A Day and A Night in the ER

 Welp, it's happened again. After waiting longer than I should have, I called the advice nurse about my increasingly uncomfortable condition. She said I needed to be "seen" within the next four hours; I should go to Urgent Care or the ER. Mkay? The nearest Urgent Care run by my HMO was 47 miles away. There is a Primary Care run by another outfit in my little town, and as it happens they take my insurance, so I've been able to go there for immediate care, but not this time. They wouldn't be able to see me for at least 24 hours. Low on staff, high on patients. Mkay? 

So the choice was the Urgent Care way out there. They could see me in a couple of hours.

I got there and was informed they were running behind, but they'd get to me as quickly as they could. It was only about an hour later (c. Noon) when I was called in to the examining room. BP and temp were OK; I was alert, coherent, ambulatory -- with some difficulty. Described symptoms and problems.

"Dude, you need to go to the ER, stat."

Oh fuck. I hate the ER. Nothing but turmoil, stress and strain, lack of care, waiting and waiting and waiting while the place fills up with more and more suffering, disease, madness and pain. What is the point. 

The nearest ER as it happened was another 15 miles or so away, and the Urgent Care said they would call over and let them know I was coming, and they said it would probably be less of a wait there because they would probably have fewer patients.

Mkay. We get to this ER, and truth was there were hardly any patients in the waiting room. Five, maybe six. Most had already been triaged. Some had been seen and were waiting for test results.

It was calm. Very little obvious suffering. Quite a few people came in while I was waiting for triage (c. 30 min). Nearly all were members of one family there to see their relative who was being treated inside. They were allowed in two by two. 

Triage was straightforward, and I was told to wait in the lobby. They'd see me inside as soon as they could. 

More patients came in while I waited. More visitors came to see the one special patient as well as other patients in treatment. Some of those who arrived were in really bad shape. Extreme pain, unable to walk, one couldn't even sit and her wheelchair ride was torture for her. Some appeared to be having strokes or heart attacks. 

And believe it or not, all of those I saw in serious distress were treated promptly and compassionately by the very young staff, none were left to linger unattended. Some were treated directly in the lobby, others were wheeled or ushered into the ER treatment areas, but none were neglected.

This was astonishing. I have never been in an ER where staff did not neglect the patients, ignored their suffering, even disparaged those who sought treatment. I have never been in an ER where prompt treatment of severe conditions was the rule. I have been in ERs where staff had no interest in or consideration of patients waiting, and where patients died while waiting without any care at all. The cynicism and contempt for patients in some ERs I've been in has been off the charts, and it's happened so often, in so many different ERs in California and New Mexico, I took it for granted as just the culture of these places. It's outrageous, but there you are.

This was an entirely different situation altogether. I didn't need immediate treatment, though I would have appreciated the pain medication I eventually received had it been administered while I waited. I got an xray within an hour of arrival, but had to wait to be "seen." My distress was minimal compared to some of the patients who sought care, and everyone who needed immediate care received it compassionately. Those of us who had to wait mostly did so with equanimity; so many others were in much worse shape than we were.

After about 5 hours waiting in the lobby, I was called in to the treatment area and assigned a room where I was introduced to the nurse and CNP who would be treating me. Both were kind and positive. As it turned out, the nursing staff would have a shift change in an hour, but the CNP stayed with me throughout. 

Treatment would take just about 8 hours.  During that time, I received a CT scan, pain medication, Ringer's lactate, anti-nausea and anti-inflammatory medication, and two different treatments for the condition I was there for. Neither was fully effective while I was there, but I was discharged with a prescription for another medication to take if the ER treatments didn't work within the next 6 hours or so.

When I read the after visit summary, I noticed that the CNP had missed a finding on the CT scan -- I had a hernia -- which which was probably a contributory or precipitating cause of the problems that sent me to the ER. Oh. I suspected the hernia, and I pointed out the odd swelling and pain in my groin, but it was not recognized by me or anyone else for what it was at the time. The CNP said it was "gas". And I saw on the CT scan report that there was considerable build up of "gas." But missing a hernia with obvious symptoms (I realized later) was odd. 

The treatments that were administered in the ER did work effectively the next day at home, so that part of the problem was taken care of, thankfully. The hernia has not been addressed yet, though the swelling and pain are not as severe.

It seems to me, I've had this condition before -- a hernia, that is -- and after several weeks, it self-repaired. We'll see. It's not fun, but it's bearable. Primarily it limits my movement. 

What I can say about the overall experience in the ER this time is that it was worlds better than any ER I've been in (for myself or on behalf of others). Even though part of my problem was missed by the staff, or perhaps not missed but dismissed as not that important, I was treated with consideration and respect, was given needed medications and treatment, was tested and imaged to a fare-thee-well, and discharged with explicit instructions and medication prescriptions with orders to return promptly to the ER if none of it worked.

Well, it did work, and I'm grateful.

Now to deal with the hernia... 🤪

Another Memory Exercise. Some Things About This House

There are lots more memory aids now than once there were. It's easier to remember but also easier to get confused. One of my memory aids for the house in the San Gabriel Valley I've posted about several times is Google Street View. It's become something of a historical record because it records the appearance of the house and neighborhood over time, in this case from 2008 to 2022. A major change -- to me -- took place after 2011. 

This is a screenshot of my house and the house next door (where the Vegas lived when I lived in the neighborhood) taken in October 2011:

 

Several things: The Vegas' house is light brown, which it was when I lived in the neighborhood. The house where I lived is painted yellow -- which it wasn't when I lived there. But it was yellow the last time I saw it in person in 1969. When I lived there, the house was painted white with dark green (Hunter Green) trim. 

There's a heavily cracked blacktop asphalt driveway, the only one still remaining in the neighborhood. That was put down some weeks or months after we moved in in 1954. All the driveways in the neighborhood were blacktop initially. Before the driveway was installed, it was just graded dirt which turned muddy when it rained. My mother was livid about it. But the house itself wasn't finished when we moved in. There were still parts needed stucco and plaster, some plumbing fixtures weren't installed in the shower, trim still needed to be applied on the interior and exterior, and the house hadn't been painted. 

Part of the problem was that our house was the last one on the street to be built and finished. This was the Post War housing boom, and houses were being built all over the Los Angeles Basin at a furious clip. This neighborhood was being developed so fast that Life Magazine did a feature on one family that moved from Connecticut to California and faced the dilemma of the New and Incomplete Reality of Los Angeles -- and this particular neighborhood --  at the time.

What had been essentially wild country -- hills and pasture, hills and oak forest, etc -- was turned into housing overnight. Initially, there were no curbs, gutters, sewers, or other amenities that would come later. Finishing the neighborhood, to the extent it ever would be finished took years. 

The curbing you see in the picture didn't arrive until long after we moved out in 1959. I'm not sure curbs were there in 1969. And I've noticed on Street View that the sections built on street extensions later (in the '60s and '70s) have street lights while the sections built in the '50s do not.

In the picture you see a rusty rural mailbox. That was put in by my mother after a dispute she had with the post office. It was probably 1956 or so. Initially, she'd mounted a fishing creel on the wall beside the front door to collect the mail. One day she got a notice stating that her mail receptacle was not regulation and must be replaced or US Mail would no longer be delivered to that address. If I recall correctly (ha!) there was no indication of what would be acceptable. So I suspect she marched down to the post office (I don't remember where it was) and demanded to see the regulations, and she found that a rural mailbox would be... fine. 

She went to the hardware store and bought one with a metal stand. She painted the box with flowers and vines and such, mounted it on the stand and put the whole apparatus in the ground (may have had help from a neighbor) beside the driveway. With a note that said, "Put Mail Here."

Later she found out that a rural mailbox in a suburban neighborhood like ours wasn't regulation either,  and she got a British iron letterbox at an antique store and mounted it where the fishing creel had been, and that was where the mail was deposited until we moved. I think she took that British letterbox with her when we moved, but I'm not entirely sure. I seem to remember it turning up in several later houses but it may have been another one.

There's a large tree next to the mailbox in the picture up top. That's an oak (madrone?) that I planted between 1956 and 1958. It was a seedling that sprouted up in the hills beyond the end of the street. I dug it up and carried it down the hill in a can of some sort and planted it in the front yard when I got home. It grew. It's somewhat unusual because oaks don't like being disturbed especially as seedlings. But this one did fine. It was maybe two-three feet tall when we left.  Sadly, the oak tree and the mailbox are now gone (a/o 05/22). But they had quite a long run.

The Odd Persistence and Absence of Memory

Note: there has been much editing since I first published this post. And a discovery or two.

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This goes back to that picture haul I was gifted with on Father's Day. One picture in particular sticks in my mind, but there were several taken on what I think was the same day in the summer of 1957 (I was 8 or 9), and while I focus on one, the others might be referred to from time to time for context.

The photo in question is one of me sitting on the couch in the living room of my house in the San Gabriel Valley of California on a sunny but probably smoggy day. There's a sort of misty quality to the photo which I find intriguing. It's probably due to a dirty lens, but when I think of that, I also wonder who took the picture. The picture appears to be taken from the level of the seating, and I suspect the camera was placed on the seat of a wing chair that faced the sofa (a sofa that was actually a sofa-sleeper.) I'm holding a fluffy cat whose name I don't remember. I don't recall the picture being taken -- nor do I recall ever seeing it before. This makes me wonder. 

I don't recall having a camera of my own at that time of my life, but maybe I did. There was a dual lens reflex camera I remember using frequently a few years later after moving to Northern California, and it is at least possible that I had it much earlier and that the picture in question was taken with it -- or one like it. I say that because I have a vague memory of more than one such camera.

But the problem of who took the picture -- or the series that day -- is vexing. I have the feeling that I took them with a shutter-timer. But I have no memory of having a camera with a shutter timer until much later in the '60s or even the '70s.

So I think the camera was placed on a chair, the timer was set, and I got in position -- with a cat -- before the shutter was tripped. If there was someone else there, who could it have been?

I had quite a few friends in the neighborhood, but they rarely came over to my house. I usually went to their houses, and I remember many games of canasta or Monopoly at friends' houses, but hardly any at mine, and when we did play cards or Monopoly at my house, we sat on the front porch, never that I recall in the house or backyard. The rarity had to do with the fact that I was there by myself while my mother was at work at the hospital, and she was quite clear that she didn't want me to bring other kids over to our house while she was not there. Could she have taken the pictures? Perhaps, but I don't think so.

These pictures were taken at my house in the living room and the back and side yards of me and my pets and there appears to be no one else there. Which would be right -- it would be very rare for one of my friends or another adult to be there when my mother wasn't.

This is one of the many oddities of memory, though. I could be misremembering. There were times, I know there were times, when a friend, a neighbor, or another adult came over when I was there alone, I just don't remember it happening as part of taking these pictures, nor do I remember my mother taking the pictures, and there is nothing in these pictures that indicates anyone else was there.

And I don't remember these pictures being taken or ever seeing them before Father's Day this year.

The sight of a much younger me sitting in my living room in 1957 holding a cat is somewhat jarring. I remember the room quite well and its furnishings. I remember what that couch upholstery felt like (rough) and look of the round oak table we used as a coffee table (it had been a tall mission style "center table" that my mother had cut down). I remember the antique mirror hanging above the couch and the Currier & Ives prints on either side. I remember the white cotton shag rug under the table -- and how glad I was when my mother bought it and brought it home. If I remember correctly -- and I may not -- the walls of the room were painted gray-green. There was a huge picture window at one end facing the mountains to the north and I remember the light from that window being very bright despite its northern exposure.

The story of the rugs in that house is kind of important to my memories of living there. The house was not quite finished when we moved in in 1954. There was still stucco-ing and painting going on and there were bits of trim being applied and plumbing fixtures being installed (if I recall correctly, the shower wasn't finished when we moved in). There was no landscaping; the lot was bare and dusty. There were no sewers, no curbs, no gutters. Initially the driveway wasn't finished, and one day the asphalt pavement was put down, but we had to be careful not to walk or drive on it for a time. The absence of sewers meant that the plumbing drained into a cesspool -- not even a septic tank -- in the front yard, and I remember it had to be pumped out from time to time. The sewer line was installed the year after we moved in.

We had a few braided rugs that had come with us from other houses, but they were small and didn't do much to muffle the echoes of footfalls in the house. Oh yes, I remember the house being very echoey due to the plaster walls and hardwood floors. The white cotton shag rug in the living room probably appeared some time in 1957 -- my mother also got a new car that year -- and even though it wasn't all that big (probably 6x9 though it may have been 9x12) it made a big difference because it was soft and sound absorbing, and I remember the echoey-ness of the house diminishing greatly once that rug was put down.

By the time these pictures were taken the back and side yards -- and the front, too but there were no pictures of that -- had been planted with grass and bougainvilleas and roses and there was a water feature in the backyard ringed with bricks and lattice fencing put up to hide the incinerator (which I think we couldn't use after 1956) and to mask the side yard where the clothes line was.

I had asthma and the smog was bad in the San Gabriel Valley, so being outside (or inside for that matter) could be difficult for me. I had attacks fairly often until we moved to Northern California in 1959. But oh well. It was what it was.

I remember the house was painted white with hunter green trim, quite different from other houses in the neighborhood which were mostly brown, beige or gray with white trim. I remember my mother insisted on white and dark green trim. She said there was a reason, but I don't remember what it was.

I'm 8 or 9 years old in these pictures, and I'm surprised at how skinny I was. I don't remember being skinny until I was a teenager. In fact, I remember being kind of pudgy up until the age of 14 or 15 when I started getting taller. So seeing how skinny I was at 8 or 9 is a revelation.

There's an exercise I'm supposed to do prior to a Zen workshop coming up: describe yourself from the point of view of the Earth.

From the point of view of the Earth, of course, these descriptions of myself as skinny or chubby or alone or with friends or my age in these pictures or really anything are silly, irrelevant, laughable. From the point of view of the Earth, I don't exist as an individual at all. The minuteness of humans in the context of the whole wide world -- which itself is minute in the context of the Solar System -- is striking. There is no "me" in that context; there is no "we." Less than a mote of dust. 

And yet from the point of view of the Earth, I and the aggregate of humanity of which I am a infinitesimal part are in the process of "killing the planet." Perhaps like a disease organism might do to me or someone else at human scale.

The planet, the Earth, is responding. Cranking up an immune response against which I and the aggregate of humanity have no real response.

In thinking about these matters of scale and existence/non-existence, past and future, I recall the teachings of Vimalakirti  and all the Buddha-realms beyond our ken. Perspective is hard to obtain. Once obtained, it may be hard to maintain, and memory may fade. But what is is no matter whether we see or know it or not. 

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Silly me. I looked on the back of the photo and found a note written in my mother's handwriting stating that the "we" took the picture in the house, and the flash didn't work. Note says, "How was I to know it needed batteries!"