A Joke Falls Flat

I would rather have remained entirely ignorant of the quality of care available at midnight at the emergency room of the hospital on the south side of Gardnerville, Nevada. However, the cards dealt me that particular education as the coda to my week’s vacation in the Lake Tahoe area.

Friday night at about 9:00 I began noticing a sharp pain in my abdomen, just to the right of my navel and within my ample belly by several inches. I took an aspirin and finished my glass of wine, and resumed catching up on my Ordinary Times reading. (That’s right, I was reading these very pages.)

Around 10:30, I got up to answer nature’s call and found that the pain had not receded but indeed had grown much more intense, and migrated lower, further within my great big belly, and closer to my right hip. Sharp pain, migrating to just over the right hip, feels tender to the touch and firmer than the left side. I may not be a doctor, but I know I haven’t had my appendix out yet.

I tried to stand up, and had difficulty with the pain. And then I vomited up my basically undigested dinner. Which sealed it for me: if this isn’t appendicitis, that would be great, but if it is and I do nothing about it, it’ll freaking kill me. And we’re half an hour or more away from the nearest hospital, which is down the mountain in Gardnerville.

I informed my sleeping wife that we needed to go to the hospital and she thought we should just pack our stuff up and head back home from there, since we were going to check out the next morning anyway. So that took the better part of an uncomfortable hour, and then we drove down the hill.

An aside: a lot of places offer “emergency medicine” or “emergent care” and look like hospitals but really are clinics, that do not have 24-hour services available. Such was the first health care provider that we came across in Gardnerville. I’d noted this place on our drive in and mentally filed its location away under a “just in case,” and when “just in case” actually happened, I drove there to find it completely closed. In the future, it may pay to learn where the actual hospital is in town when visiting a new location, rather than just remembering where vaguely medical-looking stuff is.

Another aside: if you ever have the pleasure of visiting Garnderville, you’ll find it’s a charming, quaint community. Most everything is on the main drag, and the town’s leaders have gone to some effort to cultivate local businesses, both tourism-centered and otherwise, all on the main drag. Which has a resulting speed limit of 25 miles an hour for the entire length of town. When you are in pain and need to get to a hospital, in the middle of the night when there are no other vehicles anywhere in sight, adhering to this speed limit is a very, very frustrating thing to do.

Anyway, back to the subject at hand.

I’ve needed to use the emergency room in my own community before. It’s crowded, smelly, staffed by surly and unemphatic clerks, and the wait for medical care is hours long. I was prepared for a similar gauntlet — surely on a Friday just before midnight, some people who had been asked to leave the nightly meeting of the local gun and knife club would surely be taxing the staff’s attention. It certainly would be here at home.

But no. One other person was in the waiting room, half-asleep. We had the place essentially all to ourselves.The admitting nurse took me right away, took my insurance information right away, and within three minutes of walking in, I had been introduced to an attending nurse who had zero other patients. No waiting. I gave my samples, she got me in a hospital gown, took my vitals, and covered me with a warmed blanket.

A doctor was with me within ten minutes of the time I walked in the door.

They put an IV in me, blasted me with an anti-nauseal and a narcotic of some kind for the pain, and suddenly I felt loopy like I was drunk so I was no longer aware of time passing so well. By then the pain had migrated further towards my back, and the doctor found nothing odd in my blood or urine lab results (which seemed to come back almost instantly) so he wanted some radiography. I got ultrasounded for stones in my kidney or gall bladder, and then got a CAT scan to confirm the health of my internal organs.

I needed the orderly’s assistance getting out of my gurney and onto the CAT scan table. When I did that, he made sure to line me up so that a guidance laser was pointing exactly halfway between my legs. So what did he expect me to say other than “You expect me to talk, Goldfinger?”

The name’s Likko. Burt Likko.

Granted, I was sky-high on a narcotic painkiller at the time, but I thought I was being really funny. The orderly didn’t get the joke at all. Later he said that no one had ever made that joke before. Really? Really? Hasn’t everyone seen Goldfinger? I can see not giving Goldfinger’s exact line from the movie in reply, since it’s a hospital and sometimes people get nervous, but a variant would be entirely appropriate: “No, Mr. Bond, I expect you to be scanned.”

They couldn’t find anything wrong with me. They printed out all my records, gave me a sample pack of pain pills and a prescription to fill if I wanted more, and sent me on my way. Amazingly, it was three in the morning when we left — I suppose it was the drugs but I’d had no sensation of that much time passing.

My entire experience, from the time we walked in the door until the time we walked out, was superlative. (Other than the orderly not getting my very, very funny James Bond joke.) It turns out that adequate facilities, trained and pleasant staff, and no other patients competing for resources can result in really high quality medical care.

I haven’t got the bill yet.

And it’s hardly the hospital’s fault I had a bummer for a tail end to my vacation. No diagnosis for what actually caused that pain — that’ll be an issue for my regular doctor here at home. But I’m not writing about my malady. I’m writing because I had as good an experience as could have been possible under those circumstances. To tell the story necessarily involves sharing those circumstances.

Prices at gas stations, lines in grocery stores, real estate prices, friendliness of interactions — that’s all nice, but needing help at an odd time of night is a good test of what a place is really like, how the people and facilities there will respond when put to stress. If this incident is any indication, that small city south of Reno must be a real nice place to live, even if the pace of life is a bit slower than I’m used to.
 
Burt Likko is the pseudonym of an attorney in Southern California. His interests include Constitutional law with a special interest in law relating to the concept of separation of church and state, cooking, good wine, and bad science fiction movies. Follow his sporadic Tweets at @burtlikko, and his Flipboard at Burt Likko.