

I felt alone and lost in a sea of people with sick children who could have been seen quickly and much cheaper by a local Emergicare doctor, while my chest was hurting like hell and needed immediate attention.

It is sad that, after paying half of my income in taxes and being forced to purchase three medical insurance premiums, I cannot get medical care in my own country. Illegals flood the emergency rooms in northern Virginia. As human beings, they have a right to be treated too but must I pay for them and must my medical care become secondary and tertiary to their needs?

Thirty years ago there were no Emergicare facilities where we lived and ER wait was extensive in the small southern town. I had to wait once eight hours when my child had 104.5 F fever before we could see a doctor. In that case it was because of the shortage of doctors - nobody wanted to practice medicine in a small town.

Locals had to travel 100 miles or more to the nearest larger town in order to seek medical care.  People were really nice in the local ER then but my daughter could have had a seizure. I gave her liquid Motrin but the fever was not coming down. She needed an antibiotic shot right away. She eventually got it but I am saddened to this day when I think about the length of our wait and what could have happened in that time.

Going to an ER was a big deal back then as charges were huge and people actually had to pay them immediately or over time. Today Americans and illegals flock to ERs for convenience. They use emergency rooms as their GP doctor because they have no idea how much it cost to use emergency services, they don’t care, and someone else is paying for their visit.

While we pay medical bills of illegals from Mexico and Central America, consider the situation when an elderly American residing in Mexico, was taken to a private hospital in Guadalajara recently by her American son. Following a fall and arrival at the hospital, within 30 minutes, the only American patient got a CT scan, two X-rays, blood tests, and specialist doctors to read the results. The hospital did not accept Medicare Part A insurance. The admission fee alone was 90,000 pesos ($4,500). Because the test readings were within normal range, the son asked to have the IV removed and she was discharged. The IV removal took three hours. The son had to leave his passport "hostage" with the promise to pay on Monday when the banks opened. The actual medical bill was 12,200 pesos ($610).

According to the Associated Press, starting on January 1, 2019, “Medicare will require hospitals to post their standard prices online and make electronic records more readily available for patients.”

“Seema Verma, head of the Centers for Medicare and Medicaid Services, said the new requirement for online prices reflects the Trump administration’s ongoing efforts to encourage patients to become better-educated decision makers in their own care.” https://wjla.com/news/nation-world/medicare-will-require-hospitals-to-post-all-prices-online?fbclid=IwAR0ZhFVXxkyuRf64csFSMQV4x29X39xOJX0RFPjjqOWnSDeuapfe_JwQgkA

Americans should educate themselves before heading to the nearest ER, but what about all the illegal aliens who don’t speak English and who flood emergency rooms because they know medical care is free and is paid for by American taxpayers?

 

Visiting a Nursing Home, a Sobering Reality

 

Photo: Ileana Johnson 2016

Entering the nursing home, I never know what human drama peppered with dark comedy emerges. It is a life that most Americans turn their eyes and minds away from. The residents are the forgotten sick, disabled, recuperating, and old Americans about whom few dare to whisper. “This is where people go to die,” I was told by a very good friend. “I would never put my mom in such a place.” But this is where people live now and they want dignity and proper medical care delivered with humanity and patience.

It is bad enough that they cease to have an identity, they are reduced to a wing or room number. It is bad enough that they feel trapped and isolated as they no longer have the freedom to do things they’ve always enjoyed. It is bad enough that they spend most of the time alone because the families have long abandoned and forgotten them. It is bad enough that they realize their own mortality and understand that, when they leave, it will be because they’ve passed on. It is bad enough that no one takes them seriously anymore. They’ve lost their dignity as they are no longer able to feed, bathe, and wipe themselves. They depend on the kindness or meanness of someone else who is paid to care for them but often abuse or neglect them.

On the positive side, the residents get medical care, however slowly or quickly, three meals a day that they may not have gotten before; they befriend others in the same position in life, and are forced to participate in activities to stimulate their minds and social skills.

The smell of bodily fluids is overwhelming on most days, even for those used to it. Patients are showered twice a week, some screaming for help because they’ve been bathed last month and they don’t need it again. Some don’t speak English but scream and protest a shower anyway. In their third world countries, it is hard to find water and soap or indoor plumbing, so showers are rare.

There are never enough caretakers to handle the entire floor of patients and some are left to wallow in their feces and urine. It is difficult and time consuming to change diapers on someone who cannot move and many are left for 5-12 hours in beds entirely wet. Even babies scream bloody murder if they are not changed every two hours and are left with a wet diaper too long. Patients develop constant urinary tract infections from such neglect. One caretaker to five patients is not enough help. I don’t know what the margin of profit is for nursing homes but the large fees charged per patient should at least include keeping them clean and dry. It is not easy convincing a 160 pound person to cooperate – much harder than dealing with a 10 pound baby.

A few crafty patients escape through the elevators even though they are coded. One man was chased half way down the road on the side of a very busy highway. A woman was sitting on a bench outside, all dressed up, ready to go for an imaginary job interview. Another patient, who can still dial the phone, calls 911 regularly screaming for help; the police comes and stays outside for a while. It is hard to ignore calls of desperation even from a dementia patient. You never know when the call might be real.

Patients are transported to doctors and left there for hours. Nobody comes back on time to pick them up and some are forgotten. When they are discovered missing, a search ensues. A doctor’s office eventually calls a cab, the patient is delivered back to the nursing home and the nursing home refuses to pay the fare. Mary* suffered such an indignity recently when the cabby threw her wheelchair in disgust on the curb, potentially injuring the patient who was semi-mobile. She did not have the $11 to pay the fare.

There is an ombudsman listed on the wall if a patient needs help or is being abused but who is going to call them? Many patients have been abandoned there by their relatives who only show up once a year, usually around the holidays, to make sure their relatives don’t leave them out of the will.

Many patients are so alone, I’ve never seen anybody visit them in the two years I’ve gone by regularly. I advocate for better care for my mom, but most have nobody to make sure their relatives are properly treated and handled with care and respect.

But some staff members really do care, and it is heartbreaking for them to see their patients die - they are sad and shed tears. Encountering mortality and imagining the end of life for every human being is a very sobering experience. Nobody wants to ever live in such a place, they would rather die suddenly.

Jeremy* is the oldest resident, he has few family members left, his parents, who were his caretakers, have passed on long time ago. He still remembers his previous life and talks in halted speech about his mom’s pancakes.

Barbie* kept packing her bags to go home every day for a year and a half. She was sweet, wondering around other patients’ rooms, asking them if they knew when her daughter was coming to pick her up. She died one day when she stopped eating and drinking. She finally went home to heaven without her packed bags. Yesterday I saw her frilly favorite blanket and other personal possessions in a clear plastic bag in the hallway, waiting to be donated.

A Russian man talks constantly about his homeland, his garden, and his wife, especially how beautiful his town was. Nobody knows what he is saying except me. I hear his voice and my eyes tear up wondering how this man wound up in this particular nursing home, so far away from Russia.

The staff is far away from home too, they are mostly African and Asian transplants. Some speak English well, some don’t. Some are dedicated to their jobs, others could not care less. Those are the ones to watch because they are abusive physically, verbally, and neglectful.

They have coloring activities for people with severe dementia; those patients are kept behind locked doors in a wing sadly named Arcadia. The rest get to play bingo, have coffee socials, outings to Walmart, or a Christmas party and a collective monthly birthday party. Musicians are brought in once in a while to entertain those who still have their faculties but are suffering of other illnesses. A beautiful brown lab wonders the halls and enters certain rooms to let residents pet her. She is old herself, with a bad hip, slowly waddling in pain across the hard linoleum.

There is a beautiful Christmas tree in the lobby but most patients never get to see it as they are never ambulatory. Transport vans come and go, delivering the really sick patients on sudden visits to the ER. Some come back, some don’t.

When a new neighbor passes suddenly, the reality of a corpse behind a closed door across the hallway is a very sobering experience. There was once life there, screaming in pain, now it is silence. I am not sure if the soul has gone to heaven or it’s still hovering over the deceased’s bedridden body.

People screaming in pain become a daily reality. There is no medicine that could take their entire pain away. Such a cocktail of drugs would rob them entirely of their humanity and they would become comatose. Staff nurses can only do so much to alleviate their patients’ pain.

A nursing home visit should be a required part of American high school and college education. No matter how ugly, sad, or cheery, it is a reminder of where we all might wind up someday if we live long enough. It’s a vivid lesson about the frailty of human nature, a lesson that nobody should take their good health for granted, and we should behave decently and morally towards our fellow humans.

 

*Not their real names

My Dad Was Left to Die 25 Years Ago

My Daddy shortly before his untimely death

Today marks a quarter of a century since the passing of my Dad before his time. He did not die a natural death, it was an agonizing 30 days of deliberate starvation in the hospital and lack of medical care, lingering and clinging to life after one last beating by communist goons. They cracked his skull when they threw him in a pit of metal lathe shavings from a refinery’s scaffolding. It was not the first time he had been beaten for various reasons, but this time it was most cruel. The metal shavings caused tiny bleeding cuts all over his body as well.

Dad was a very honest man and hated all the theft and stealing that took place around him every day. He would not take one piece of anything from his job even if it was thrown in the trash. Everybody worked for the government for the same inadequate and “equal” salary. People stole from their jobs and traded (bartered) with other workers who also took materials or finished goods from their workplace in order to survive. Dad reported often such theft and the culprits would take their revenge when Dad least expected. Other times orders came from on high to teach him another lesson for having raised a child like me who chose to live in the freedom of capitalist America at that time over the exploitation and tyranny of communism. He never hid his anti-communist feelings and steadfastly refused to become a member of the Communist Party.

He was 61 years old and preparing to fly with exuberant anticipation to the United States to see his only child receive her doctoral diploma on May 13, 1989. In his excitement, he had packed a suitcase since January when the dreaded Securitatea (security police) notified him by phone that he had been cleared and a passport was forthcoming. Little did he know that even then, his passport and permission could still be revoked, which they did. He wrote and called a few times, at great expense, to ask me what to pack and what I wanted as a graduation gift.

I just wanted my Dad. I had not seen him in four years. Every time he applied for a passport, the communist handlers told him NO with impunity, calling him downtown to the precinct just to harass him. He had no fame or fortune, just enough money saved in the bank account for his burial. The commies had already confiscated everything when my mom defected to the United States after a three month visit. They punished him for her staying behind in the free America of 1980. For nine years we tried to bring him as well with no success. The communists left him with the clothes on his back and the rented, sparsely decorated, and tiny concrete block apartment on the fifth floor of Block A6 in which I spent part of my childhood. He had just retired and had received two months’ worth of his meager pay for which he had worked since he was 18 years old, 43 years of hard manual labor.

A phone call from my uncle shattered my happiness. I did not want to go to graduation anymore. I worked so hard for the degree but, at that moment, I only cared about my ailing dad. He clung to life for almost 30 days, spoon-fed water and clear soup by his sister Marcela, an angel sent from above. The hospital did not do much to ease his pain or make him better; they just gave him a terminal diagnosis and a bed in the ward where he spent his last days in a conscious but unable to speak much state. He shrank to 80 pounds in 30 days.

Such was the socialist medical care – rationed care for the masses and the best treatment and access for the communist elites. Dad needed a CT scan to save his life and state of the art medical care and drugs. There was only one CT scan machine available in the Communist Party hospital to which my Dad was not allowed access. He expired 30 days later, holding in his hand a wrinkled Easter Sunday photograph of me with his two granddaughters.

In physical therapy at the time, unable to travel 8,000 miles by plane to the hospital and to the funeral, I was devastated. The president of the university convinced me to at least attend Commencement Exercises. I reluctantly agreed only because my Dad would have wanted me to go and see my efforts through to the end.  Our President at the time, George Bush Sr. was going to hand out doctoral diplomas and shake my hand. He subsequently wrote to me a very lovely and caring letter of encouragement.

I pinned on my mortar board the phrase, “4 DAD,” in big, bold letters, and dedicated my degree to him. I would have never made it there had it not been for his loving care and encouragement to strive to be the best during my 18 years of growing up in our modest abode.  I think Dad was so proud, smiling from Heaven, and I felt his presence beside me. It was a beautiful and hot sunny day, not a cloud in the sky when I accepted my diploma with shaking hands and tears streaming down my cheeks.

I hope my Dad’s passing 25 years ago on May 12, 1989, a victim of Ceausescu’s totalitarian and brutal regime, and the death of 100 million other innocents who died at the hands of Bolsheviks, Stalinists, Maoists, Castroists, and other Marxist dictators, will serve as a wake-up call for all the misguided and misinformed Americans who believe the lies that communism is the answer to undeserved redistribution of wealth, non-existent "social justice," and "equality" by government fiat.

My first trip to the hospital

My husband and I drove to Tupelo in his grandfather's old beat up 1962 Chevrolet Impala. I learned how to drive in this car around the pastures on the farm in Woodland, terrorizing the stampeding cows. It was the color of puke green and the seats had seen better days, oozing rubber from every vinyl crack. It baked in the sun while Sterling went fishing. We were glad to have the old car, it was heavy, burned a quart of oil a week, but it always cranked and took us where we needed to go. I covered the seats with towels, to make it more comfortable to ride in. When we went to parties or church, people were too embarrassed to ride with us.

My in-laws had decided for me that I had to have my tonsils removed. I was scared to death since I've never been admitted to a hospital before and I did not know what to expect. I had heard horror stories under communist care and I saw the results of Romanian surgical skills hopping on crutches, deformed, maimed, or worse, in graves. I was frightened and I thought I was going to die.

I've always had issues with tonsil infections growing up. I was given so much Streptomycin, I am still surprised that I can see, hear, and smell. Moving to a totally different climate, a sub-tropical, extremely humid and hot, created challenges that my body was unable to fight off very well and exacerbated any symptom I've previously had. I was plagued by more infections and severe nose bleeds from allergies to plants and flowers unknown to my immune system.

Here we were going to Tupelo - I felt like going to the scaffold. I had asked my husband to buy me a meal at KFC, it was the only food that somewhat resembled the fried chicken I ate in Romania, and, if I was going to die, I wanted to have comfort food as my last meal. He refused, since surgical patients cannot eat and drink hours before surgery. Sam* was laughing all the way, having a good time at my expense.

We did have insurance, so they were going to kick us out of the hospital shortly after the procedure unless complications arose. Everything seemed like a luxury hotel. The friendliness of the admission personnel and staff in general was a sharp contrast to the insulting rudeness and carelessness of the Romanian medical corps. The bed was clean, comfortable, I did not have to bring my own sheets, I had my own room, nurses checked on me every so many minutes, the doctors were friendly, knowledgeable, did not reuse needles and bandages, I had my own bathroom in the room, I had a TV, and the walls had been freshly painted in a "cheerful" grey color. Even so, it beat the Romanian hospitals where layers of paint from World War II were still chipping everywhere, revealing water, rust, and blood stains. And the floor was a mosaic of dubious marks. Imagine that, a TV in my hospital room - I had to wait until twelfth grade in high school in order to have a black and white TV with two channels playing mostly communist propaganda. It was lunchtime, the aroma of cooked food was everywhere, and I thought, "great, they are bringing my last meal."

Slightly drowsy and feeling no pain, I thought I had died and went to heaven and I just did not know it yet. I gave my husband my last wishes before they put me to sleep, firmly believing that I would not wake up again as I was counting backwards from 10. I had written a good-bye letter to my parents. In typical independent young person fashion, I had not told them I was having surgery - I did not want them to worry unnecessarily - there was nothing they could have done since I was 8,000 miles away.

I woke up in the recovery room, fire in my throat, and I thought, "oh, I did not go to heaven, I must be in hell and it hurts so badly." There were some angelic faces in a bright light telling me to wake up, the surgery is over. I closed my eyes and wished it all to go away. I spied a beautiful bouquet of flowers next to my bed, sent by my friend Lois, and I really thought I had died. But every time I swallowed my saliva, a volcanic burn enveloped my throat. I asked for water and they brought me ice. I was shocked since I remembered my little cousin Rodica having the same surgery and being given hot tea. I was offered ice, ice cream, and slimy jello. Rodica was in misery for weeks, it was probably the hot tea causing her slow and painful recovery. I was pondering my demise from so much burning pain. Ice cream was truly a miraculous cure.

Romanians and Europeans in general have this fixation with cold drinks causing sore throats and stomach cramps. That is why everything served there is room temperature. Waiters give customers dirty looks if they ask for ice and bring demonstratively only a cube or two. A doctor performing a tonsillectomy there would never give ice or ice cream to a patient - not when I was growing up.

There were no complications and they sent me home the next day. I called my parents to tell them about my brief encounter with the American medical care. They were incredulous about my descriptions - they thought I was fantasizing and delirious from my surgery and describing an expensive hotel. Until my mom saw the inside of an American hospital with her own eyes, she never believed me. To this day, she says, American medicine is very advanced and futuristic, while socialized medical care standards in Romania are still fifty years behind.
*Not a real name