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A reader writes … By Robert V. Liggett

January 08, 2001

An emergency room is a unique blend of bedlam and boredom. Lying face up on an ER bed about as soft as a 2 by 6, you stare at the nothingness that is the ceiling with little to do but think about what has happened to you, what happens next and when.

You aren't being ignored. Attending nurses and doctors, looking in from time to time, are waiting for blood and other specimen tests to come back from the laboratory, for X-rays to come back from radiology.

Activity in the room, meanwhile, is bustling, paramedics coming in with ambulance patients, other patients being admitted from the waiting room, most there when you came in and probably wondering why you were taken in before them.

A sure way to gain immediate admittance into that mysterious holy of holies, the emergency room itself, is to walk up to the admissions window and say, "I am experiencing chest pains."

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Before you can even sign in you are inside, on a bed, in one of those backless hospital gowns that reduce everyone regardless of economic or community status to the lowest common denominator. Modesty goes with the clothes you were wearing when you came in. You are poked, prodded and pricked, metered and monitored until you begin to feel like some kind of electronic pin cushion.

Before long you notice everyone rushing around like Grand Central Station at train time. All but you. You are studying the emptiness that is the ceiling as if it might hold some hint of how sick you really are, a blood pressure cuff on your arm automatically inflating every few minutes, presumably monitored somewhere in that bastion of technology.

The 12-bed emergency room in El Centro Regional Medical Center is an inordinately busy place for a 108-bed hospital. Its ER load equals that of hospitals several times its size and with emergency room facilities with many times the number of beds and floor space. That is why the new facility the medical center is about to begin constructing will have a 20-bed emergency room.

Overheard are words like "stat" and "get the crash cart, we have a code blue here." Intensity crescendos like the climax of a mighty symphony. The effort is feverish, virtually all emergency room personnel gravitating to the proximity of that one critical bed.

Lying on that slab-like ER bed in a curtained-off adjacent stall, thankfully unable to see what is actually going on, the intensity and immediacy of the response to an emergency cannot help but be noted — and appreciated. It could be happening to you.

Amid that cacophony of intense activity and movement of equipment are the sharp commands emanating from someone, presumably a doctor. You think more than articulate a prayer not only for that troubled patient but for the relatives who cannot be too far away.

Finally, you hear faintly the words, author unknown, "We have a pulse." The tempo of activity doesn't slow, but the sense of emergency begins to taper. And again, you are staring at the nothingness that is the ceiling, wondering, now back to your own problems.

You have been there for three hours, too much time to think about yourself. But you have learned a couple of things about ERs. The beds are hard because ER staffers never know when they might be called upon to administer cardio-pulmonary resuscitation and the needles in your veins and their connections to the IV bags above you are called saline locks or simply heplocks because they are often used for the injection of a blood thinner called heparin.

Finally, a nurse comes in to announce, "You are being admitted and we're taking you to ICU."

The intensive care unit is a different world, calm, serene, one-to-one nurses who cater to every desire as well as to every medical need, desired or not. You are still immobilized by IVs, needles taped into every vein that can be accessed. You wonder how much blood can be drawn before the flow needs to be reversed.

At least it is quiet. Reading is possible even if sleep isn't. (An inviolate rule: Never go to a hospital or a doctor's office without a book.) But the square-tiled nothingness that is the ceiling is not really much different from that in the emergency room.

Robert V. Liggett is an El Centro resident and the former managing editor of this newspaper.

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