Homeless and in the Emergency Room: The Pitfalls and Tragedy
Roger Wade is a contributing author to the Homelessness Resource Center, this being his sixth article since 2010. In his newest contribution, he describes the immediate and long-term damage that can occur when health providers subscribe to homeless stereotypes, and how these stereotypes can lead to a self-fulfilling prophecy.
In the United States, it is my understanding that many hospital emergency rooms will render care to an individual regardless of their medical insurance or financial status. Although the type of care may vary, the one constant I have experienced is an emergency room’s procedure termed the “triage process.” It involves an intake nurse, a financial status representative, and a preparatory R.N. who takes your vital signs before a doctor sees you. This format can be efficient and courteous, however, for a homeless man, it can be more like an interrogation.
When this triage process occurs, it gives one the feeling that one is being corralled into the stereotypical mindset of medical personnel who think a homeless man is just after drugs, trying to get out of the cold, or he just wants somebody to talk to. From the insurance liaison to the prep-nurse, then the doctor, they will ask dismissive questions seemingly formatted to confirm their suspicions of a homeless man seeking drugs.
Permit me now, dear reader, to share with you a personal medical problem I had recently as a graphic illustration of the pitfalls a homeless man may endure in a visit to the hospital’s emergency room:
In early 2011, I began experiencing a very painful condition in my right leg. Needing medical care, I went to a nearby hospital’s emergency room for a diagnosis of what was wrong with me, a solution for the problem, and pain medication.
I was told it was my sciatic nerve that was acting up and that it would eventually get better. I was given a prescription for a limited supply of narcotic pain medication and sent on my way.
It didn’t get better, so I started to visit other hospital emergency rooms, trying to get a reasonable explanation as to why my condition persisted. I was given various diagnostic solutions spanning from “give it some rest,” to “try some rehabilitative exercises” (a homeless man’s very existence is a rehabilitative exercise). And, after more very sincere talking, the doctor would reluctantly prescribe more pain medication.
After visiting too many emergency rooms, one of the hospitals decided they would give me an X-ray of my spine. It showed nothing wrong—exponentially arousing the medical staffs’ suspicions of this homeless man just wanting drugs.
My future E.R. visits became a bewildering process of not knowing what was wrong with my sciatic nerve, if there would ever be a long-term solution, but still needing strong narcotic pain medications. I found myself having to travel to other cities, to other ERs because of the aggravating dismissive attitudes of the medicos I had been in contact with.
After a couple more months of enduring this blackened future of continuous six- to seven-pain level without drugs, I experienced a happening close to a miracle when I encountered an intelligent, compassionate doctor who realized that I should be given an MRI, a much more precise and discernible diagnostic test than an X-ray.
The MRI graphically displayed a synovial cyst at the bottom of my spine pressing on my sciatic nerve: the cause of my incessant and unremitting pain in my right leg.
This exceptional doctor then referred me to a spinal institute where a neurosurgeon agreed to remove the cyst; the procedure was done shortly thereafter. After the surgery my pain was completely gone.
So, my dear reader, after months of exhaustive, humiliating, painful treks to various hospital emergency rooms, the frustrations of trying to break through the stereotypical attitudes of the medical personnel to convince them there was something seriously wrong with me, the nightmare was over.
However, it is profoundly significant that I add that, although my physical pain was gone, I was indelibly left with the memory of how, as a homeless man, I was treated by many professionals in the medical field.
Finally, I want to accentuate how the lack of a concerned, intelligent medical diagnosis over many months of visits to ERs forced me to bounce around from one hospital to the next, seeking temporary narcotic pain medication. The ultimate irony to this fractured scenario is that even though the cause of my pain was finally accurately diagnosed and corrected, with all of the narcotic pain medications I had taken, I had become—despite the successful surgery—the medico’s original stereotype of what a homeless man is who visits emergency rooms… a “drug addict.”
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