A Day in the Emergency Department of a Public Hospital

Yesterday, Saturday in Australia, hubby woke up with severe pain down his right leg. He had had a very bad night and could not bear the bedclothes to touch his skin. We decided to call an ambulance and rang 000, our version of 911.

I just had time to wash and quickly dress myself before the ambos arrived. They assessed the situation, administered some morphine and took him off to the nearest public hospital. I gathered some things - most recent (2014) medical history, medications, spectacles and dentures, shoes and socks - and followed in the car.

Since it was only about 7 am I was able to park quite close to the ED but already they were quite busy. It took some time to find him once I was allowed past the doors to Triage. Nothing much was happening for him since he was out of pain and others had more urgent need. I left and had a cup of coffee and something to eat at the café and when I returned he was being attended to but progress was slow. A sweet doctor, an American lass as it turned out, took a very detailed medical history and examination before ordering blood tests. He is Type 2 Diabetic and of interest was his blood sugar, uric acid levels and leucosytes, plus a whole lot more. Results ruled out infection and gout. An Xray was taken that showed no obvious fracture.

Mid morning he was moved from Triage to the Short Stay Unit and admitted. At this stage we were asked if he would like to be a private or a public patient. If we were to choose the latter there would be no charge under our universal healthcare system but equally, if we chose to utilise our health insurance, since we have top hospital cover, we would not be out of pocket. We chose the latter because it helps the hospital with their costs. I was rewarded with free parking for as long as needed and a voucher for coffee at the café.

While we were parked in SSU I observed a number of the other patients. There was one darling old man who looked like the geriatric Bilbo Baggins from LOTR. He was quite shrunken and it was easy to picture him as an elderly Hobbit. Whenever someone approached his bed he roused and greeted them with a lovely smile and a friendly "Hello". He never complained once. They were assessing him for dementia before admitting him to the geriatric ward. I was amused by his answer to the question "When did World War II end? His reply - "I don't know. It's never really ended, has it?" Then he wanted to talk about his life history and I heard that he was in Latvia during WWII.

The hospital seems to depend on people from all parts of the globe. Asian and African faces are quite common. Some are born in Australia but others are more recent immigrants. This is confusing for some of the older patients and for some, quite terrifying. I had an aunt like that. She did not want to be cared for in an intimate way by anyone with a brown skin. She was also an old maid and was very uncomfortable with male nurses. Male doctors were OK though.

With my aunt in mind, I wasn't too surprised by the screaming old lady who was wheeled in. She was in a state of extreme anxiety, possibly fear, and kept shrieking "Don't touch me!" and "Get away from me!", over and over. She wouldn't even accept a drink of water until all of the men and dark skinned people left the area. The poor old dear was like a frightened child, sobbing, calling out for blankets and becoming hysterical at all attempts to take her blood pressure. I felt sorry for the staff who were having such a difficult time trying to care for this old woman who had no-one she trusted to help calm her down. In the end they just let her be and she went to sleep.

Finally, after hubby had been served his second hospital meal for the day, the doctor, who was still on duty, came to explain that in her opinion the problem was nerve pain. The discharge letter was extremely detailed with regard to all of the tests and examinations and hubby is to see his GP on Tuesday for follow up treatment/medications. In the mean time he has some strong pain meds he can use.

A full day in the ED cost us nothing and even if we did not have health cover, it would still have cost nothing. This is how universal single payer health care works in conjunction with private health insurance. When we go to the GP it will cost nothing because he bulk bills Medicare, our universal scheme.

I wish Americans would look to the various schemes in other countries before deciding that single payer schemes are not functional. With the right planning and administration they are national assets.