So this happened to me on Thursday night …
Hilarity did not ensue, but there is definitely a happy ending. The TL;DR Take: I’m back at home, I was treated successfully for something other than COVID-19 entirely, but I was witness to some interesting scenes and gained some insight into what’s to come in the fight against this pandemic.
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Sometimes I feel like Forrest Gump, stumbling into small scenes of history. And so it was that on Thursday evening, I spent 4 hours at an LA ER the same night the whole state was going under lockdown for COVID-19.
First point: I wasn’t there for COVID reasons. I was presenting signs of possible looming appendicitis (bad) or kidney stones (better, if you can believe it) and finally decided that I shouldn’t wait any longer to go to the ER after I had a Teladoc consultation the night before that recommended I go in (side note: telemedicine is the future. It was free, functional and more useful than simply Googling my symptoms and finding out what WebMD.com thinks that I have. I did mine by phone, spoke to a real, board-certified doctor, and he answered my questions in a less hurried way than many “live” doctors have in the past. It’s not a perfect substitute for being seen by a specialist (see below), but it’s a fantastic addition to the portfolio of care options and it should precede all non-emergency visits whenever possible in my opinion. But I digress …)
I walked over to my local hospital, but not before I wolfed down two slices of NY-Style Pizza (takeaway, of course, under the new restaurant guidelines) and having packed an overnight kit of a magazine, phone charger, shaving kit and a change of clothes. As a Canadian turned Californian, I’m used to marathon ER visits. I was prepared for a 12 to 24 siege …
Part of my decision to go to the ER that night was that California was going under statewide lockdown at midnight. More top of mind was that my symptoms had worsened in the past hours, and I reasoned that it would be a very bad idea to wait to actually have appendicitis … and especially not in the middle of a full-blown Coronavirus health care crisis. Time was not on my side, as an old and wise friend of mine kept reminding me.
That said, as luck would have it, I seemed to have timed my visit perfectly. I walked in at 7 pm PST and there was literally no one in the ER waiting area. I saw an admitting nurse right away who took my insurance details surprisingly cheerfully and processed my admittance shockingly fast. I was almost immediately interviewed by a triage nurse who was warm and friendly. She took my medical history and vitals, confirmed that I did the right thing to come in, and then apologized profusely for having to put me in a gurney in the hallway because the hospital was full right now. As a Canadian, I expected the hallway! Don’t get me wrong: I love socialized medical care. I’ve been in hospitals from London to Montreal, and I believe that health care is a universal human right. But the price for that is comfort and we Canucks (and Brits who have experienced the NHS) know that we’re not getting the white glove treatment in our hospitals — and that’s ok.
As I lay in my gurney near the ER triage area, I realized that I had a front-row seat to the biggest story in the world playing out in the biggest state in America. I asked the admitting nurse how they were all faring. Her tone was comforting even while her words were chilling. “I’m not an alarmist by nature,”, she said. “Until last weekend, I thought that this was bullshit. But it’s real now. And I can only assume that 100% of the health care workers in this hospital have it or are going to get it. That’s just reality.”
“50% of the country will get this virus, and most of us will be able to ride it out at home with cold meds and isolation. That’s the good news. But older people, those with underlying conditions … there are some tough times coming and tough choices that are going to have to, unfortunately, be made …”
I let those numbers and words sink in. It’s one thing to hear a talking head on cable news say them; it’s quite another when a grizzled health care professional on the front line of the pandemic validates the ubiquity of likely contagion, but also the partially comforting thought that for many this will not be life-threatening. What will be, of course, is if the surge in cases overwhelms the capacity of the system to absorb and treat them, the way it has so tragically in Northern Italy.
As I waited for my blood to be taken and my exams arranged (extraordinarily efficiently, I should point out), emergency personnel cycled in and out of the area with first a trickle and then a steady flow of new cases. LAFD first responders brought in a couple of sets of people on ambulance gurneys who were claiming to have COVID-19 and the ward reacted with cool dispatch.
It seems like I was literally in the calm between two storms. The ultrasound technician told me that it’s been the craziest two weeks in his over two decades working in emergency health care. Their hospital has been swamped, but largely with the “worried well” — people who are convinced that they have the virus but often turn out not to. Still others were coming in with chest pains, due in part to the understandable anxiety that these unprecedented times have triggered.
But I got the distinct sense that these preceding two weeks were so hectic not just because of the hysterical reaction some people have had, but also due to the headless response of officials up and down the line. Right now, my nurse reassured me, they have their shit together, and indeed they looked like a well-oiled machine from my layman’s view. There were still gaps apparent, though. Most notably, no one was being tested still. The nurses all took great pains to tell incoming patients that they would not be testing them for COVID-19 and that they would assume that they have it and act accordingly. This was because the testing kits just weren’t there in large enough numbers, nor were there enough masks and protective gowns. I even heard some orderlies express envy at one firefighter for the quality of his splash kit, a bit like an experienced shoe store salesgirl might admire a client coming with the latest Christian Louboutins. Real recognizes real, as they say …
Interestingly, I got the impression that they were happy to deal with a person who was calm, polite and who presented with real symptoms that needed to be checked out and that were not COVID-19. I was almost apologetic to be there under the circumstances (you can take the boy out of Canada but not Canada out of the boy!) and doubtlessly acted as such. I think my non-COVID-19 symptoms offered a strange sense of normalcy for them — a reminder of what their jobs were like before all of this happened.
These health care workers are literally on the front lines of a war that’s just about to go nuclear. They’ve been working overtime for weeks, I overheard, but largely dealing with false positives until now. The real test begins imminently. My read is that the people are ready even if the system supporting them is not. But the courtesy, professionalism, and stoicism I witnessed on Thursday evening was a wonder to behold, and it left me feeling encouraged that we will weather this storm.
10 days ago, putting on my mega trends forecaster’s hat, I tried to game out how this crisis would impact the world in the short term as well as the long. I got a few things right (though I didn’t expect to be proven correct in mere days; circumstances are changing so fast that what seemed outlandish at the time became ordinary a scant week later). But one prediction I made was that this moment would forever change the way we look at health care workers. Just as the “forever wars’ of the 21st century have justifiably elevated American servicemen and women to heroic status, so too, I conjectured, would this battle anoint nurses, orderlies, doctors and everyone else involved in the health care system as heroes, too.
In the US, it’s not uncommon for ordinary folks to stop people in uniform and thank them for their service. I think that’s a wonderfully appropriate gesture of respect to the brave men and women who risk their lives in faraway lands. So I’d like to extend that tradition here, tonight, and tell the doctors, nurses and orderlies at Marina del Rey Cedars-Sinai: thank you for your service, now and in the future. This patient — and this nation, I’m sure — is grateful. But in addition to our gratitude, we need to give them our own contribution to service — which is to embrace social distancing, stay at the house and stop hoarding items — like masks and hand sanitizers — that are luxuries for us but life-saving for them. It’s really not that hard; as one meme on Facebook recently put it, our grandparents were called to war and we’re being called to sit on the couch. We can do that, at least.
Epilogue: I got discharged at 11 pm — 4 hours in and out. Turns out that I did pass a kidney stone 11 days ago (!) and developed an infection as a result which was causing the fluctuating pain. I’m on antibiotics now and am honestly relieved not to have the Damoclesian sword of another kidney stone or appendicitis hanging over me. And while genuinely thanking them for their service, I truly hope not to need their services again any time soon …
