Patient Lost In Aisle Five of the ER


For two days the inside of my ribcage has been sore. A dull throb, even, on the left side. I am looking at myself in the mirror. The night it began I felt lightheaded and my left arm had a pulsating throb, dull, numbing in heartbeats right down the nerves and veins to the fingertips. That was two nights ago and the soreness beneath my ribcage has not waned. This has now become disconcerting. I shout downstairs for my wife.

There are ten hospitals within a two-hour drive. The hospitals nearest the city have the highest average ER-costs. There are websites dedicated to comparing hospital costs, for the consumer’s benefit. There are five levels of ER care depending on how much you’re dying. If you’re a Level 5 dying, the costs are highest. I understand from a business perspective this makes sense. But I don’t know what kind of heart attack this might be, hopefully a minor, not near-death one. People can have minor attacks without even knowing. I am hoping for this.

90-minute drive to the next county, rural hospital, cheapest ER. We’ve brought the credit card to prepare for Level I Might Die.

The ER waiting room has bandages, gauze, Neosporin, crutches, braces, IV bags, in vending machines along the wall. I take my family through the security checkpoint and am greeted my a polite hostess who walks us to an empty bank of seats. I fill out forms and pass along my information. No, I do not have health insurance (pangs of guilt). I am handed a financial assistance form. I am an asshole bilking the insurance pool.

We are led down a cozily-lit hallway, in the patient rooms we pass are flickers of candlelight and soothing audio of nature. There are shiny metal carts draped with white cloth, clean china and those ornate metal domes that keep meals hot until the butlers can serve. The end of the hall we make a left, antiseptically pungent white fluorescent light. We wait in the financial assistance room. My vitals are read, EKG, awaiting the results. Everything appears fine. This is great. I’m not at risk of a heart-attack, I don’t drink copiously or smoke or do hard drugs, I’m not over 60 and I’m not morbidly obese. But the EKG doesn’t always pick up everything. If I’d like to, they can take an X-ray to look for obstructions or swelling, the only heart-attack signs the EKG won’t pick up. How much extra? About a grand. This is okay, I filled out the financial assistance form, I have a credit card, my chest hurts. What aisle for the X-ray? We’ll take you to the Radiology Department.

It probably wasn’t a heart-attack, is the verdict. Probably pulled a muscle or a tendon or a ligament in my chest. I work manual labor, this sounds plausible. I am given the bill for services rendered and sent home with Ohio Health System key-chain, bumper sticker, and t-shirt Made In Taiwan.

My wife is asking about the bills. It’s okay, see this one right here, the hospital gave us 75% financial assistance, the $800 is only the original charge, before the sliding-scale discount. Yeah, says wife, but then these other two bills. This one for $400 is for the ER doctors, and this one for $1,200 is for the Radiology doctors. This warrants several hours of phone calls: elevator On-Hold music, transfers between departments, telephone line dead-ends. It is explained: the ER doctors and the Radiology doctors don’t actually work for the hospital, just in the hospital, they have their own companies they work for and you have to call their respective billing departments for questions concerning your payments. Can you transfer me? No, sir, I can’t transfer your call to a different company. Have a nice month.

I’m an idiot. My illusions of how the world works are the puerile impressions of Sim City. As a kid, at the computer, building fake digital cities and you always had to build a police station, a fire department, and a hospital. Zoom in to the Sim City streets, see the little cop cars, fire trucks, ambulances racing to save the dying Sims. You had to raise taxes and allocate funds. It was a computer game for kids, of course it was simple.

Sim City is not real life. It is time to grow up. Be a good citizen, follow the law, make your monthly payments to an insurance corporation.

Someone was breaking into our car last week. Wife the insomniac saw through the window, stranger with a coat hanger crammed down car door window slit, trying to disengage the door lock. She called the police. We were standing in the street beside our ravaged Nissan, the police officer taking our information, filling out clip-board forms. He tore off the yellow carbon copy and handed it over, a bill for $800, make all checks payable to Riverside United Security Services.

Yes, this makes sense, this isn’t Sim City.


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