Interminable ER night as seen by terminal optimist

Monday, February 17, 2003 at 12:00am

I have met the patron saint of the half-full glass. In a world defined by narcissism, victims and crybabies, S.J. is beacon of selflessness, patience and optimism.

This is true for her even at age 76 as she deals with cancer and was recently shed of one breast. And true even with a painful, chronic, post-operative infection that sent her to a hospital emergency room two weeks ago for the sort of experience that would have sent less saintly sorts into a homicidal rage.

This event sheds light on the catastrophe that is our nation's health-care system. It was late Friday afternoon of course, when all infections seem to perk up and doctors vanish into weekend twilight. The doctor on call promised to see her right away at the hospital emergency room.

Arrival time: 3:45 p.m. By 7 p.m., the waiting room had filled with a smorgasbord of humanity. A large extended family seemed to be holding a reunion while the family patriarch lay dying beyond a curtain in the next room. Next to S.J. sat a woman who also seemed to be dying. Outside, a car zoomed up, someone pushed a body out of the passenger seat, and the car sped away.

S.J. realized she wasn't dying, but she also understood that her infection could become life-threatening if untreated. Her concerns were elsewhere, however, as she worried mostly about the children tumbling around the room missing their bedtime. It was now past 9.

Sometime around 10 p.m., after waiting almost six hours, S.J. was escorted to a gurney, where she was treated to an I.V. During the next two hours, her infection got inspected and discussed. Yes, it was a whopper of an infection all right, the sort of thing one might want to keep an eye on overnight. Alas, she was told at midnight, there were no empty beds.

S.J. was sent home. The doctor who had promised to meet her never materialized.

Two weeks later, the infection is still making life miserable for S.J. She's trying a new, stronger antibiotic this week. She tells the story of her visit to ER hell as though it were not such a big thing.

"I figured I was supposed to learn something from it so I've focused on that," said S.J. "I learned a little more patience and humility. And I also learned that if you ever have surgery, make sure you ask your doctor for an antibiotic to start immediately."

The half-full glass.

Here's the half-empty glass: No one should have to wait eight hours for a doctor, but thousands do every day. The crisis in our emergency rooms isn't new, but it's getting worse. A new study released Monday by the Center for Studying Health System Change (HSC, www.hschange.org) found that emergency-room overflow owing to increased demand and fewer hospital beds is putting patients at risk.

"Serious threats to patient care are emerging," said Paul B. Ginsburg, president of HSC, a nonpartisan policy research group.

The biggest problem is that more than 40 million Americans have no medical insurance and turn to the emergency room for their health care. As ER visits increase

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