New York Cares

Loam Disher Issue: Section:

“I always imagined entering Bellevue in a
straight jacket but instead it was on crutches”

Application of Stress
The bare fixture in the corner shed the only light in the sterile smelling chamber and I could just make out the nervous look on the technician's face as he scurried out of sight, leaving me alone on the cold table.
I could hear sinister footsteps nearing, slowly. Then they stopped and two large hands grabbed my injured right foot. Before I could roll away or even scream the man twisted my broken foot as far as it would go, causing my body to buck, eyes water and a deep groan to escape somewhere in my neck.
“What the f..........” Determined to not let anyone ever hurt me that way again I tried to kick the sadistic pig with my good leg only to find air. He was gone. I quickly searched the room for a way out and just as I was lowering myself off the table preparing for the long hop the worried technician returned, a slight look of relief replacing his earlier trepidation. I raised my crutch to defend myself against further assault.
“Sorry about that sir, I just take the pictures, I promise” he apologized.
“You said it would only hurt a little? That was the most painful thing anyone has ever done to me!”
“If I told you the truth you would have run...er... well,  crutched out of here” he continued, removing the lead mat from my lap. “They have to make sure its broken.”
“Well it’s definitely broken now. That was torture!”
“Wait til you get the bill” he said shaking his head as if to say "why did I ever take this job?"

The Scene of the Crime
I heard a crack. Or a pop but more a crack and with it went my balance replaced with paralytic pain. The elation of moments before, running in my park with friends and my youngest son, a post world cup pick up game to die for. Or, as the case turned out, to be crippled for. As my brain took in the information that my foot was well and truly fucked all I could think of was my wife. How could I tell her? We had a deal that I wouldn't do anything stupid and this was as stupid as stupid gets. It isn't that my wife doesn't like my stupid side, (in fact I think its one of her attractions to me), or that she finds soccer stupid. On the contrary, her coo's to the studs of world futbol were part of my motivation to hit the pitch with such vigor.  No, it’s that we can't afford my stupidity. We don't have health insurance. And I'm in a heap in Tompkins Square Park unable to stand, with my little boy staring at me, his crushed look matching my deflating emotions. What now?
Sitting on the bench with my swollen ankle elevated as the game slowly resumed I had a moment to take inventory. Softball on Thursday- out of the question. Most likely for the season. Rehearsal across town tomorrow night-doubtful. Possible job at the end of the week-unimaginable. Driving family upstate on Saturday morning - to early to tell. Getting the 4 blocks home and up 3 stories of tenement steps was mountain enough. Never once did the emergency room enter my thoughts.
Living without health insurance immediately adjusts the way you react to an injury. The mental rolodex scrolls through people who might be able to help.
Just get me home and iced and elevated and I'll power through.  It's always worked before.
"Hey babe" I nervously said when my wife answered the phone, "I've hurt my ankle, seriously. Yes. I know. I don't know how I'm going to get home. Ok. I'm sorry."     Miraculously I made it home, with the help of my son and visiting father and a friend who wheeled me to a taxi on her bike.
Once on my couch I called my doctor. Sure he lives in San Francisco and I'm in New York, he can't see my ankle and he has no x-rays to look at but he's one of my best friends and a chiropractor and a healer and he always answers my calls. Between him and the internet I've managed to stay fairly healthy and active for last seven years of uninsured life.
"What hurts" he answered.
When I finished he advised an elevation and ice routine and told me to get an xray.
I sent my mother who was staying with me to buy me some crutches and the next morning I hobbled around the corner to the clinic and waited to be seen.
Avoid clinics and emergency rooms in July at all cost.  Where did I just read that? I thought, trying to get comfortable in the waiting room.
July is the month that the new residences start and you will find yourself attended to by someone who is too young to remember ER ! Finally my name was called and I crutched into the office of a young man who looked as though he had not yet had his first shave. He was delightful and attentive, sympathetic to my plight, interested in the kind if work I did (and would not be doing for awhile). He felt my ankle and came to the conclusion that I had merely damaged the ligaments. “You’ll have to stay off it but you should be fine. In a few weeks you can start to exercise it. Here’s a prescription for an ankle harness, kind of like a blow up splint.”
I asked if I could get an xray just to put my mind at rest. He answered that I could if I wanted but neither he nor his supervisor felt it was necessary. Part of me felt like crutching out of there with nothing but the good news but the fear of my ankle getting worse and still not having an xray made me push the young doctor to order one up.
He returned a couple of minutes later and informed me that the radiologist wouldn’t be in for two days but if I still wanted it by then I should make an appointment at the front desk.
Which I did, even allowing a little hop into my hobble.
2 days passed and I was feeling quite positive with my prognosis but still I made the trip down the stairs (a terrifying descent, bouncing down on my left foot, barely keeping my balance).
The radiologist had a tattoo on her neck and reminded me of Lisbeth Salander, the heroine of the Swedish publishing sensation The Girl With The Dragon Tattoo that I had finally found the excuse to read.

"You need to go to the emergency room sir" the radiologist broke my train of thought. "You've got a major fracture, maybe 2.  Look."
There it was, long split in the long bone leading down to my ankle.
“That's your fibula and that's your tibia. I don’t get paid to read these, they’ll do that upstairs, but I can see that they’re both fractured”.
 By the time I made it upstairs an administrator and a doctor were there to meet me. It was the fastest anyone in the medical profession had ever attended to me and I could tell lawsuit was on their mind.
“So, you have some fractures eh?” the woman doctor said in a russian accent. “You will have to go to a hospital.”
“I don’t have insurance, which is why I came here, I was told I was fine and only discovered I wasn't by my own demands  for the xray and now you’re telling me I should go to the emergency room?”
“ Go to bellevue, they are a city hospital and will work with you on the cost. I'm sorry.” she said bluntly, the administrator nervously biting the inside of her lip, wondering where she would ever find another job this good in this economy after I sue her clinic for all it's worth.
That's when the nausea returned. The reality becoming clear that I was not  going to be able to will this away or argue my way out. Hospitals mean bills and bills I cannot afford.
Sorry?
Everything that had kept me away from conventional medicine was on display. Endless waiting to see someone who then completely misdiagnosed me and was unable to confirm with an xray resulting in 2 days at best wasted and at worst doing serious damage to my injury that should have been in a cast.

The Waiting Room
I always imagined entering bellevue in a straight jacket but instead it was on crutches. It’s impressive. A multiple story atrium more resembling an airport terminal wraps the old hospitals facade, with a neon signs directing you where to go. Bur arrive at the ER gate and all the artifice disappears.  As derelict as Beth Israel down the road. Crutch through the triage, mistakenly say that my pain is a 2 which apparently puts me at the bottom of the pile and proceed to wait for the next 3 or 4 hours. Thank god for Stieg Larson. I was now well into "The Girl Who Played With Fire" and but for the soreness and pressure in my foot, I didn't mind the excuse to dive back into Mikael and Lisbeth's world.    
It was hard to read with the many distractions. The lady next to me on the right had apparently made the trip from uptown solely to sit in the waiting room. A nurse helped her up, asking "Lillian, are you feeling ok?"
"Yes"
"You don't have an appointment today"
"I know"
The nurse gave an exhausted but compassionate sigh "Then why are you here Lillian?"
"Just sitting I suppose"
"Do you have a bus pass?"
"Yes, I can take the bus"
"Larry will help you to the bus stop, ok Lillian?"
"Thank you"
Across from me a man was occasionally moaning, his eyes were closed and I couldn't see any external injury, he suddenly opened his eyes and looked straight into mine. I quickly returned to my book. Some time later I felt another pair of eyes on me and realized it was the asian lady boy across and to my left. I'd noticed her as I entered she being far and away the most attractive patient in the place, dressed to the nines in heels that made her appear 6 and a half feet tall. She seemed in no pain whatsoever, as if she was enjoying an inside joke, and I had already convinced myself that she was only there for some kind of social experiment, like Helena Bonham Carter in fight club.
"What did you do" she asked in a soft but deep voice"
"Soccer"
“Oh” her expression of concern far too dramatic to be convincing.
“And you?” I asked.
She just smiled as if she didn’t understand the question.
Having taken the brief flirtation as far as I was willing to I returned to my book.
Many chapters and hours later I was finally called into an equally crowded ER theater where I waited another hour with an equally diverse bunch including a convict in orange prison garb and handcuffs and the three police escorts that were in charge of him.
And then the torture, the cast and the “goodbye, see you in 6 weeks, stay off your foot”

Sand Crutching

Week 3 of cast and crutches.
Am consumed with despair. Self esteem at an all time low and still the whole month to go.

Week 5
Sand in my cast. Gotta keep it dry. What if it doesn’t heal? Never in my life have I wanted summer to be over but it can’t end quick enough now.

V Day!
“You shall be released” said the otherwise humorless young surgeon, surely overwhelmed by the masses that he’d seen before us and the ones still to come. After a 4 hour wait, not to mention the 7 weeks on crutches, it was all I could do not to kiss him. He prescribed me a large storm trooper boot to wear and said see you in 6 weeks. He didn’t even stay to see me take my first steps but Eddie the jovial cast man did after he mercifully sawed mine off.
Standing on my injured ankle and leg for the first time it was immediately apparent that the bones were healed but the rest was still mangled. Mangled I can deal with and I hobbled out the hospital before anyone could find a reason to recast me.
My arms felt like feathers, finally free of lifting, and I decided to peek at the bill.
There were the usual astronomical charges;
visit - $650
xray 1 - $200
xray 2 - $200
xray 3 - $225
application of stress - $173

As far as I can tell that is a charge for torturing me.

Happy Ending
My overall impression of the medical staff I encountered, except for the negligent youth and his supervisor at Ryan Nena clinic, was favorable. Hardworking, compassionate people registering, x-raying, balancing all that a city hospital brings. But a city hospital was all I needed and I felt a sense of civic pride from experiencing my tax dollars at work.

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