The familiar antiseptic smell hits me as I walk through the ER door. I look around for someone to check in with, squinting at times from the bright open space and the drowsy blur of high blood sugar. I finally catch the attention of someone at the reception desk. I stand for several minutes, leaning on the counter, without any response from them. They don't realize I am a patient with an emergency. "May I help you? Are you looking for someone?" they asked. My red backpack slung over my shoulder weighs heavily as I calmly wait. They don't notice I am short of breath, having walked myself to the ER from my apartment, sick, in pain and with high blood sugar. I am 29, but look 22, by many accounts, which undoubtedly contributes to their incredulity.
Straining to hear with one ear, trying to talk without enough breath and with liquid gravel blocking my throat, I say softly, "I'm here to be seen." "You're...oh you're a patient...oh, ok, what's going on?" I continue, clearing my throat, and trying to subtly turn my head to hear as well as possible."I have a bad ear infection...I have been trying to get it treated for a few days and I'm taking antibiotics, but it's much worse." Knowing the pain scale... I offer, "My pain is an 8-9 out of 10," trying to concentrate as my forehead, ear and neck throb with heat. "I have type 1 Diabetes and I've only been able to eat about half a sandwich today. I took twice the insulin...My blood sugar has been high for hours, I'm in pain, I have ketones, I don't know if my eardrum's perforated...it's ringing and completely clogged." They register me and I enter a small triage room, a little dizzy from my ear filling and draining, knocked out from the pain, my throat burning with dehydration. Everything looked a little off balance and I was ushered, shakily, onto a stretcher. The nurse came in through a door behind me and moved around to talk to me, ask history and take a blood sample including a finger stick. I am comforted by the quick treatment and think I am going to go straight back to see a doctor. He tells me they would most likely start fluids and IV antibiotics. All the while I think this must be why the Emergency Room here is so highly rated.
I am sent back into the waiting room.
I wait, in pain, with my eyes closed and my ear ringing, leaking and excruciating. There is more triage in a cubicle like area that has windows with blinds. The second nurse is not so helpful. He takes vitals and a rushed history while typing disinterestedly, half listening because he had to. I summarize that I have type 1 Diabetes, High Blood sugar (the fingerstick ER did was 399) and had been seen twice already for an ear infection that's much worse. I try to get the words out while keeping myself from choking on the congestion draining into my throat and with almost no ability to hear out of my left side.
I am sent back into the waiting room.
I sit near the cubicle triage area. I figure if my eardrum perforates or I collapse or something they would see it and help. Naive. They signed up to help sick people, right? I didn't sign up to be sick...surely they understood that, right? Naive. I sit holding myself up in the hard chair, partly by hugging my red backpack. In it are a few books that I fantasize I'll get to study while waiting in the ER. My eyes are closed for most of the wait, blocking out the extra stimulus of sight and light because the ear pain and clogging was almost too much to endure. My ear is the size of my head, pushing, pulling, vibrating inside of throbbing inside of trembling. Scratching and stabbing with dull, flat and muffled hearing except for the crystal clear sound of my own breathing, sniffling and crackling of fluid. Tears begin streaming down my face as I sit, still, and silent. I struggle to keep from moaning awkwardly, out loud, in pain. Not tears of emotion...tears of pure physical agony and exhaustion.
I open my eyes for a second to look around. The emergency room is still not that full, it's not a level I trauma center, why is it taking so long? I see patients getting walked back who arrived after me. Tears keep streaming down my face and as I look around I inadvertently make eye contact with the rushed triage nurse. He has no patient in his "office" at the time. He looks away flustered and closes the blinds angrily. Crash. I guess he doesn't want to see me.
I wait longer. Then, they take me back.
Climbing on to a stretcher, situated between two curtains, I try to navigate my shaky body to judge the angle of the head of the bed and it's width. "Can you pull up the railing," I said. Click. I lie back on the hard foam, no pillow, and close my eyes. A blur of staff come through to take my history. An IV is started after I point out spots on my arm that I know won't infiltrate. Piece of cake. Matt walks into the room, backpack slung over his shoulder. He had been studying for law school finals. A Resident arrives to check my ear. He stands at my left side, takes a gentle look and asks questions. Matt says "She can't hear you out of that side." The Dr moves to my other side and starts drawing a picture on a paper towel. He shows me and says loudly, pointing to a drawing of an open ear canal, "this is a normal ear canal." Then he points to his drawing of two converging lines and says "this is your ear canal...swollen completely shut." An Attending comes in to examine the ear and the tender tissue around it. "You need a CT scan, I think your ear infection has spread to your skull base...the entire left side of your face and head are swollen." I feel a little stunned but too sick to react. I just shake my head, in affirmation, and close my eyes. Another Resident comes in, after a while, to clean my ear. He emphatically describes all of the "purulent and awful, red, black, yellow..." debris he removes from my ear, and commenting how bad the infection is.
Now admitted, I get fluids and medications. I communicate to staff an insulin dosage that I have estimated, without assistance, and take a bolus through my pump. Although I have dangerous signs of acute Diabetes complications from the infection, the Diabetes takes a back burner for the entire hospitalization. Except for the hospital's inadequate "Diabetes protocol" I check my own fingersticks, figure out my own dosages and treat my own hypos. This ignorance and added burden frustrates me, from extremely late meal trays, to surly or no response regarding hypoglycemia. After all, I wouldn't be in this predicament if not for the Diabetes, but I need to just keep "one eye open" and pull myself through it. I've just got to figure it out, I think to myself, and get well enough to get back to my classes and life. My shoulders tense.
My bed is ready.
Staff helps me onto another stretcher, laying the cold IV bags next to me, bumping my bare shoulder. We roll down the hallway. I hate rolling through the hallway on a stretcher. It's bright, cold, I look and feel awful, strangers and staff look. There is a breeze from the motion. I shift my eyes downward to check whether I am covered. Ok, I have a blanket over my haphazard gown now. The wheels on the stretcher continue to screech and hum. We get to my room; my bed is next to the door. I have a roomate who is snoring. It's about midnight. I explain that I haven't eaten, and a tech brings me a turkey sandwich, packaged shortbread cookies and an 8oz diet gingerale from the unit fridge. I eat voraciously, salty, sweet and artificially refreshing. At least I have a pillow now, and it's dark. Sleep.
Sleep. Wake up to nurses. Sleep. Wake up to pain. Sleep. Wake up to roomate. Sleep. Wake up to bright lights abruptly turned around me. Deep breath. I guess it's morning. I yawn and squint my eyes. The whole "crew" was standing around me, eager to see what was probably the youngest malignant OE they had ever seen. Several ask questions and histories. Some look at the ear and then they leave. Sleep.
A few bites of lukewarm oatmeal and tea for breakfast. In walks a senior medical student. He acts as a Liason between me and staff. I am thankful for his help and communication efforts. He leaves. The ENT who was in morning rounds walks in, examines the ear and cleans it again. He says a bunch of stuff. I mention that my blood sugar is still h...He cuts me off and says "Well, that's because you're in the hospital..." He leaves.
It's after lunch and I notice how grungy I feel and remember that I had not been given a new gown or any toiletries. I have to go to the bathroom. I sit in bed for quite a while contemplating using the room's bathroom. I finally get up strength and am motivated by the indignity of having to use a bedpan and wobble over to the bathroom. I look around and notice that my poor roomate had left bodily fluids around the bathroom, including a stool sample. My heart sinks and I peek out of my room to get the attention of a nurse. They say I can use the staff bathroom. I do and return to bed, still grungy and waiting for the requested help with a new gown etc. I wait.
It's evening and the nurse comes in to tell me that they are moving me to another room. I go. Another night of sleep and interruptions. My pain is a 6/10. I wake up in the morning to a similar scene. After lunch I remember I am still in the same gown, and without toiletries. I had mentioned it the nurses several times. My friend the med student walks in and I let him know. He says he will get a PCA to help. Oh good, I thought to myself, as a PCA walks in... I perk up and start to ask her for help...She keeps walking past me to go to my roomate. As she leaves I catch her attention and tell her it's been two days since I've changed. She keeps walking toward the door and says "Sorry, you're not my patient." Later someone finally did help.
My med student friend comes back late in the afternoon and explains that I would be getting a PICC that evening so I could be dischared on IV antibiotics...hopefully the next day. My favorite. Knowing it was fruitless, I tried to talk him out of it and asked him to find out what alternatives there were. He made a valiant effort.
In rolls a screechy cart being pushed by a masked IV nurse. She was confident, and had strong looking arms. I tell her that PICC lines aren't my favorite. She explains the procedure and proceeds to double numb my arm around the site and inserts the line without incident. Why didn't they double numb the site the other times? I thought to myself. Piece of cake.
I start to consistently get my appetite back that evening. I sleep a little more comfortably except for some swelling with my PICC. My pain is a 4/10. I spend most of the next day in the hospital and get disharged some time after dinner. Matt arrives to bring me home and I begin to fantasize excitedly about the prospect of taking a shower and make sure I have the supplies I need to wrap the PICC. This trip to the hospital is a wrap.
I return to class a few days later and even hang a bag of Meropenem in my VW GTI before a Microbiology lab (I actually have a picture of this somewhere). I don't want to be late so I try to squeeze the bag a little so it would go in faster...I rock that lab...and the whole class. Afterall...I have an increased depth of perspective on the effects of infectious disease.
