emergency.
We handed her a Styrofoam cup of Methodone, to help with the withdrawal symptoms. By her medical record, I knew she was young. She smiled. She thanked us. The light behind her eyes was dimming but you could still see a flicker. We gave her a sandwich and a container of apple juice while the doctor examined her hand. The infection looked better, he said, and the plan was to give antibiotics and send her back to the part of the hospital she'd come from. Her skin was red, swollen, dry--infected from where she'd inserted a needle--and while receiving antibiotics through a vein in her arm, she'd used the access to put more drugs in, which had landed her back in our care in the ER. Her pain was cyclical. Her sickness devastating. Her demeanor so calm, so grateful for care. After every interaction, she smiled and said thank you. When the antibiotics finished dripping into her arm, she was wheeled away.
*
I was spending my clinical day in the ER, a rare and special assignment that I was grateful for. My hospital assignment this semester is known for their trauma care and large population of homeless men and women, people battling addiction and substance misuse, those with complex social issues such as partner violence and unstable income, and a crowded ER waiting room, especially in colder months when people with no other place to get warm will gather for as long as the many public safety officers will allow them to. I was nervous to head to the ER, expecting gore and trauma and frenetic energy.
*
The nurse showed me where to pinch the flesh of his upper arm with one gloved hand while I gave the injection with the other. It was a vaccine for Hepatitis A, which had been spreading around the shelters, likely one of the ones where he lived. I inserted the needle onto the blue face of a small animal, part of a bright, intricate tattoo that covered the span of his shoulder. A nervous, novice student, I pushed the needle and the medicine in too slowly, and he grimaced in pain. "Go faster," the nurse told me quietly, and I hurriedly pushed the rest in, stumbling over my apologies. The patient dropped back off to sleep, having been stabilized from the seizure he'd come in with. When we got back to the computer, the toxicology screens were back, positive for cocaine. After a few hours, he was discharged, and the nurse wished him good luck.
*
There was no gore, thankfully. There were medications, urine collections to measure, tubes of blood to draw and test, and sandwiches, and cups of water, and lots and lots of documentation. The day seemed long and slow, as if nothing was really happening, until I got home and started thinking through the patients one by one and wondered if I had actually been there for three days straight.
*
His stretcher was in the hallway among others, as there weren't enough ER rooms yet, as there weren't enough beds available upstairs to send up the patients who no longer needed ER care but needed to stay at the hospital. He was fully dressed, sleeping under his coat. The EMT who'd brought him in gave us the story--he'd been vomiting at a bus stop and a stranger called 911. He'd told the EMTs he'd used K2, a synthetic marijuana. His coat was heavy--too heavy for April, even though it was only 40 degrees outside--and had a thick, musty smell. The doctor asked him to confirm that he had used K2. The man nodded, half-asleep. The doctor asked if he had used anything else--calmly, pragmatically--and the man shook his head no. He said he was hungry and nodded off. We brought him a sandwich and a ginger ale. An hour later, we checked his blood sugar level with a simple finger prick. Minutes later, he got off the stretcher and walked out of the ER. My nurse documented in her notes that the patient had "eloped."
*
My nurse loved her job, but wondered if she should be looking to switch departments soon. She was worried that she was getting desensitized, losing feeling for her patients, after taking on so much for so long. As if her tolerance for this overwhelming desperation had gotten so high that the regular doses no longer cut through. I was green, of course, wanting to know so much about what had led to these admissions, and wanting to see so much more for each one of them, even as the nurses casually predicted which ones would be back for all the same reasons.
*
There was the young man with sickle cell anemia who was a frequent visitor to the ER, his pain unmanageable on his own. The man in his 50s who had been out of prison for less than a year (after decades of being locked up) who said he was grateful to God every day and grateful for everything we did for him, despite the fact that he had lost all but one of his toes to diabetes. The man wearing a knit cap who spoke no English and had been waiting over 12 hours in his makeshift room on a stretcher until a room upstairs was available. His frustrations were many--with the EKG wires, for prohibiting his ability to leave the room, with his congestive heart failure medication (a diuretic), for making him have to urinate constantly into the portable urinal in the room, with the nurse for speaking no Spanish (luckily I can speak enough that we managed). And the man trembling uncontrollably after being hit by a car, his ankle bearing a painful looking curve as if a grapefruit had been tucked under his skin. He was soft spoken, and anxious, and promptly given medication to help ease the shaking, which the doctors quickly understood was also from alcohol withdrawal--the cans of beer he'd purchased shortly before being hit by the car were in the bag beside the stretcher.
*
The word emergency is defined as an unforeseen combination of circumstances or the resulting state that calls for immediate action, or an urgent need for assistance or relief. It's clear why this area of the hospital is named as such. And why our national problems of substance abuse, healthcare access, homelessness, domestic violence, and economic inequity should also be named as such. But each time I saw the despairing word "emergency," I wondered about its etymology--after looking at the word long enough, I realized the first 6 letters are "emerge."
*
According to one source, "emergency" comes from the 1630s, the present participle form of "emergere," the same root of the word "emerge." Emergere means to rise out or up or bring forth, bring to light, or arise out or up, come forth, come up, come out, rise. It is formed from the combination of e- ("out") + mergere ("to dip, sink"). So literally, to come out of sinking, to come out of the depths.
It may be naive to imagine any of our patients emerging. But I'm not desensitized yet. I want to envision the young woman bright-eyed, smiling, safe. I want to envision social services that have enough funding to deal with the systemic causes and amplifiers of addiction. I want to envision the eloped patient laughing in a clean white t-shirt.
There is hope in the phrase come forth, come up, come out, rise. There is hope in emerging. And because they come from the same place, perhaps, in time, there is hope to be found in emergency.