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By Nick Kipley
The mentally disabled man sitting in the wheelchair pukes into hospital-issue green-plastic vomit bag held open at spittoon-width by a green-plastic ring and his mother pats him on the back. From elsewhere in the waiting room comes a phlegmy hacking bout. An old woman who looks so jaded and sick and old that she could be the main character in a Greek myth, clutches her own hospital-issue green-plastic vomit bag-which is empty (for now).
There are 43 people, give or take, in the waiting room of Citrus Valley Medical Center’s Queen Of The Valley Campus, at 11:45pm, on the last night that the Affordable Healthcare Act-Obama Care-is open for enrolment.
The Waiting Room is ‘C’, shaped, with the admissions counter and its Plexiglas barrier skirting the outside of the ‘C’ and a subdivided nodule housing the bathrooms contained within a smaller, enclosed ‘c’. Cc: with the Waiting room comprising the cul-de-sac of space between the C’s.
Filling every available square foot of non-counter space are rows of chairs facing each other so that everyone in their side of the ‘C’ can see everyone else in that side, as well as their side’s own prominently-displayed, forty-inch, flat screen T.V. The flat screens are either playing late news or the History Channel and their presence in their respective branch of the ‘C’ is omnipresent.
Queen of the Valley’s Emergency Department is not allowed to deny any patient treatment and cannot legally give out better care to one patient over another dependent upon their health insurance plan (or lack thereof). The attendant working behind the counter-who didn’t want to be named-said that patient care in the ER is given out in terms of extremity. If you come in with a bad stomach ailment and sit for a full six hours before some random dude who hobbles in off the street, screaming, in his tibia and fibula protruding from the end of a bloodstained and shredded pant leg, guess who gets to see the doctor first?
As it should be. In London a few years ago, the National Health Service (NHS) ran a series of laconically English posters describing a fictitious youth named, “Joe.” In one poster, Joe was sitting patiently in Accident & Emergency (A&E is ‘English’ English for what Americans call “the ER”) suffering silently from a knife-wound to the gut. The caption read something like: “A&E: Do you really need it? Don’t be the one to hold up Joe.”
Which, in the U.S., would be lawsuit city for any number of your Gloria Allred type figures. Which, to be fair, is a really dumb mentality we’ve cultivated as a nation. But this entitlement is not-and here’s the big theory-designated to one single socio/economic class: it stems from a group of people whose sense of entitlement and self-worth is so gigantic that it has come to affect every social interaction today. And I’m not talking about the generation of people born in the 1980’s. You can leave them out of this (for now). According to current policy, since that generation is mostly in debt and isn’t buying houses their political capital is effectively nil. No, this isn’t a commentary about people born in the 1980’s, this is a piece discussing the generation who MADE the 1980’s.
This idea of instant-gratification was manufactured by the same people who call people on welfare lazy and think that billionaires with stock options should get bonuses when they first inflate the economy, and then ignite it like a flaming zeppelin with their ubiquitous cigar-end. But in order to arrive at that logic you need to be willing to reward “risk takers” because the future is totally impossible to conceive.
That is to say: our country’s current cultural and political ethos seems to stem from a political rhetoric/series of mass-media institutions designed to instill overwhelming fear that tomorrow might not arrive, so that today we must live as ravenously as possible.
And this is fair enough, given the people in power were told at the age of approximately six, that at literally any given second at any time-day or night-everything could get vaporized in a cataclysmic mushroom cloud. So it makes sense to that end: why put off tomorrow what you can spend money on today? Why not experiment with mind-blowing psychedelics and orgiastic sexual free-for all’s when tomorrow we could all be a series of green-glowing skeletons lying strewn about in a surreally vacant landscape where not even weeds can grow?
But, to be fair, that’s literally how life (and death) works FOR EVERYONE.
We’re all just one genetically-eroded blood vessel away from a ruptured aorta or mind-wiping brain hemorrhage.
But does that mean we should do everything in our current power to live life to the absolute fullest at all times? Of course not. Choosing to do that would be horrifyingly reckless. Plus, if you live “life to the fullest” then, doesn’t eventually that “fullest” just become “life?” In order words: could this be the root cause why certain people admonish Ronald Reagan for all his alleged ‘accomplishments?’
Could it be that many current politicians-regardless on what side of the aisle their loyalties lie-liked Ronald Reagan (or at least the 1980’s) not because of the short-term economic stability that came with the era, but because maybe these politicians were-at that point in their lives-relatively young and optimistic and able to live their lives to the absolute (economic) fullest?
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And could it maybe be that by their mis-construction of such memories about the days when they were young, that some people in ruling administration see Regan-style tax breaks not as something detrimental for the country’s long-term economic success, but as a way that will make everything easygoing and comfortable again?
Which begs the question: is a lot of current policy just the midlife crisis of the Baby Boomers?
But instead of dying their hair or buying say, a speedboat or something, these people in the ruling administration are eroding the future generation’s ability to compete in the first truly global economy because they want to relive a time when Learjets were novel, and being able to afford a cell phone meant that you were actually somebody?
Anyways. These are the thoughts that seem to come out of nowhere after watching an hour of late news on the forty-inch in The Waiting Room of Queen of The Valley’s ER. In the chairs in each section of the ‘C’ there are approximately three or four concerned adults-some seated some standing-rocking and patting a bundle of cartoon colored blankets. The universal sign for: “Sick kid.”
At 12:30pm, a woman sitting adjacent to the admissions counter holds her stomach and sits doubled over in pain. Her teenage daughter carefully drinks a fluorescent green soda in a way that avoids her mouth-piercings. When asked, the woman-who does not give her name-says that she’s in for “Gallbladder trouble.” Which sounds serious. Does she need medication for this condition? “Yeah. But spicy foods-you know like chili and hot sauce-‘activates’ it.” She claims that she only comes to the ER, “when she really needs to,” and has been sitting for three hours now, “It’s horrible. I’ve been here since 9. People keep going ahead of me.”
It’s easy, at One-AM, to be oversimplistic and to begin casting blame for the very existence of this fluorescent purgatory. The lighting itself has the effect of distending a single moment for hours. The clocks seem to run in reverse, the news isn’t news, and the reruns on the History Channel are the only thing that really mark the passage of time.
So, while sitting in The Waiting Room the patients think-over and over again-about why they’re here and get frustrated that this is the only option. In people’s faces you can see a hard sort of reasoning occurring that explodes into a list of grievances the moment they are asked: “So, what brings you here?”
The sick kid, the hospital issue vomit bag, the unseen gall bladder all promulgate hugely opinionated tirades depending upon how long the person has been sitting there for, and for what. As the hours pass, this reasoning hardens: it bakes into a full-fledged opinion that dovetails with wider-ranging political notions and bigger interconnected reasons that spur spontaneous conversation for the pure catharsis that such conversation can bring.
Of these notions, which are distended through long rambling conversations in which the people participating glance back and forth between who they are talking to and an old episode of ‘Duck Dynasty’ there are usually four points.
First of all, there is no other way to alleviate how uncomfortable everything is.
Secondly, the notion that “Everyone is equal, unless they are so wounded that they literally have to be rushed into care,” is rapidly dispelled by more upper-middle-class-looking citizens strolling right-through the process.
Third, a variation on one of the following themes is mentioned which, in no particular order, leads to a variation on one of the concurrent themes: the nurses and other healthcare professionals are overpaid and don’t really care for their patients… some of these people really aren’t that sick and are just faking it… someone should do something about people who abuse this system… Greedy Politicans who cut services in order to line their own pockets are the ones responsible for this… All the “Big People” are greedy, how do you think they got so big?… this is what socialism would look like… Europe has free healthcare… if I knew that my taxes would actually go to fixing something I wouldn’t mind, but you can’t trust those people… everything is already so broken but who wants to fix it?…
Back and forth these little thoughts float until they are freed by a commercial break. Then they go freely, back and forth, like the unseen pendulum of that huge invisible clock stealing away everyone’s life in this godawful room.
Until, finally, the fourth notion occurs: someone says something that genuinely makes the side of their ‘C’ laugh. The Waiting Room in an ER demonstrates the very simple notion that people bond through humor, and that humor-organic, real, natural humor-doesn’t stem from forty-inch digital images of Rednecks stomping through swamps, or a barrage of clever alcohol commercials, but from a group’s acceptance of uncomfortable truth’s that arise from physical discomfort.
To put it very simply, when you force a room full of sunny Southern Californians with stomach aliments and broken bones into a public space where there is effectively no escape, they start to act a little bit like any New Yorker you bump into on a pleasant summer’s day in a public park. I don’t know if that says something about your average Southern Californian’s lack of capacity for physical unease, or that if it really glues down the stereotype that New Yorkers are thick skinned and somewhat hilariously pushy-either way, let the record show that this reporter has only been to New York City twice, and was born and raised in San Bernardino County so maybe the entire point is moot. Whatever.
The lighting in the room seems to brighten in a warm way with this laughter; the harshness of the fluorescence is dulled. But then, to the twang of banjo music, all smiles gradually melt and all eyes drift back towards the bearded rednecks and their fanboats and crawdad traps.
The man in the wheelchair vomits into his bag again. A few people get up and move to the other arm of the “C.”
And once on that side, it is conceivable that the questions start again: how many are faking it?… who here is really sick?… the kids are sick, that’s for sure, and they guy in the wheelchair is violently ill but who else?… that woman complaining about her gallbladder sounded serious but she’s just sitting there looking at her phone now as though she’s waiting for a bus… the room smells like puke… that kid must have a fever, he’s all red… is her gallbladder as serious as that infant? Less serious? More serious than the mentally disabled man now painfully dry heaving into the bag, or less?
The chairs are positioned so there’s no way to comfortably lie down. It is One AM, now, and Duck Dynasty has given way to a knockoff show called, “Appalachian Outlaws.” Beneath the forty-inch flatscreen now displaying images of the Outlaw creeping around an abandoned barn with his turkey gun in search of, “gobblers to kilt,” sits a Mother her Daughter.
The Mother says she is willing to go by, “Tisha,” but does not give her Daughter’s name. And in retrospective pondering has decided that the reason as to why people refuse to give their names in a hospital waiting room is because when one is ill or has been sitting for hours in an uncomfortable situation, the last thing one wants to do is say something compromising of one’s character that is solely a byproduct of fatigue or nausea or pain or all three. Besides, on a more basic, human, level: who wants their name in the paper as, “the guy who kept puking into the plastic bag?” when talking to a reporter whose line of questioning includes, “So what do you think of the ObamaCare website?” Nobody, that’s who. Tisha’s daughter is about twelve and is listening to whatever musician that tinny sound coming out of her earbuds is, and looks bored with her surroundings yet simultaneously overwhelmed by everything: pulling a face that most adults learn how to conceal by the time they have to enter the workforce. Her eyes slightly red but she would not dare to cry in public.
“It goes by severity,” Tisha says, “you wait three or four hours up here, and then they take you back and you wait three or four hours back there. She was sick with the flu two weeks ago, and tonight her stomach hurt so bad that she couldn’t stop crying. I said, you know, do you really need to go to emergency? But she insisted.”
Tisha said that she had considered leaving but was afraid that the hospital would bill her insurance regardless of the amount of time she’d spent sitting, waiting for nothing.
“They take you in by how severe it is,” Tisha repeated, “they tell you you got six people ahead of you, but that keeps getting bumped up. We’ve had one person ahead of us for the last hour and people keep going back to be seen.”
The woman seated across from Tisha-who is willing to go by the name Maria for this article was also sitting with her daughter-adds, “One kid was here two hours ago and he was crying and crying and wouldn’t stop. For two hours he was crying and crying like a little baby and they wouldn’t even give him anything [for the pain]. He was fourteen years old.”
“And they charge you the price of a five-star hotel,” Tisha adds, “Except in a five-star you get treated like royalty. Here you get treated like crap.”
Maria nods solemnly, “And someone dies here,” she says, gesturing to the general area, “It was my son’s friend. He got caught with some drugs so he swallowed them. He came in here, told them what happened and they told him, ‘go sit, go sit,’ and he had an overdose. Died right here.”
“My girlfriend had a miscarriage right in that bathroom,” says Tisha, “She came in and she was bleeding. I was with her. She had already lost three babies so she was sensitive about it so I brought her here. They made us sit. But then,” Tisha says, gesturing in the same manner as Maria but towards the women’s restroom, “we went in there and it [the fetus] came out. And I took it [the stillbirth] in a napkin and went [up to the receptionist] and said ‘Look. She just had a miscarriage and she’s in the bathroom crying.'”
This immediately fires up the circle of conversation again, but after a few minutes Appalachian Outlaws ends and an incredibly noisy infomercial that you would only find after hours on the History Channel comes on.
On screen, a guy in a polo shirt is trying to sell the room a sleeve of 2015 American Silver Eagle silver coins, or a 1oz. silver bar for the low, low, price of only $21.95. This deal is unheard of. These coins are straight from the U.S. Mint. He will send you the original sleeve bearing the signature of the U.S. Treasurer to prove it.
A mom and her young son enter the ER, walk up to the counter, and sign in. The kid has a strip of gauze wrapped around his head vertically, holding a cotton pad to the top of his chin by a knot in the gauze secured on the top of his head. He looks like an old-movie version of a person with a toothache. He is not crying or vomiting and is actually-despite the bandage-able to converse with his mother in that robotically-articulate yet mildly sing-song intonation that very young, moderately intelligent children use when talking to adults. His mom answers in inaudible monosyllables while nervously looking at the people seated in the chairs. Her gaze locks upon the mentally man sitting in the wheelchair whose green plastic puke bag now dangles slightly from his lap. She is well dressed for a mom at Two AM. Not ten minutes pass before they are whisked through the door.
Despite the noise of the nonstop infomercial, the conversation has been continuing this entire time. But, as though some huge and darkly funny force has confirmed something everyone’s known all along, the discussion it gets stuck in a morbid joke-loop centering around the concept: “How do they choose who gets to go back there first?”
On the wall, below the forty-inch is a metal plate with a single black circle in its center. A placard above the plate says, “To Change Channel Press Button.” The button in question has been forcibly pressed into the wall and is totally inaccessible. The black circle is a hole that appears to have been formed by someone trying to change the channel so hard that they physically broke a wall fixture.
This reporter was unable to take a photo of the audacious button, as the battery life on any modern cell phone only lasts for so long.
“That’s how long you’re here,” Trisha says, “Your phone dies.”
“I got a charger,” Maria’s daughter says.
“Well we might as well steal some electricity then,” says Maria.
Laughter, again, in this section of The Waiting Room.
After what feels like years of the mind-numbing sales pitch, a young expectant mother (who, of course, chose to remain nameless) stands up and storms up to the window dividing the clerical staff from the patients. She get’s a man’s attention and shouts: “Hey! Get up and change the f- T.V.!”
“Why don’t you do it?” the man says back, raising his voice enough to be heard through the glass, “the [channel] changer is on the side.”
“I’m five-months pregnant. I’m not getting up on a chair.”
This Reporter, in overhearing the conversation and not wanting to watch young pregnant woman fall out of an E.R. waiting room chair, stood up and immediately began canvassing channels with the “changer” on the side of the forty-inch flatscreen until the room unanimously agrees that the best show to watch is one that can objectively be called, “Standard Cop Drama,” at best.
The eyes in the Waiting Room drift up to the screen where a cop is chasing a guy through a Downtown L.A. parking garage yet this time, the screen isn’t enough to keep everyone’s attention for long.
“I came in an hour ago because I was having trouble breathing,” the young expectant mother says, “I haven’t even done triage yet. They haven’t checked my oxygen or anything. The first thing they say to me when I walk in is, ‘You got ten people ahead of you.’ Hello! I have asthma and I’m pregnant! I don’t know if my baby is getting enough oxygen. He says to me ‘Get up on that chair.’ What if I fall?” she snorts, “Well, I guess they’d make me pay for that too.”
When people in the emergency room talk about what ails them, a duel hierarchy is constructed. The people the sickest and the people who have been waiting the longest get to talk the loudest and air their grievances fully. They are supported by others. There is a genuine sense of compassion. The sick kids seem to trump one another based on how small they are. With the single, swaddled, newborn in The Waiting Room trumping everybody. The newborn is actual a one-month-old whose mom says his name is Ethan. He has been in the waiting room since eleven. His parents brought him in because he doesn’t yet know how to drink water and choked while trying to learn how to drink some. He is swaddled and sleeping peacefully. His mother holds him up to her face so that it’s conceivable that he can feel her breath. His father looks preternaturally tense and constantly scans the room.
Standard Cop Drama ends and on comes another infomercial. This one has a digital timer in the bottom right hand corner counting backwards from twenty-five minutes, down to the millisecond. This digital timer is designed to incentivize late night callers to pick up the phone [OPERATORS ARE STANDING BY!] and take advantage of this new anti-aging product made from the New Zealand spring water-scientifically proven to be the purest water in the world.
When the mentally disabled man lets loose again, this time not so much vomiting as it is a rattling yelp that escapes his throat followed by a horrible sloshing sound, the entire room stiffens up. The time on the infomercial’s countdown has barely reached the 23:58:00 mark but because of the overpowering odor, it feels like the presenter has been trying to peddle New Zealand water for centuries.
Ethan’s mom covers him with a big jacket and bounces him while Ethan’s dad stares with hopeless intensity at the stricken man. Another rattling yelp. Ethan’s mom buries herself under the jacket with her son and remains under even after the noises stop.
The disabled man raises his arms in surrender, holding the swinging bag; his mom stands up, takes the bag, and gives him a hug. Cradling his head and rocking back and forth as he reaches up from the wheelchair. When he pukes again, this time it spills down the front of his shirt. He is not vomiting food, but a white froth. The room stinks of bile and not a single person isn’t covering their nose after this.
The lighting in the room has been exactly the same since 11:00pm.
And this reporter would like to comment on how loud the crickets are, and how fresh the springtime air smells in the San Gabriel Valley as you cross a deserted parking lot for your car at 2:22AM
So going back to that English NHS poster and how all of this horror can be avoided. No government legislature is going to change the selfish mentality cultivated in the last half of the 20th century. No amount of posters or reform or tax breaks or spending boosts will change what essentially has constructed a mentality based around the maximization of immediate pleasure despite long terms risks or consequences. What needs to be undertaken by the generation born in the 1980’s is a radical reappraisal of what one has in mind when thinking of the word, “wealth.”
It’s not enough to fund hospitals in order to make them bigger and more efficient, this shift will have more to do with learning to establish the severity of one’s ailment in terms of establishing how annoying it might be for someone to deal with you.
If you know that you have a gallbladder problem for which you need to take medication; and you know that this problem is one that is ‘activated’ by spicy food; and knowing this, if you then eat spicy food, you really shouldn’t go to the emergency room. In essence: why should everyone in The Waiting Room have to structure a chunk of their life around one selfish individual whose quest to maximize pleasure for a short-term gain led to sitting them taking a chair in the ER for six hours on a Sunday night?
But then, maybe we should all begin to ask ourselves-as a nation-“Is the burrito (or whatever) worth it?”
What the generation born out of the Regan years is actually incredibly good at is that through the bondage of low-paying jobs and crippling student debt, they’ve come (for the most part) to begin separating Keynesian doctrine that claims individuals have the right to maximize “one’s right to unlimited consumption,” from John Locke’s ‘inalienable rights’ of “life, liberty, and property.”
Bounded by constraints not faced by prior generations, this generation is learning that by chasing happiness on a small, neighborly scale, they can begin to address any malady-be it social, monetary, or physical-as an informed community group who has to sacrifice only a little for the sake of benefitting the whole. So in the future, rather than face the horrible forced interactions of The Waiting Room, this generation might find an alternative.
Rather than be bounded in interaction by the horrifying constraints of History Channel reruns and the stench of vomit, they are learning how to work within one’s community to change things slowly but securely. If they come to realize this, they may actually begin participating in the democratic process. But until then-until this counterculture of organic growth and small-scale perfectionism can truly find a niche that cannot be immediately be snatched up by the corporate combine-harvester and spit out as cultural artifacts designed to be bought en mass-they remain jaded by the whole process, gazing listlessly upon screens between conversations. A self-imposed fugue.
Until the generation born of Reganomics gets fed up with the egocentric policies of the Me-Generation, they are very much like those in the Queen Of The Valley Campus of the Citrus Valley Medical Center: Waiting and Uncomfortable and fully aware of a secret hierarchy of need that favors some over others.