Learning About Our Need for a Full-Service Hospital the Hard Way
By Robert Widmann
I was getting ready for bed and had just sat down at the computer for a final check of my emails when I felt something come over me. I focused on the date and time on the screen for some reason. It was 11:29pm on January 31, 2017. I was getting dizzy. I stood up and wasn’t certain of my place in the room. I began to feel nauseous. On my way to the bathroom, I began to reach out for the walls to steady myself. I tried, but couldn’t throw up. I was thirsty and drank water, but on the way to the bedroom, I began to bump into doorways, walls, and furniture. I live alone and so this, I worried, could be serious. I thought that if I could lie down, I might feel better. Even in the darkness, I sensed the room spinning. I was not getting better; I was getting worse. Should I call 911? I tried to think. Meanwhile, I sensed a flutter in my chest. I’d had that before and had dealt with it over many years. My heart, the doctors told me, just skips a beat every so often. It was benign. But, now, the flutter seemed more insistent.
What to do? I live about 100 yards from the entrance to the Northwell Emergency Room. Could I walk there? I’d had a ride in a New York Fire Department emergency vehicle a few years ago. It would take them time to arrive and they would need to copy down information and then go through an assigned physical check out. I also recalled that the co-pay for the ride was $250. I decided that I wasn’t that sick! I would walk.
After dressing slowly, I descended two flights of stairs, holding on carefully to railings and walls. On the street, it was cold and, as I concentrated on each step, I realized that I was lurching, with one foot tending to drag. It was like walking while drunk.
At the Northwell Emergency Room Entrance, the guard waved me away. “You have to go around to the front entrance,” he said. It was another 50 yards. I just shook my head no. “I think I’m having a medical emergency,” I said. He then waved me in and helped me to a reception area where a pleasant young woman came up to us. I repeated, “I think I am having a medical emergency.” She nodded. “Have a seat,” she said brightly. “I’ll be right back to take your medical information.”
In about 15 minutes, I was whisked into a large bright room with a private toilet. After a few more minutes, the doctor on duty came by. She was quite serious and professional. I described my symptoms and, soon after, began a series of tests: I had my blood pressure checked; got hooked up to an electronic heart monitor, then an EKG; got a portable X-ray of my chest; and then had a CAT scan of my brain. After that, I had another EKG and my blood pressure taken yet again.
The doctor said that, while the picture wasn’t bad, it wasn’t good either. I had a heart rate of 46, a blood pressure reading of 230 something over 90, and was showing a phase 2 heart block. I needed to be under the care of a cardiologist. Since there was none on duty at Northwell at that time, she would have to ship me to a hospital with a cardiologist on duty and a room to which I could be admitted. She said that she had been checking but, so far, could not find a hospital with an available room.
“Admitted?” I said, “Why admitted?” “Oh, Mr. Widmann,” she said, “You are in fairly serious condition here and we cannot let you back out on the street without a pacemaker.”
“Pacemaker!” I said. It was all I could think to say. I was not only dizzy now, I was stunned. Also, my tongue was getting thicker and my mouth drier. They had attached a spike and I was getting, I supposed, the standard IV drip.
As in all emergency rooms, and I’ve been in more than a couple over my too many years, there comes a blizzard of doctors, technicians, and tests. Then, you are left alone with your drip bag, your electronic heart monitor beeping away, and your darkening thoughts. Just outside the door, young people in blue scrubs were passing time and laughing. I wondered if I were dying. Funny, dumb way to go, I thought.
It was getting close to 2:00am when I heard someone say my name. I’d heard that voice for most of an hour. It was my doctor and she’d been trying to locate a hospital room for me without success. She’d even called my PCP, Dr. Monte Peterson, and at 1:30am found him in his office! At work! He’d recommended that I be sent to Beth Israel because my medical information was fully plugged into the Mount Sinai/Beth Israel computer systems.
And so, at about 3:30am, I was trucked over to Beth Israel to await a hospital room and to be monitored by the on-duty cardiologist. This place was bigger, busier, less bright, and new. But here, again, the flurry of tests was conducted and then I was checked by the doctor on duty and the cardiologist. I would be admitted sometime in the morning. But morning came and there was still no bed upstairs. The nurse came around right after the doctors, but I forgot to ask her for water. That was a mistake.
I was stuck in the Beth Israel Emergency Room awaiting admission to the hospital proper. The strong overhead lights were left on and the heart monitor had an extra loud beep to it, preventing sleep. The spike was still irritating in my arm but no drip was attached now. In my discomfort and restlessness, a wire from the heart monitor broke loose and the damned thing began to emit a pulsing shriek. This went on for 10 minutes or so before someone came to remedy the situation. At around 6:00am, a wire got unattached again and again the device shrieked away, but nobody came to check on it. Finally, after sorting through the wires, I found where the wire had broken loose from the stuck-on metal nipple and re-attached it.
The wait for a room became an ordeal. I had one glass of water at Northwell at about 2:00am but none after that, so I was becoming very thirsty. At 8:00am, a flight of five cardiologists popped into the room—very professional, very sincere. All stethoscoped my chest, asked some probing questions, told me that I’d be seeing the head cardiologist later in the day, and said that they were still awaiting a room for me upstairs. But there was no nurse or nurse assistant to get me some water!
Technicians appeared, one after another, to carry on more testing—blood pressure, another EKG, and an echocardiogram. I asked the blood pressure technician for some water and he assured me that my nurse would come through in a few minutes. But, no nurse and no water. I thought that at lunchtime somebody would certainly show up with food and drink. But this was not to happen, either.
At about 12:30pm, I climbed out of the bed, dragging the monitor wires behind me and got part of the way to the door. I rasped out in a hoarse voice as hospital personnel in blue and green scrubs stepped past quickly, “Please, please, I need some water! Can somebody get me some water?” This was no joke. Finally, a young man in scrubs stopped at my door and promised to get a nurse. This is how I was able to get a glass of apple juice and a sandwich.
The afternoon dragged by. I had brought along a cellphone and a tablet, but both soon tapped out. I did succeed in dozing off, but the naps were interrupted by a series of cardiology residents and interns all wanting to know my symptoms and how they developed. I was assured that a pacemaker installation these days was a really simple procedure. Now that pacemakers were really small and flat, one would tuck in tidily right under the skin on my chest. In my dizziness and confusion, I forgot to ask them to send a nurse so I could get some water. Somebody would come by.
But nobody did. There was a sink in the room and I thought that if, worse comes to worst, I could get a drink out of the faucet using the paper cup from the juice.
Well, it did come to that point. Once again, I scrooched out of the bed with monitor wires trailing behind me, the electronic monitor screeching in protest. But when I tapped the red sensor at the base of the spigot, hot water came roaring out.
I tried to clear the fog and think about my condition. Was all of this due to my heart skipping an occasional beat? One pill I regularly take made me dizzy once when I had accidentally doubled up on it. Was that it? I had doubled up on the drug. I took this pill before I went to bed. I must have doubled up on it. But it should be wearing off soon. Hmmm.
It was getting to be the late afternoon. I had now been in two emergency rooms for about 15 hours, 13 of which had been at Beth Israel awaiting admission. But admission required a room and this had not happened in those 13 hours. In my time at Beth Israel, I’d had one glass of juice and a turkey roll sandwich. I was getting angry. Where was the nursing? Where was the personal care?
I don’t know which doctor it was who popped in just before 6:00pm, but my frustration had built to the point where I just had to unload, to vent. Sorry about that, doctor. I told him I had to get out of there, that “this has been a terrible experience,” that I couldn’t take it any longer, and so forth. No foul language. I try not to use it. I tried to convince him that the dizziness, the nausea, and the dry mouth were THE issues, not the skipped beats. This doctor agreed to start the discharge process if that was what I really wanted, but warned that it could be very dangerous to make such a decision against the advice of hospital staff.
About 20 minutes later, three doctors showed up and I explained why I wanted to leave. I gave them my theory. They did not disagree, though they were highly dubious and warned against leaving. I insisted.
When this group left and the fog began to clear a bit, I remembered a time long, long ago, when I was a younger man. I had been dancing in the sun to a big band, a swing band, and my mouth had dried and my tongue felt thick. I got dizzy and then nauseous. When I reached the fountain and drank and drank and drank, I began to feel better despite disparaging remarks coming from the line building up behind. I was dehydrated, then and now. I was sure of it.
When a technician popped into the room pushing the blood pressure cuff on wheels, he announced, “I’m here to make a test.” I didn’t shout at him, but almost. I let him know very certainly that I didn’t need another test; I needed water! He left the room fast. Meanwhile, the first doctor reappeared mercifully carrying a beautiful container of water. I’m sure that medical advice on dehydration advises one to drink slowly and over a period of time. But I drank fast. And lo! The technician re-appeared with two containers of water. Beautiful, delicious water! I had finished up most of those when two other doctors appeared, or maybe these were two of the three previous doctors. In my state, who knew?
I began to feel better. In 15 minutes, I was signing the papers, asserting my demand for discharge and absolving hospital and staff of any fault therefore. They pulled out the plugs, tore off most of the stick-on electrodes, and took out the spike. I was on my way out at about 6:30pm. I walked down to 14th Street, took the crosstown bus to 8th Avenue and, in a few minutes, I was home where I drank lots more water. It was over.
Since the above experience, I have followed up with an excellent Beth Israel cardiologist and, upon her recommendation, returned to Beth Israel for a stress test. So far so good. The skipped heartbeat is indeed benign.
Don’t try this stunt in your local medical facility.
Cost to the government: an estimated $20,000.