The Circus That Is Healthcare
by
K. Michael Williams
On March 23, 2023, ya boy got hit by a car. Less than a block from his house. Some kid racing to get who knows where. Going too fast for a left turn in the dark.
The headlights barrel toward me. In hindsight, I can’t understand why I didn’t pull a Rockford or Starsky. You know, dive out the way, tuck and roll, land in a dramatic Spidey crouch. Adrenaline-pumping music in the background. But I don’t. I glare dumbly as the engine bears down on me, like the proverbial deer or possum.
The impact itself didn’t hurt. And that’s not a vague recollection. I clearly remember landing on the hood and simply falling off. No pain. It was hitting the street that left a lasting impression. The screaming starts immediately. I’m talking about an anguished virginal soul suddenly entrapped in the dank pits of Hell Agony. I’d be surprised if my wails weren’t heard for miles. And I couldn’t stop. And wouldn’t. For hours. The depth of vocally announcing my pain tapered off, but not the grief clutching every fiber of my right side, flushing the anguish through my mouth.
The impact itself didn’t hurt. And that’s not a vague recollection. I clearly remember landing on the hood and simply falling off. No pain. It was hitting the street that left a lasting impression. The screaming starts immediately.
*****
In emergency situations, responders take you to the nearest hospital, which, in this case, was Jamaica. Jamaica Hospital. Dare I say its reputation among the general public isn’t what you want to hear when looking for healthcare? I’d visited before for family emergencies. But I had no idea…
*****
I go into the ER screaming. Any movement gives my entire body a reason to belch with grief, but overall, the agony centers around my midsection, specifically the right side.
I lay on a stretcher for hours before the staff chooses to investigate. C-scans and X-rays. MRIs. Nothing appears to be out of place. They don’t understand why I’m in so much pain.
What irks me from the start is different staff members asking for my name and date of birth. Not necessarily unusual in these situations. They need to make sure they’re treating the right individual, right? Except, for some reason, they keep giving me the wrong birth date. Whenever I give them my correct birth info, I get puzzled looks. Apparently, whoever did my paperwork put in the wrong date and no matter how many times I correct the info, no one bothers to put it on record.
Now, because the tests couldn’t ascertain any precise problem, the doctors assume it’s just some sprain and I’m overexaggerating the condition. Despite excruciating pain, they want to send me home. I’m given a pair of crutches and told once I learn how to use them, ya boy’s homeward bound.
The crutches only make me dizzy, crushing me both emotionally and physically. Even slight movement is torture, yet the hospital insists I have to walk. They can’t discharge me if I’m not walking and, to their mind, there’s no reason why I couldn’t.
Add to that, a brotha hates hospitals, doctors, medicine, etc., and wants to get the fuck outta dodge. I struggle to comply. I spend hours trying to stand up, to use the crutches, to move my limbs, to walk on that hip. I do this with minimal help from staff.
During one of those tests, a radiologist asks, “You’re here for a fall?”
I give her a look. “No. I was hit by a car.”
She looks at me as if I slapped her across the face.
Eventually, a nurse watching me decides there has to be more to this. I assume she speaks to someone up the food chain. Whatever, someone’s convinced I probably need more tests. I’m sent back for a fresh round X-rays, more MRIs, and additional scans.
We should note that, by now, there’s a new shift on duty. I have to wonder if perhaps the new crew is a little more diligent.
During one of those tests, a radiologist asks, “You’re here for a fall?”
I give her a look. “No. I was hit by a car.”
She looks at me as if I slapped her across the face.
So, almost six hours after I go into the ER, hours after lying helpless on a stretcher while begging my right leg to stop whatever the hell it’s doing, the hospital determines I have a fractured pelvis.
More tests. Just to make sure, I guess.
Yes, I have a fractured pelvis and need surgery.
I’m not going home after all. I’m going under the knife.
My wife’s reaction?
The fuck you are!
As I said, this hospital doesn’t have the rep you want in a care facility and she hated — hated! — this place. And she’d be damned if these people were going to cut me open. She immediately gets on the phone and calls a hospital in Long Island that we both like. In my 60+ years, I’ve only had one hospital stay and it was at Long Island Jewish in New Hyde Park. And despite my reservations about the medical community, I like the place.
Reaching out to an LIJ rep, my wife asks for the procedures and requirements for getting me transferred. Simple enough. Jamaica Hospital has to call Long Island Jewish and make the arrangements.
Note at this point, still screaming in the ER, I have no idea my wife made this call.
Wait for it…
My smiling doctor comes to me with good news. All blonde and big teeth, she informs me I don’t need surgery after all. Curiously, while revealing this, she sardonically comments that my wife will love to hear that. Yet, at the same time, she seems blissfully unaware of how their flip-flopping on my condition might make someone wonder if these people know what the fuck they’re doing.
Now, remember, I’m still in tremendous pain. Yet, the doctor continues to beam with good news. We’re discharging you and sending you home. From her tone, sounds like I’d just won the lottery.
I call my wife. For some twisted reason, I do believe what I’m told is good news. Despite my immobility, I don’t want surgery. I don’t want to stay here. I want to believe I’m fine and can go home.
I call my wife with what I thought was the good news. Instead, she’s puzzled and annoyed. She doesn’t know what the hell’s going on. She asked for a transfer and supplied the hospital with the information they needed to initiate it. Instead, minutes after that call, the hospital announces I don’t need surgery and I’m going home. All in a ten-minute period. Nowhere near enough time to call another hospital and make transfer arrangements. No time at all to reverse their medical opinion and come tell me I don’t need surgery “after all.” The timeline’s too tight.
So, wifey and I put two and two together: someone, somewhere quickly decides if I wasn’t having the surgery at Jamaica, I’m outta here. It’s the only logical reason why the hospital wouldn’t follow through on our request for the transfer and reverse their medical opinion in almost the same breath!
So, in no time at all, I’m back on crutches, climbing into my wife’s car for a painful trip home. Every bump and brake prompt choking pain. I still haven’t been trained in the proper use of crutches. Every step I take is agonizing. Plus, I’ve been discharged with no medical counsel for what needs to be done to get better. Rest? Exercise? Follow-up? Not one word.
No meds. Nothing to alleviate the pain. The hospital claims to have sent prescriptions to my local pharmacy. I spend the next 48 hours going back and forth with Jamaica about this. They keep insisting my meds are ready. My pharmacy insists they never received the order. I finally get relief three days after discharge. I have not slept in all that time.
The Sunday after discharge I no longer pretend I can tolerate the pain and that everything will be alright if I keep a stiff upper chin. My wife has urged me to go to another hospital since before I left Jamacia. I finally agree. We drive to Long Island Jewish.
When we get to LIJ, we drive around to the emergency entrance. A nurse meets us as I strain every fiber of my being to get on the crutches. I barely make it two steps as the nurse approaches us.
“What’s wrong?” the nurse asks.
I tell her I got hit by a car and have a fractured pelvis.
The next words to come out of that woman’s mouth tells me coming to LIJ is the right move.
“What’re you doing on crutches? You’re not supposed to be on your feet at all. Get back in the car and I’ll send out a stretcher.”
*****
I spent five days at LIJ. I get the procedure to correct the fracture. I get physical therapy to get me started while my doctors put together a plan for further PT and supervision at home. There’s still pain, but it’s greatly reduced. I have my meds.
Even the hospital food’s outstanding!
*****
Let’s face it, only the rich can truly afford reliable healthcare. As with all things, the less you have the more likely you’ll be subjected to inadequate services. I’m not saying you can’t depend on good healthcare wherever you go. I’m attesting that whether you need a good doctor or want a five-star dinner, what’s in your wallet impacts the results.
The disparity in healthcare opportunities is frightening, especially for the poor, people of color, and the disadvantaged.
Our healthcare system is a testament to unfairness. It’s expensive, complicated, and dysfunctional. The system consists of maddening health insurance plans that create obstacles at every turn. The rule of thumb is not highest quality but lowest costs. This country spends billions more on healthcare compared to other high-income nations, yet we score poorly on crucial health issues like preventable hospital admissions, maternal mortality, and life expectancy.
For many individuals, accepting a Jamacia Hospital is akin to being incarcerated. Like those behind the wall, many, unable to go anywhere else, find themselves accepting the unacceptable when it comes to their health with the only alternative being no treatment at all.
The disparity in healthcare opportunities is frightening, especially for the poor, people of color, and the disadvantaged. Health insurer policies and protocols are designed to manage costs, not ensure appropriate care. I can remember a day when a newborn and their mother might stay in the hospital for a few days. But when my first two children were born, seeing no complications, mother and child were sent home the day after birth.
Studies show insurers handcuff the medical community. They deny the best prescriptions, approving cheaper medication and treatments. That contributes to over 90% of care delays and has led to patients abandoning suggested treatment.
While I do believe all this played a factor in the treatment received at Jamaica, I don’t believe that’s what’s completely wrong with the facility. That place has implemented a series of policies and a lack of empathy that’s influenced an attitude toward treatment, patients, and getting the job done sufficiently. It includes choosing to send a patient home while ignoring their condition.
*****
There’s one final note I want you to consider. Nature versus nurture. Yes, we can argue how diverse the healthcare industry can be based on factors like wealth, societal status, insurance, and politics. All of it will be true. But I’d like you to take into account the following:
I was treated at completely different hospitals in completely different regions in the same one-week period for the same condition. One of those facilities was in the hood. One was not in the hood. One provided unsatisfying, compassionless treatment. The other filled ya boy with confidence that he was in the best of hands and could look forward to a better future.
And I used the same insurance for both.
*****
I have a long recovery ahead of me. At least three or four months. But, after a rough start and thanks to the care and attention of the right medical team, I’m focused on getting better.
K. Michael Williams is in many ways a founding member of the Re/Creation experience which began on Rikers Island in 2017. He is a freelance ghostwriter, an advocate for social justice reform, and Re/Creation’s editor. He enjoys his privacy while striving to be an engaging member of his community. He's a grandfather and lover of movies of the undead. He’s also a couch potato and loves reading, music, and all things pop culture as long as it’s from the 1970s or earlier.
