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shannon_aSo Kimberly's been having "episodes". We don't properly know what to call them. She starts having significant cognitive impairment, she has problems with balance and manual dexterity, she can't remember things or figure out things, she slurs her words. More recently, she's had weird sensory inputs. This goes on for 2-6 hours, and then she's back to normal. It's been going on since July 4th.
We've had rafts of tests done, with rafts more to go. There's no consensus as to the cause, but her neurologist is currently exploring the possibility of seizures. So, she's got an MRI and an EEG scheduled, but the problem with an EEG is that it will only show anything interesting if Kimberly is actually have a seizure at the time of the test.
So after Kimberly's most recent episode, where she was smelling smoke, which is new, one of her doctors said we really need to go into the ER for a situation like that, where there's weird sensory input, and we need to press them to do an EEG while she's symptomatic.
Which is our prelude to yesterday's useless, annoying, and upsetting episode.
Kimberly gets home at about 4.30 yesterday and when I got to see her at 4.45 she tells me that she's basically lost the previous 15 minute and that she's having weird sensations in her toes, like fish are biting them. (It later spreads to weird sensations in her legs, hands, and tongue.) So, I decide we're off the ER, because this is the exact sort of sensory weirdness that her doctor was worried about the night before.
We go through the metal-detector rigamarole at the ER, because this area sucks. And pretty soon we're talking to the intake nurse. I heavily press upon him that we're trying to rule out a seizure (or rule one in, I guess), and so we need to get Kimberly into an EEG while she's symptomatic, and that means soon, because these episodes have a limited shelf life. Kimberly is by this point having increased problems with confusion and is slow responding to questions, and somewhere in all of that, we get the point across. He gets Kimberly into a wheelchair and pushes us over to wait for the triage doctor, who will see us next.
Which is the last time things will happen quickly all night, and generally when things go to shit.
We get called into the triage doctor a few minutes later. She opens the door, glances at Kimberly in the wheelchair, and then turns around, offering no help. So, Kimberly starts to get out of the chair and I quickly get in there to help her if needed.
And one of the other patients starts screaming, "Why is she going in when we was here first!?" After the third or fourth scream of this, with the staff not doing a damned thing, I turn around and say, "My wife is having a seizure." Which may or may not be true, but it's my best brief explanation of the situation.
And so as we're going into the triage room, the triage doctor attacks us for the first time, saying "How could she be having a seizure when she's walking!?" Because apparently surly doctors confined to the ER at Alta Bates didn't study hard enough to know that there are other types of seizures than motor seizures: non-motor seizures to be precise. I say, "We think it might be non-motor seizures" which is the sort of medical information that a patient should never have to explain to a doctor.
And then when the door closes, she rips into me again, saying, "You can NOT respond to another patient like that", referring to my answering the screaming person that they failed to control in the waiting room. And, I admit, at this point I lose my cool. I shouldn't have, but at least I direct it toward the person outside the door, rather than the asshole of a doctor that we're now saddled with. But I give my colorful description of what I think of a person who kept yelling at us because we were deemed a more time-important case. And the doctor tells me to leave the triage room.
And look, I understand where she's coming from. As I said, they've got a metal detector out front because they get gang members and people from the street with mental health problems and tweakers into that ER. She's certainly regularly dealing with drunk college students (who clog up the ER every Friday and Saturday) and about every time I'm at the ER, there's some out-of-his-mind homeless guy stomping around and ranting. But, as Kimberly points out, she escalated straight to "get out of the room" with no warning in between. And my outburst was the result of being verbally attacked twice, first by the person in the waiting room who the staff ignored and then by the doctor herself. And, it's also pretty obvious to me that she's got a power trip thing going on, like it's the only thing she gets for herself in a job that she pretty obviously both hates and is bad at.
I calm down damned fast and put myself in an entirely supplicant position to her power mongering. I flat out apologize and tell her that wife is very vulnerable and needs me there. After telling me three or so times to leave, asshole-doctor has apparently received enough groveling because she just acknowledges my presence and continues on.
Not that she's of any use.
For one, she attacks Kimberly one more time by denying the whole idea that she could be confused. She tries to get Kimberly to define confusion and tells her that doesn't sound like confusion when Kimberly explains her inability to focus her attention on what's important. (And I'm thinking, "Can you not hear the huge delays in her answering questions?" But I'm at this point letting Kimberly talk as much as she can and me as little as I can, because I've got my temper under control, but I'm not sure it's going to stay that way if someone goes at me directly, like the doctor is at Kimberly.)
The doctor also tells us that the ER doesn't have any access to an EEG. She says that if they decided to admit Kimberly, they could do an EEG in the morning. I tell her that's useless because in the morning Kimberly probably won't be symptomatic. She says several times that she just doesn't know what she can do.
That really should have been our cue to leave. I mean, there are some scary sensory symptoms that Kimberly is still having, so maybe it's good to literally be there at the hospital, but I'm not convinced otherwise. But then the doctor says there's something they can check for in blood. So we stay.
Kimberly gives some blood, and then they tell us there are no rooms, so they're going to stick us in the back waiting room.
("Away from the yeller in the front waiting room", I think. We thankfully never see her again.)
There are about half-a-dozen people there, and we soon realize how bad conditions are when a young Russian man sticks his head outside the waiting room to ask if the staff still knows he's there.
He gets shouted down from outside the room by a female sufficiently nasty that Kimberly and I sort of assume it's the asshole triage doctor. But I don't know why she'd be way over here, so maybe they just had multiple bad people on staff last night. In any case, the nasty care provider objects to the Russian's claim that he's been there for five and a half hours, and makes him recant and admit it's only been four and a half hours. They then offer a long diatribe about how they know exactly where every patient is.
The young Russian man tries to explain to Kimberly and me how very long he's been there, and we nod and smile politely. He sits back down.
Over the next few hours, patients come and go. We see the people ahead of us slowly decrease.
Meanwhile, care providers come into the room any number of times asking for someone not there. It becomes quickly obvious that they have no fucking idea where their patients actually are.
(We suspect this may be in part because some people are leaving. At least three people just get up on their own and never come back, including young Russian man. But they've lost far more than three people.)
We soon see people who came in after us getting into rooms.
No, we don't throw fits over this.
But it's pretty obvious that asshole doctor has triaged us quite low.
Kimberly's symptoms fade about 2-2.5 hours after they started, between 7 and 7.30, and it's becoming increasingly obvious that we're sitting here for absolutely no reason at this point.
I still don't trust myself to go deal with people who will argue with me, so I let Kimberly go out to try and get released. We can't just walk out because they've got an IV-thingy stuck in her arm. She comes back five or so minutes later and lets me know that not only did the staff refuse, but they talked down to her while doing so, like she was a six-year-old.
It's good I wasn't the one out there.
At some point we hear on the intercom that the triage doctor has gotten a call back from the doctor who is on-call for Kimberly's neurologist. No one ever bothers to tell us anything about this.
Meanwhile, a tweaker gets brought in and left on a gurney out in the hall. He keeps telling staff that he's hallucinating and says all he needs is some Ativan and he'll be fine. The staff test him by demanding he describe his hallucinations. He doesn't offer anything very descriptive. They refuse to give him Ativan because they say he'll stop breathing.
The tweaker going through withdrawal is left directly outside our room, largely unsupervised.
At some point we strike up a conversation with a couple of the other patients, all overcoming our reluctance to talk to strangers in a hospital setting because we've suddenly got this shared adversity of sitting in this damned back waiting room for hours while the staff can't even be bothered to check in on us.
I'm pretty happy to talk to a young mother across from us, because she'd been really visibly agitated a lot of the time we were there, and she obviously calms down when talking to us about just random things. She's apparently sitting there because there's some concern that she might have appendicitis. Yeah, a back waiting room with no one checking on us seems like a great place for someone who could have an appendix burst at any time.
I'm less happy to talk with the Florida man who ruined his feet by overdrinking during winter stints in Miami and who fixed up a hotel really nice, but no one wanted to come. I mean, he's nice enough but he talks and talks and talks.
And we don't talk much with the young man who's been there since 4.30 waiting blood test results. At one time he flags down a nurse and is simply told, "If there was something bad, they would have told us by now." Which apparently means: otherwise, you can sit down, shut up, and wait.
A nurse comes by at some point to talk about the wait. It's the first human interaction we've gotten since entering the hellish back waiting room, other than nurses shouting down people seeking information and other staff looking for patients that they can't locate. The nurse mentions the idea that people might want to leave, but blows it off. Except Kimberly doesn't let him. After he goes straight through, "If anyone wants to leave ..." and then moves on as if no one would, Kimberly says, "I want to leave!"
Because she's now thoroughly past the episode. And we now know there's no chance of an EEG, not that it would matter at this point. So we're just burning our evening in a place with sick people all around.
The nurse gets us out of there some time later ... and brings us to waiting room #3, in the way back of the ER. He seems generally helpful, the second such person at the hospital after the intake nurse, who's now something like 3.5 hours in the rear view mirror.
And we wait more and more and more. Our helpful nurse goes on break. But by this point it's obvious that we're out of the pre-ER-room purgatory, into a place where things are actually getting down, albeit at a slow rate. And where they're actually treating us like human beings rather than spending all their time ignoring or attacking us.
And eventually a doctor comes by, lets them know they didn't see anything in the blood test, but can't rule anything out, and discharges Kimberly, "against doctor's orders". Which hopefully doesn't cause problems with the insurance payment in this f***ed up things we call a healthcare system in the US. But that's entirely a problem for another day (and hopefully not a problem at all).
The helpful nurse comes back from break as we're checking out and thanks us for being patient, and I should have thanked him for his help because I always do my best to recognize that good service providers aren't responsible for shitty systems, but I'm too annoyed by the whole situation to do more than nod.
On our way out we wave to the young man who got his blood tested at about 4.30. He's still in the secondary waiting room. It's now 9.30.
We've unfortunately been to Alta Bates ER a number of times in our twenty years in south Berkeley. And, it always sucks. If you go in for a physical health problems, you're not out in less than 4-5 hours, and most of that time is spent sitting around while no one talks to you.
But yesterday was a real highlight. Because we were there for almost 4.5 hours, from about 5pm to 9.30 or so. And we never even got a room. And we saw the worst doctor that I've ever had the misfortune to interact with (though Kimberly has dealt with worse, IMO). And we learned that they couldn't even do an EEG if they wanted to despite machines being within a few hundred yards, not that they particularly cared about Kimberly's symptoms once we got back to a doctor; they seemed more intent on deriding and doubting them.
And as I've said, yes that hospital has to deal with a lot of people who are deranged or drugged or drunk or lying to them, or all three.
But it's no excuse.
Alta Bates ER at Ashby & Telegraph gets 1 star.
We've had rafts of tests done, with rafts more to go. There's no consensus as to the cause, but her neurologist is currently exploring the possibility of seizures. So, she's got an MRI and an EEG scheduled, but the problem with an EEG is that it will only show anything interesting if Kimberly is actually have a seizure at the time of the test.
So after Kimberly's most recent episode, where she was smelling smoke, which is new, one of her doctors said we really need to go into the ER for a situation like that, where there's weird sensory input, and we need to press them to do an EEG while she's symptomatic.
Which is our prelude to yesterday's useless, annoying, and upsetting episode.
Kimberly gets home at about 4.30 yesterday and when I got to see her at 4.45 she tells me that she's basically lost the previous 15 minute and that she's having weird sensations in her toes, like fish are biting them. (It later spreads to weird sensations in her legs, hands, and tongue.) So, I decide we're off the ER, because this is the exact sort of sensory weirdness that her doctor was worried about the night before.
We go through the metal-detector rigamarole at the ER, because this area sucks. And pretty soon we're talking to the intake nurse. I heavily press upon him that we're trying to rule out a seizure (or rule one in, I guess), and so we need to get Kimberly into an EEG while she's symptomatic, and that means soon, because these episodes have a limited shelf life. Kimberly is by this point having increased problems with confusion and is slow responding to questions, and somewhere in all of that, we get the point across. He gets Kimberly into a wheelchair and pushes us over to wait for the triage doctor, who will see us next.
Which is the last time things will happen quickly all night, and generally when things go to shit.
We get called into the triage doctor a few minutes later. She opens the door, glances at Kimberly in the wheelchair, and then turns around, offering no help. So, Kimberly starts to get out of the chair and I quickly get in there to help her if needed.
And one of the other patients starts screaming, "Why is she going in when we was here first!?" After the third or fourth scream of this, with the staff not doing a damned thing, I turn around and say, "My wife is having a seizure." Which may or may not be true, but it's my best brief explanation of the situation.
And so as we're going into the triage room, the triage doctor attacks us for the first time, saying "How could she be having a seizure when she's walking!?" Because apparently surly doctors confined to the ER at Alta Bates didn't study hard enough to know that there are other types of seizures than motor seizures: non-motor seizures to be precise. I say, "We think it might be non-motor seizures" which is the sort of medical information that a patient should never have to explain to a doctor.
And then when the door closes, she rips into me again, saying, "You can NOT respond to another patient like that", referring to my answering the screaming person that they failed to control in the waiting room. And, I admit, at this point I lose my cool. I shouldn't have, but at least I direct it toward the person outside the door, rather than the asshole of a doctor that we're now saddled with. But I give my colorful description of what I think of a person who kept yelling at us because we were deemed a more time-important case. And the doctor tells me to leave the triage room.
And look, I understand where she's coming from. As I said, they've got a metal detector out front because they get gang members and people from the street with mental health problems and tweakers into that ER. She's certainly regularly dealing with drunk college students (who clog up the ER every Friday and Saturday) and about every time I'm at the ER, there's some out-of-his-mind homeless guy stomping around and ranting. But, as Kimberly points out, she escalated straight to "get out of the room" with no warning in between. And my outburst was the result of being verbally attacked twice, first by the person in the waiting room who the staff ignored and then by the doctor herself. And, it's also pretty obvious to me that she's got a power trip thing going on, like it's the only thing she gets for herself in a job that she pretty obviously both hates and is bad at.
I calm down damned fast and put myself in an entirely supplicant position to her power mongering. I flat out apologize and tell her that wife is very vulnerable and needs me there. After telling me three or so times to leave, asshole-doctor has apparently received enough groveling because she just acknowledges my presence and continues on.
Not that she's of any use.
For one, she attacks Kimberly one more time by denying the whole idea that she could be confused. She tries to get Kimberly to define confusion and tells her that doesn't sound like confusion when Kimberly explains her inability to focus her attention on what's important. (And I'm thinking, "Can you not hear the huge delays in her answering questions?" But I'm at this point letting Kimberly talk as much as she can and me as little as I can, because I've got my temper under control, but I'm not sure it's going to stay that way if someone goes at me directly, like the doctor is at Kimberly.)
The doctor also tells us that the ER doesn't have any access to an EEG. She says that if they decided to admit Kimberly, they could do an EEG in the morning. I tell her that's useless because in the morning Kimberly probably won't be symptomatic. She says several times that she just doesn't know what she can do.
That really should have been our cue to leave. I mean, there are some scary sensory symptoms that Kimberly is still having, so maybe it's good to literally be there at the hospital, but I'm not convinced otherwise. But then the doctor says there's something they can check for in blood. So we stay.
Kimberly gives some blood, and then they tell us there are no rooms, so they're going to stick us in the back waiting room.
("Away from the yeller in the front waiting room", I think. We thankfully never see her again.)
There are about half-a-dozen people there, and we soon realize how bad conditions are when a young Russian man sticks his head outside the waiting room to ask if the staff still knows he's there.
He gets shouted down from outside the room by a female sufficiently nasty that Kimberly and I sort of assume it's the asshole triage doctor. But I don't know why she'd be way over here, so maybe they just had multiple bad people on staff last night. In any case, the nasty care provider objects to the Russian's claim that he's been there for five and a half hours, and makes him recant and admit it's only been four and a half hours. They then offer a long diatribe about how they know exactly where every patient is.
The young Russian man tries to explain to Kimberly and me how very long he's been there, and we nod and smile politely. He sits back down.
Over the next few hours, patients come and go. We see the people ahead of us slowly decrease.
Meanwhile, care providers come into the room any number of times asking for someone not there. It becomes quickly obvious that they have no fucking idea where their patients actually are.
(We suspect this may be in part because some people are leaving. At least three people just get up on their own and never come back, including young Russian man. But they've lost far more than three people.)
We soon see people who came in after us getting into rooms.
No, we don't throw fits over this.
But it's pretty obvious that asshole doctor has triaged us quite low.
Kimberly's symptoms fade about 2-2.5 hours after they started, between 7 and 7.30, and it's becoming increasingly obvious that we're sitting here for absolutely no reason at this point.
I still don't trust myself to go deal with people who will argue with me, so I let Kimberly go out to try and get released. We can't just walk out because they've got an IV-thingy stuck in her arm. She comes back five or so minutes later and lets me know that not only did the staff refuse, but they talked down to her while doing so, like she was a six-year-old.
It's good I wasn't the one out there.
At some point we hear on the intercom that the triage doctor has gotten a call back from the doctor who is on-call for Kimberly's neurologist. No one ever bothers to tell us anything about this.
Meanwhile, a tweaker gets brought in and left on a gurney out in the hall. He keeps telling staff that he's hallucinating and says all he needs is some Ativan and he'll be fine. The staff test him by demanding he describe his hallucinations. He doesn't offer anything very descriptive. They refuse to give him Ativan because they say he'll stop breathing.
The tweaker going through withdrawal is left directly outside our room, largely unsupervised.
At some point we strike up a conversation with a couple of the other patients, all overcoming our reluctance to talk to strangers in a hospital setting because we've suddenly got this shared adversity of sitting in this damned back waiting room for hours while the staff can't even be bothered to check in on us.
I'm pretty happy to talk to a young mother across from us, because she'd been really visibly agitated a lot of the time we were there, and she obviously calms down when talking to us about just random things. She's apparently sitting there because there's some concern that she might have appendicitis. Yeah, a back waiting room with no one checking on us seems like a great place for someone who could have an appendix burst at any time.
I'm less happy to talk with the Florida man who ruined his feet by overdrinking during winter stints in Miami and who fixed up a hotel really nice, but no one wanted to come. I mean, he's nice enough but he talks and talks and talks.
And we don't talk much with the young man who's been there since 4.30 waiting blood test results. At one time he flags down a nurse and is simply told, "If there was something bad, they would have told us by now." Which apparently means: otherwise, you can sit down, shut up, and wait.
A nurse comes by at some point to talk about the wait. It's the first human interaction we've gotten since entering the hellish back waiting room, other than nurses shouting down people seeking information and other staff looking for patients that they can't locate. The nurse mentions the idea that people might want to leave, but blows it off. Except Kimberly doesn't let him. After he goes straight through, "If anyone wants to leave ..." and then moves on as if no one would, Kimberly says, "I want to leave!"
Because she's now thoroughly past the episode. And we now know there's no chance of an EEG, not that it would matter at this point. So we're just burning our evening in a place with sick people all around.
The nurse gets us out of there some time later ... and brings us to waiting room #3, in the way back of the ER. He seems generally helpful, the second such person at the hospital after the intake nurse, who's now something like 3.5 hours in the rear view mirror.
And we wait more and more and more. Our helpful nurse goes on break. But by this point it's obvious that we're out of the pre-ER-room purgatory, into a place where things are actually getting down, albeit at a slow rate. And where they're actually treating us like human beings rather than spending all their time ignoring or attacking us.
And eventually a doctor comes by, lets them know they didn't see anything in the blood test, but can't rule anything out, and discharges Kimberly, "against doctor's orders". Which hopefully doesn't cause problems with the insurance payment in this f***ed up things we call a healthcare system in the US. But that's entirely a problem for another day (and hopefully not a problem at all).
The helpful nurse comes back from break as we're checking out and thanks us for being patient, and I should have thanked him for his help because I always do my best to recognize that good service providers aren't responsible for shitty systems, but I'm too annoyed by the whole situation to do more than nod.
On our way out we wave to the young man who got his blood tested at about 4.30. He's still in the secondary waiting room. It's now 9.30.
We've unfortunately been to Alta Bates ER a number of times in our twenty years in south Berkeley. And, it always sucks. If you go in for a physical health problems, you're not out in less than 4-5 hours, and most of that time is spent sitting around while no one talks to you.
But yesterday was a real highlight. Because we were there for almost 4.5 hours, from about 5pm to 9.30 or so. And we never even got a room. And we saw the worst doctor that I've ever had the misfortune to interact with (though Kimberly has dealt with worse, IMO). And we learned that they couldn't even do an EEG if they wanted to despite machines being within a few hundred yards, not that they particularly cared about Kimberly's symptoms once we got back to a doctor; they seemed more intent on deriding and doubting them.
And as I've said, yes that hospital has to deal with a lot of people who are deranged or drugged or drunk or lying to them, or all three.
But it's no excuse.
Alta Bates ER at Ashby & Telegraph gets 1 star.