Red sign that says "Emergency" with an arrow on it, and some tree branches next to it.

Photo credit: SEIU

Hey everyone! Glad to be back. I’ve been out for a few of days because I’m recovering from surgery, and the road to where I am today in terms of my health has been a bit bumpy.  Bumpy in ways that reveal the cracks in our health care system, and the systematic denial of quality care to marginalized groups of people.  Let me tell you all about it.

A couple of weeks ago, I was getting ready to go to work when I found myself in some pain.  I was dressed and ready to go, but I decided that I had to lie down for a bit.  Soon, the pain became so bad that I decided it was probably a good idea to go to the emergency room, so I took a cab over to a hospital a few blocks from where I live in Brooklyn.  I checked in, and once they asked me what it was that I was feeling, they quickly admitted me, saying that they had to rule out appendicitis.

I spent one of the worst thirteen hours in recent memory in that ER.  I was in a lot of pain – throwing up from the pain, in fact – but that was not the worst part. So here I am, in the ER, bawling from the pain, vomiting.  A nurse yells at me not to throw up on the floor (what I was supposed to do: unclear).  Another nurse is trying to put an IV in me, while a guy from administration is asking for all my personal information and insurance information at this most convenient of times.   He asks the name of my emergency contact, and I give the name of my girlfriend, who is with me.  When he asks what my relationship to her is, she is briefly silent, trying to assess the cost of the truth at this moment.  “She’s my partner!” I say.  Veda sees him write “friend.”  Shortly afterward, they make her leave.

After some morphine calmed down my pain a bit, I got a CT scan.  A couple hours later the doctors said I had some “masses in my abdomen,” and that they needed to give me a sonogram.  A while after the sonogram, a doctor told me that I had some “very large masses” in my ovaries, and that I would have to stay overnight.  I started to cry, and the doctor walked away.

Once I composed myself and had some time to talk with my partner (who they were only letting in to be with me for fifteen minutes at a time, once an hour), I got into question mode.  What are they going to do to me overnight?  Why do I have to stay?  What do you mean by “masses”?  Do I have cancer? What’s going on?  Why haven’t they told me any of this?

It took a couple of hours of bugging nurses and people ignoring me to get a doctor to talk to me to answer the questions I had.  By the time I finally got someone, the doctor that had been in charge of my care had left, and some other, random (as far as I could tell) doctor came to me.  I asked him to explain what exactly was going on with me, because at this point, ten hours later, nobody had done so.  This doctor was very short with me, and used complex medical jargon to describe my situation, a lot of which went over my head.  I asked him why I had to stay overnight.  “It’s easier for us that way,” he responded.

This, I think, is a good point at which I can check my privileges in this situation.  I have health insurance, meaning that I will not owe thousands of dollars for a day in which I was humiliated over and over.  My employer offers paid sick time, meaning that I will still be able to make rent this month despite all the time I’ve had to take off, and that I will have a job to return to when I am done recovering.  I am a cisgender woman; a complication with my ovaries would have gone down quite differently if I were gender non-conforming or trans.  I have educational privilege, and am particularly knowledgeable in reproductive health, meaning that I had some grasp on what questions I could even ask of my doctor.  I am able-bodied.  I’m light-skinned. But even through this thick layer of privilege, the gaping cracks in our medical system are very visible.

The staff was short, unaccommodating, and downright mean at times, but I don’t suspect that this was because they were bad people.  The ER I went to is located in a low-income community of color – nearly 36% of people in my community board receive some form of public assistance, and over 30% are immigrants.  Health care is a business in this country, and those that can’t afford insurance are simply out of luck, and have to go get their primary care needs taken care of in emergency rooms.   I was in an emergency room that was full of people who were either ill with something that a primary care doctor could have taken care of had they had access to one, or something that had become an emergency because it was not taken care of earlier.  This is what happens when health care is something people have to buy into: as long as people have to pay, there will be people who are not able to afford it.  And the people that cannot afford it: they are not random. The uninsured in this country are disproportionately poor, disproportionately people of color, disproportionately immigrants and non-English speakers.  So really, it’s no surprise that an emergency room in my neighborhood is overcrowded, and that the staff there are overworked, underpaid, and moody.

A single-payer health care system would ease the weight placed on emergency rooms by ensuring that everyone could go to a primary care doctor – or any doctor – as soon as they need one.  In almost any other industrialized nation, I could have given the hospital my name and my medical records would have been available electronically, avoiding asking me about payment information and contacts at the same time as I was vomiting from pain and getting an IV inserted. But instead we have a fragmented, privatized health care system in which profit, instead of health, is first.  It’s a damn shame.

I ended up running away from the hospital that night, actually.  After two hours of trying to leave the legit way, I put my clothes on, took out my IV, and left.  The hospital security guards ended up catching me and making me go back, but after that I was out in five minutes.  But the only reason I did this is because I knew I could call my own doctors in the morning.  After much wrangling with the hospital to fax my records to my physician the next morning, I learned more about what had happened to me the previous day in a two-minute conversation with her than I had the entire day at the ER.  You see, the doctors I had seen the previous day did not see it fit to let me in on what was happening with me; instead of letting me make decisions about my body based on their advice, they were making all the decisions, despite the fact that I was completely conscious and capable. Though some medical schools are making strides at addressing the problematic power dynamic between physicians and patients, the ER physicians were clearly not in on that discussion, and it made me feel powerless and vulnerable.  The fact that the physicians at the ER were dodgy about answering my questions and involving me in the decision-making around my health is seriously fucked up, but it’s sadly typical as well; it’s a story I’ve heard many times, almost always coming from women, almost always having to do with sexual and reproductive health.

Now I am recovering from surgery, which was performed by a doctor I trust at a great hospital. I came out pretty lucky out of all of this, but my mind is on those who aren’t so lucky in this game.  Health care reform will change some things, sure, but our health care system remains a for-profit business model, a model that is fundamentally flawed.  There are some pretty wide cracks in there, and, as usual, the persons falling through them will not be random.  When will we learn?