Unwell

I'm not crazy, I'm just a little unwell
I know right now you can't tell
But stay awhile and maybe then you'll see
A different side of me


"Give me your tired, your poor, your huddled masses yearning to breathe free." These iconic words inscribed on the Statue of Liberty, for over a century, have welcomed the lost and the found, the young and old, the oppression-fleeing and the opportunity-seeking, to America and all of its promise. I spent my afternoon among the tired, poor, huddled masses of Sacramento and I am convinced that this inscription belongs at the entrance to every hospital in our nation, because nothing can describe what I saw today better than this iconic phrase.

The morning began slowly. A handful of accidents, a number of abdominal pains, and some kids with fevers. Nothing remarkable.

And then all hell broke loose.

In what seemed like the blink of an eye, we were slammed. A couple nurses talking among themselves: "Who here is the least sick?" Translation: we need to make room, and fast. Nearly every bed was occupied, the waiting room was packed, ambulances lined up to bring in their casualties, the social worker ran around like mad calling patient family members, gurneys and stretchers flew down the halls like magic carpets, and the staff waded their way through fractures, abrasions, drunkards and overdoses. The halls were lined with occupied gurneys as if they were the latest interior decor. Venturing into the ED (emergency department), what I saw reminded me of the inscription on the Statue of Liberty. Before my eyes huddled the tired, the poor, and those just yearning for care, attention, and comfort. I was transported to a ship circa one hundred years ago, as hopefuls from all over the world took to the seas and braved the wind, rain, and disease for the promise of a better life; here, hopefuls braved their doubts, fears, and ailments for the promise of a healthier life.

It can be hard to see the light in the ED when so much of what comes through is tragic. Both a tragedy and a comedy, however, was a special delivery from EMS. Screaming at volume 11 at no one in particular, this patient was livid about everything and did not go unnoticed. My co-worker turns to me: "Can't they sedate him/her or something?" My response: "They really should give him/her something." A nurse walks by not moments later: "Can we get him/her some Valium?" An EMT strolls by shortly after: "You guys should get him/her some Valium." Good thing all the docs were tied up in resus (the resuscitation room) working on an accident victim and couldn't order any sedatives for the crazy. So for an hour, we all had the pleasure of listening to incredibly loud delusions and accusations of conspiracy. Every patient, nurse, doc, undergrad intern, and med student united in agreement, by a simple smile, a chuckle, a roll-of-the-eye, that this patient was certifiably insane.

A number of incredibly polite patients struck up conversations with us as we observed the urgency swirling around us. "This is a great hospital and if my life was in danger, this is where I'd like to come." "Do you have a sister? You look just like [insert name here], you could pass for her sister!" A couple patients even commented on their very vocal peer, chuckling to themselves, shaking their heads in disbelief... or getting irritated because they wanted to nap. The nurses on duty were working their hearts out trying to handle a growing patient load, God bless them, but one still took a moment to smile sweetly and chat with me quickly about her kids. The EMTs joked with us about the crazy patient as they walked the halls, and the police officers made sure the wandering drunk didn't come near us.

No matter whether rich or poor, in the ED everyone is the same. Scared, lonely, uncomfortable, and yet somehow united in mutual struggle with their own bodies. It was messy, crazy, uncensored, and tragically poetic. There was nothing happening at UCDMC that can't be seen at the average American hospital on an average American day in an average American neighborhood. Today reminded me of one of the many reasons I want to practice medicine: to help those who don't know how to help themselves. One does not need to be poor, incompetent, or even unhealthy to not know how to help themselves, because at the end of the day, we are all just a little unwell.