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Entries in nosebleed (1)

ER

Yes, I love the show “ER” – and I’ve even mentioned it before here. The show has lots of drama, not only because of the variety and intensity of the emergency-room cases they present, but because of the lives of the characters we see developed. However, that’s not what this little essay is about. What I’d like to talk about now is my personal experience of the emergency room. My most recent exposure was just a couple of days ago – and I’ll get to that in a little bit.

First, a little history.

Probably the most interesting emergency-room time I had was the night I passed a kidney stone, but was nonetheless diagnosed with bladder cancer by the young (Doogie-Howser-looking) ER doc and the on-call urologist he consulted with. That episode lasted from dusk till dawn, and the crisis passed a couple of days later when tests showed that I did not have cancer. While I felt mostly well-cared-for that night (Katrina was with me, and she was certainly a great comfort to have around; and I had a wonderful nurse), Doogie's behavior was pretty amazingly terrible, as I recall. As he was initially delivering the bad news to me, he was talking in a soft voice, and walking backwards away from me toward the door, while using medical terminology obviously intended to obfuscate. I believe he just tried to slip that little word “carcinoma” right by me, thinking I might not notice (or know what it meant). Basically, both doctors that night came up far short in terms of getting a good review from me.

A couple of other ER experiences stick out in my mind as well. Neither were quite as bad as the one just described, thank goodness. They were drama-packed in their own right, though. One was an “urgent care” facility that we took Katrina to when she was suffering from a rupturing appendix. Although the tests were not definitive, the surgeon who was called in was right on the money in terms of a diagnosis, and the surgery the next day, I think, went mostly ok (of course, I’m not the one who had to go through it, and there was a tough post-operative period). The other episode was here in Portland four days after I moved up from Eugene in 2004. I took a fall on the pavement while walking the unfamiliar hilly streets in the Mt. Tabor neighborhood, and ended up spending almost another entire night being attended to. That I complained of “chest pain” at the front desk probably got me some special attention, I imagine.

So, now we come to my most recent visit.

I developed an early-morning nosebleed two days ago while I was in the shower. At some point I looked down and the water in the bottom of the tub was curiously pink. After I figured out what was going on, it took me almost a full hour and a half to get the bleeding under control. Given that I have had a history of nosebleeds (for me, they come with allergy territory), I have some experience in this area, so when it took that long to control I was, well, concerned. During the time I was trying to stop the bleeding, I had images of somebody, someday eventually finding me naked and dead on the bathroom floor, bled out from the nose. Not a pretty picture. And, all the while this was going on, the room started to look more and more like a crime scene. Again, rather ugly.

Well, I did get the bleeding to stop. Finally. I called my doctor’s office (it was right about 8:00 a.m. at that time), and they said if I wanted to see somebody, go to the emergency room. I drove myself, of course, all the time hoping I wouldn’t start bleeding again!

OK: I admit. This time when I visited the ER, it wasn’t quite in the category of emergency. It certainly had felt like it earlier in the morning, but by the time I got to the hospital, the situation was fairly tame. And, I guess, from an ER doc’s perspective, well, “this is a pretty uninteresting situation here.”

I had quite some time in the waiting area, and then in the little examination room I was finally shown. The nurse who checked me in was quiet but efficient. I appreciated that. After about a half hour in the examination room (I was passing time reading the morning’s paper), a young woman finally came in, introduced herself as a med student, and said that since no one else was attending to me, she thought she’d keep me company and familiarize herself with my case. She sat down, asked questions, took notes, and listened. She was pretty great, actually. After about five minutes, though, the “real” ER doc came in and took over. At that point, the med student seemed to rush away. I was sorry to see her go; it was about the only time I felt really listened to during the rest of my experience there. Not that I didn’t get attention; my nose was cauterized and packed with gauze and I had the name of a specialist to follow up with. But, during most of my time there, I believe I was an “issue” not a person. I was “the nosebleed in 4” – wow, that was not a great feeling.

Later that same day, my nose started bleeding again…I felt it happen, and, in the mirror, watched the gauze change color from white to pink. I drove to the ER again. I was bleeding when I showed up, but I still had a half-hour to wait before they called my name. During that time, sitting in public view in the waiting room, pinching my nose and swabbing my face with Kleenex, no one at the desk seemed to be overly concerned. Again, I suppose I was “just a nosebleed.” When I finally got in to see the second doc, and since the bleeding had stopped, he did nothing. In fact, was very dismissive (like: why are you here?), and didn’t even really get any of his attention until I said something like, “well, I can see that I’m not being taken seriously here.” As it turned out, all he would do was reinforce the notion that the ER had done what they could (contained the emergency and referred me on). I left with wet bloody gauze in my nose and no hope of getting it looked at again until Monday (four days away).

Well, I knew there was no way that I was going to make it that long with gauze in my nose. I just knew. (A thought validated after a sleepless night that night, not being able to breathe.) Yesterday, I removed the gauze myself, and now I seem to be doing fine.

I don’t think I’ll be remembering this episode too favorably…except for the med student who took some time to listen. Even though I was “just a nosebleed,” she saw me as a person as well...and what a difference that makes!