October 26, 2004

Triage means most people in an emergency waiting room never see the most painful ones, traffic accidents, cardiac arrests, gunshot wounds; patients rushed into operating rooms and intensive care units, family hovering just outside in some cases, absent in others.

Here a young woman has fallen asleep against her partner, his attention riveted on the televised game play. There a ninety-year-old woman, an icepack held to the side of her face, begins to sob and cry and scream in the beginnings of an anxiety attack as her husband and daughter and son-in-law try desperately to calm her down; and a middle-aged man proclaims loudly so as to be heard by the overworked staff, "Here is your care and compassion!" An elderly man unable to sit still, every five minutes asking the staff, then talking with his daughter in a carrying voice on possible variations of death, utterly oblivious to his effect on others until finally she maneouvres him outside where he continues to talk and she listens. Sprained or broken ankles, an oversized makeshift cast on someone's hand. Two smokers hovering on either side of the automatic door, not talking to each other. No one talks to anyone else.

The clock ticks over.

A young man in ragged jeans and anarchy top sits down cross-legged on the floor facing an empty corner of the room. He is waiting for his friend, who, faintly, through the barred staff-only doors, can be heard shrieking, with every so often a glimpse of the two police officers guarding him. A young medical student taking histories and learning first-hand just how vicious injury and disease can be. The night resident, the beginnings of exhaustion in his eyes, trying patiently to explain to an elderly man what a Do Not Rescusitate order implies. No young children, this time.

An uproar from the television behind him, another man tries to turn and see what just happened in the game without entirely taking his attention from his partner: he doesn't quite succeed. The woman sitting across from him informs him of the play. Two have brought coffee, picked up on the way. Two are dozing -- cannot call it sleep, not here. All the seats are occupied. The daughter is trying to catch the eye of the resident and make him talk to the person who needs to hear him and is refusing to hear him and keeps talking about cremation. On the television it is an easy miracle. In real life are chest fractures, torn esophagal tissue, damaged larynxes, burns - and no guarantee the heart will continue to beat on its own afterward. No one else speaking, not at all.

Three paramedics appreciating a not-so-busy night. Nothing immediately life-threatening tonight. You can feel the distinction in the air. Concern, not terror. Not resignation except for the wait. Not panic, more an air of distraction sought.

A large, friendly, tourist-style poster board with surrounding side panels full of various health brochures proclaims:

"Welcome to the ER"

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