A crazy little thing called pain

1 am on a Sunday night, the ER is dead but the wait is still massive. I walk in, tell them I am here for a follow-up. I believe my hand is infected. A nice man with a tribal tattoo and greyish gelled hair remembers me from the phone call I made about an hour ago. He smiles, I feel welcome and am fast tracked into the ER.

I sit on a chair and a PA approaches me. I tell her I think my hand is infected, she looks at me doubtfully and asks me why I think that. I explain my symptoms, swelling, oozing, all that fun gross stuff. She sighs and rolls her eyes. I get paranoid, think she's writing me off as a pill seeker. An Indian PA with greasy short curls full of product comes by, eyes me up and down and says, "Infection? Let me see." He smiles as he examines my wound and says, "Yes, I believe you may be right." Really? I just thought going to the ER would be a nice hobby.

The Indian man dances over to an overweight woman with a headwrap. He makes some mocking hip-hop moves goofily and she laughs, her husband, a small man in African dress laughs too. Her husband is about half her size and has been scratching her back for her. They both look miserable and she coughs in pain through her laughter. Next to her an elderly woman tries to get up from her bed. She has long yellowish white hair and it hangs long and limp, much like the wrinkled flesh on her pale thighs. Her caregiver alerts the doctors who rush over and subdue her. I hear them mutter, "She keeps trying to get up." I wish the situation was more interesting, but it ends as quickly as it begins. I do get to see that she is wearing a diaper. Exciting.

My temperature is 98.5. Nice. I am led to a set of chairs around the corner, away from the action. There are two immigrant workers passed out on stretchers. Stone drunk. A man with a lantern jaw and coke bottle glasses is sitting at the end of the row of chairs. He smiles at me and with a severe speech impedient (he speaks as though he were deaf, but hears just fine) asks me if I smoke. I say no and dive into my copy of the Sunday NY Times. An orderly gives him an egg salad sandwich. He complains and asks for turkey. She says no turkey, only tuna fish, egg salad, and bologna. He says he doesn't like bologna and chows down on the egg, staring at me the entire time. The orderly asks me my name and looks at me like I don't belong.

Soon a PA approaches him and asks what's the matter. He says, "My foot."
"Which foot?" the PA asks.
"Both feet."
He takes off his shoes and I see the flash of a curled black toenail on his little toe. The gnarliest toenail I've ever seen.
"Your toe wouldn't hurt if you cut your toenails."
"I need them cut. Are you going to take care of me? I am in pain."
"You do not need to come to the emergency room to get your toenails cut."
"But my feet hurt. I have an appointment with the foot doctor in a month but it hurts now."
"Is there anything else wrong?"
"No, my feet just hurt. My toes feel like the are being smashed in my shoes."
"well they wouldn't hurt if you cut your toenails. That's all I can do for you."

Doc walks away. The man grumbles to me, "Why I gotta cut my own toenails if I have Medicaid."
I shrug.
"Have a goodnight Beverly."
He remembered my name from when the orderly asked me. I shudder.
He goes out for a smoke and never comes back.

Two more people come in. An overweight black woman with a cane and a short white man with short spikey hair and a couple of generic bad tattoos. A horrible smell hits me. I realize the woman has taken a takeout container of chicken out of her bag and is eating it. The scent is revolting. She chases it with a juice box.

I wait. An hour passes. I read about Jil Sander moving into a ladder factory on Howard Street. I learn how worms can help prevent disease. I start and stop reading an article about childless Europeans. Someone talks to the homeless woman with a cane. It's her second hospital of the night. She says something about getting kicked out of the shelter system. The leave her be, letting her sleep there undisturbed. I can't focus. I am exhausted and overwhelmed. A PA approaches me. A Chinese man whose English is spotty, he has thick overgrown hair styled in a flattop. The hair runs down the back of his neck and is distracting. He has a huge face, wire rim glasses, and looks confused and greasy. He looks at my hand. I tell him what's wrong. He agrees and says he needs to show it to a doctor but he'll give me an antibiotic. Finally...salvation!

30 minutes pass. Nothing. No doctor. An Asian girl comes in. She is dressed in a 2000 St. Marks fashion wearing a black mini-skirt with a silver stamped python print, a ringer tee-shirt, sneakers, a backpack, and a wrist full of blue plastic bangle bracelets. She has silver glitter on her face and her legs and elbows are covered in scrapes and bruises. I overhear them talking about filing a police report. She was jumped. She is restless and stands back up moments after being seated and starts roaming, a tiny vintage skateboard under her arm. She leans the skateboard against the desk, she's spied a KitKat bar. She asks the doctor about it and he gives it to her. She smiles and chomps it down. From her backpack she produces a quart of Vitamin D whole milk. She drinks it from a styrofoam cup, not sure where she got the cup, either from the backpack or a doctor. Someone tells her she needs to sit down. She does but keeps getting up to go to the bathroom. She finishes the quart of milk.

Meanwhile I see the Asian PA who initially helped me sprint back and forth a few times. He apologizes for the wait but the only result is more waiting. I am exhausted and near tears, beyond frustrated. The homeless woman with a cane has been asleep for a while now and her stench is nearing unbearable. Finally at around 4 am the PA escorts me to see a real doctor. I am ready to snap and he does not humor my exasperation. Only looks annoyed. I calm down. In the middle of the emergency room floor the doc looks at my hand and says he doesn't see the problem. I show him the infected part, the cut web between my two fingers where I have 4 stitches. The place where is stabbed through the flesh is fine. He pokes it ruthlessly and spreads my stitched up fingers. I gasp with pain. He says four of the stitches have to come out. The wound will be left open. He says they can numb it but the numbing meds will probably hurt more than the stitch removal. I opt to go in un-numbed.

The Asian PA sits me back down. Fifteen more minutes of waiting. The room where I need to get seen opens up and he escorts me in. He rubs my hand down with alcohol. It burns. He tries to spread my fingers. I curse. He pulls on a stitch with the tweezers. I gasp. As he cuts the first suture I realize this hurts far more than the Lidocaine shot. Tears start rolling down my face uncontrollably. I am cursing and blubbering. This is terrible. Horrible. I am powerless to stop them. Three more to go. It only gets worse. I am left with a deep gash open in my web. It looks angry. The PA says he will prescribe me antibiotics. He asks if I need Vicodin. Tears still streaming down my face I nod yes. Jackpot.

I am escorted from the room. It is 4:30 am. I get my prescriptions with orders to come back in two days. I won't. My health insurance expires in one day. My COBRA monthly cost jumped from $238 to $452 and I had to bow out. I make too much money to qualify for Medicaid yet not enough to afford Healthy New York. If I come back I'll need a social worker to avoid a huge bill. At least I have a prescription Vicodin. Life doesn't completely suck.

I get my prescription for the antibiotic filled at the CVS down the block. It has a 24 hours pharmacy. The technician is sound asleep in a chair behind the counter. I can see his feet. I try to wake him up several times. Eventually a stock person has to wake him for me. He blinks bleary at me, annoyed at being disturbed and moves at a snail's pace. He tells me he does not have the Vicodin, only the antibiotic. Bummer. Fifteen minutes wait. I go to the Dunkin Donuts and get a bagel, I am starving. I love the 24 hour economy surrounding the hospital. By the time I get my prescription and get in a cab home it is 5 am. I have to work in the morning.

And no, you can't have any Vicodin. I went through hell for it and I need it.
I think doctors prescribe it as a reward to patients for the patience.