Sunday, August 16, 2009

Health care

Late yesterday afternoon, while running around the lake, I was bitten by a dog, a young black mixed breed, mostly German Shepherd. He was on a leash, but had broken free of the boy who was walking him. A single painful bite on the fleshy part of my left leg behind the knee. The boy was screaming at the dog, the dog -- once it had lunged at me and taken the bite -- seemed confused, quickly became deflated, and slunk back to his master with his tail between his legs, ashamed to look back at me, apparently contrite. The boy was scared and kept apologizing.

But the damage had been done and I was bleeding pretty good by the time I got home. I washed the wound, dressed it as best I could, and headed to St. Anthony's Hospital up in Warwick. The boy had assured me that his dog had gotten all his shots, but you can't take chances with an animal bite.

The emergency room staff was friendly and helpful. I was out of there in less than two hours, the wound cleaned and dressed, the tetanus shot administered, the prescription written out, the warning signs reviewed, and the animal bite report filled out and faxed to the Vernon Police Department.

Assuming the dog isn't carrying any disease, I'll be fine, and the whole thing will have been one of those little incidents that quickly recede into memory and become a single strand in the long narrative arc of one's life -- yup, back in 2009 I was bitten by a dog.

That's because I'm a middle-aged white man in good health with good medical insurance. The admitting nurse chatted me up, the receptionist made small talk about the nastiness of certain breeds, the orderly told me his dad liked to jog, the RN rolled her eyes when the doctor examined the wound, and the doctor -- a tired Indian chap -- told me the punctures the teeth had made were not terribly deep and that I would know within three days if infection had set in. It was all civilized, efficient, professional.

In the emergency room bed next to mine lay a ninety-one year old man moaning that he needed to go to the bathroom. All I could see of him were his swollen pink feet with their shockingly thick, yellow, cracked toenails. The nurse kept calling him, "Pumpkin."

"What is it Pumpkin? No, you can't get up and go to the bathroom. You fell and your head is filled with blood. Means I can't let you sit or stand. Do you have to tinkle or is it a bowel movement? Number one or number two?" The man groaned and muttered, "I love you." The nurse replied, "I love you too, Pumpkin. Now which is it -- pee or bowel movement?" The man groaned again, then spat out, "Bowel movement." The nurse and orderly then went to get a bed pan and shifted the patient onto it. He fought them for a spell, loudly, then quieted down to a low moan. Every couple of minutes the nurse would come by and check to see if he'd gone. But there was nothing. "Keep trying, Pumpkin. No, I can't give you anything to eat. We're going to have to send you to another hospital so they can look at your head."

"I love you," was all he said in response. The words of an injured old man in extremis.

I thought to myself, there is no such thing as
health care if you're healthy. But if you're sick or injured, alone and abject, you deserve all the care and respect humans are capable of giving. This is not a matter of dollars and cents. This is not an industrial equation, though we have tried to limit it so. Sick care.

When the man started groaning again, the orderly who was unpacking the gauze for my wound leaned over and said, "You've got to have a sense of humor to work here, 'cause a lot of the things you see and hear are not funny." I guess that's right.

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