There are certain things you wouldn't mind hearing when you go to a doctor: "Your AIDS test was negative," "No, you're not pregnant," or "Just head on home. Today's Patient Appreciation Day, and your new heart is on us." Conversely, there are things you don't want to hear: "You need to head down to the county hospital's emergency room. Now."
Just my luck, on Sept. 13 I was told just that - along with, "We're calling you a cab to take you to the emergency room. Either take it for free now or pay for your own ambulance a few hours later."
Worry, cry, scream - I apparently didn't even have time for that. I had come in because my calves were swollen and discolored and had a wound that hadn't quite healed despite being visible for a month. I was utterly terrified, and I was caught between the cracks since my insurance eligibility at PW wasn’t until Nov. 1st. As the cab's horn honked outside, I leaped up, grabbed my backpack and bolted out of the office like I was starring in "The Fugitive."
Now I was living a movie cliché: I was literally racing against time to save my life, for the doctor had also told me if I had waited five more days to see her on my scheduled appointment, .I would have wound up in the Intensive Care Unit or dead.
Even more terrifying, at that moment, was the fact that I was hurtling towards LA County/USC General Hospital – the iconic building that served as the image and inspiration for ABC’s perennial daytime soap opera, and therefore the most famous hospital in America. Anytime someone mentions they're "going to County", people assume they're either headed to prison or to a medical experience that would make them wish they were behind bars instead.
“Oh my God! Why are you there?!” was the number one reaction I received even after clarifying I was headed to be healed rather than arrested.
Well, there’s any number of reasons a person can wind up there: a) they’re uninsured, b) they’re broke, or c) they’re batshit crazy. In my case I was neither broke nor crazy, but had slipped through the cracks as my new employer was about to rant me insurance in just two more weeks. My body always has the worst timing.
I’ve never been too scared of hospitals. I grew up living at one, since my dad was a VA doctor who was a rehab specialist, picking and prescribing which prosthetic arms and legs our veteran patient needed after they’d had their limbs blown off in battle.
We lived for our first two years of his job in a rented mansion-style house on a street of homes set aside for doctors new to the area. We kids adapted easily, only wondering on occasion why we had to cover our eyes in the morning as a mental patient peed on our lawn, or wondering why none of our friends’ parents let THEM come visit us, instead insisting we come play in their bland suburban neighborhoods.
Sure, you could say it was strange to ride my bike to my dad’s office after school and hang out with old soldiers missing parts of their mind or body. But I was friends with them, especially because of the hospital chapel’s Sunday Mass, which is what my dad dragged us to because he was too lazy to drive down the mountain from the hospital into town. I was glad we were at the hospital’s Mass, because where else could I meet a man like James Keever, who was in charge of the Scripture readings but would forget to wear a belt and his pants would fall to the floor in the middle of reading Jesus parables. He’d freeze as if wondering whether the throng before him noticed – of course we had! – and then kept reading, finished, hiked his pants back up from his ankles and sat down as if nothing had happened. Or Russell Houda, a polite little man in a suit who constantly drove my dad nuts by insisting he had to let me watch “The Beverly Hillbillies,” which my dad had declared off limits to me due to Elly Mae’s ample charms.
But my adult visit to LA County Hospital was a whole other world.
During my 14-hour wait to enter the County ER, I encountered a tattooed, mohawked Nine Inch Nails fan who was awaiting emergency dental surgery to remove a stray incisor which had somehow grown in upside down, rendered the left side of his face immobile by pinching the nerves within, and was now about a half-inch away from affecting the blood vessels leading to his eyeball. At least he was nonchalant about it, noting, "I'm used to pain."
Among the dozens of oddball examples of humanity I experienced there was an ancient Asian man who looked like he was about to drop dead in his plastic chair before anyone noticed him. And an angry African-American man who said he'd been waiting 10 hours just to pick up a refill on his blood pressure medication and now felt his heart beating so hard he thought it would burst right out of his chest.
Worst of all was the young Hispanic guy in a wheelchair, who had what appeared to be a gaping split in his skin along the top of his foot. When I asked him what happened, he replied, "Lawnmower accident." As I nearly retched, he further explained that he had originally cut the foot clean off, but the doctors at LAC/USC had miraculously reattached it and tried to make it work over six months of inpatient therapy. He went home, and even without having stood on it, had managed to reopen one of the major fault lines in his flesh.
The cost of his bill was $1 million and growing by the day. But all he could do was laugh in frustrated amazement: "Hey, at least I don't have to pay for it! Thank God for ATP!"
I didn't know it yet, but ATP stands for "Ability To Pay," and it is the program that makes care for all possible, yet puts the county health system's financial stability at risk.
The idea is that, after returning home, patients are asked to set an appointment with a billing department worker in which they are to bring in proof of income and bank statement for the month in which they were hospitalized. The ultimate bill is rendered as a percentage of the funds they had available in that particular month.
For instance, my official bill for a five-day, four-night stay was an "all-inclusive" $20,828. After looking at my less than Trump-worthy financial information, my ATP payment was declared around $1600.
And if my description of my stay as a "five-day, four-night, all-inclusive" experience makes LAC/USC sound suspiciously like a resort, consider the following. While I had a severe leg infection, it did not give me pain and wasn't contagious, so I was free to walk around the hospital at will anytime I wasn't strapped to an IV or sleeping. The food was actually pretty good, and the smart guys in my wing quickly caught on to the fact they could stash extra sandwiches, snacks and sodas to use anytime they wanted.
The hospital really was like a combination of resort and "Hogan's Heroes"-style prison - lights out at 11, TV off from 1030 p.m. to 6 a.m. If you're gone from the wing more than four hours, you start over in the hell of the ER waiting room. The patio for smoking was like a prison yard for a downtown max penitentiary, on a high floor and all fenced in, but the shower was described by Paul, the guy in the next bed over, as a "monsoon" and its warm mist was indeed the best I'd ever experienced. And I don't know whether I was just easily impressed after expecting less than nothing, but the ice water was pretty damn good too.
For the four of us men who shared a big room in the orthopedics ward, it indeed seemed a shelter from the storm. Paul was a Caucasian, 50-year-old gay personal chef who had months of therapy awaiting him, since the hospital had to replace a shattered shoulder with one made of plastic. He spoke like the wizened veteran of the place, able to define another patient within seconds.
"I can always tell the ones who just did time," he'd chuckle. "It's an ultra-masculine thing going on in their air."
The other two guys were Latinos, one who had simply broken his leg in a normal fashion, the other one recovering from the agonizing removal of a leg brace that had been held in place via a seemingly endless series of screws that left his leg looking like pummeled ground beef while gasping, seemingly 24 hours a day: “Oh, Dios mio! Aye Maria!”
And then there was me: the guy with a mysterious infection the doctors never quite defined, but who was able to wander with aplomb except for the four times a day IV drips sent medicine to save my legs.
TO BE CONTINUED
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