The Patient (3 page)

It was just after 6.30 am, and Jonathan was standing at the glass screen that bore a sign reading ‘Reception – Report Here First'. The clerk behind the glass was speaking on the phone in a low whisper, and Jonathan guessed she was trying to settle a child somewhere.

‘Look in the laundry. I'm sure I washed it and put it in the dryer, and if you can't find it there, wear the green one … I have to go now … I have to go.'

She looked up at Jonathan and held up a finger to signal that she would only be a minute. He had a desire to urinate again, but he could hold on. The clerk hung up and turned around to take a form out of one of the slots behind her desk.

‘Name,' she said, looking down at the paperwork rather than at him.

‘My name, you mean?' He was genuinely confused.

‘Who else's, love? Your name, please?' There was a note of impatience in her voice as she waited for him to volunteer the information.

‘Jonathan Brewster,' he answered, and thus began the
interrogation required to establish him as a patient, an entity in the hospital.

‘Address.'

He told her, with his usual sense of satisfaction, but there was no reaction from the clerk.

‘Are you in private insurance?'

He wasn't sure whether Tracy had joined them up or not. She was always going on about how they might need it one day. Jonathan's argument was that they were in good shape and were better off spending the money on a nice dinner once a month. Anyway, there wasn't much difference in treatment, was there?

‘Have you been here before?'

No, he had not.

‘OK. Take a seat. The triage sister will be with you shortly.' Jonathan didn't know that ‘triage' meant the system of dealing with patients in order of urgency, and that, once the nurse had ascertained he presented no immediately life-threatening symptoms, his wait was going to be a long one. The clerk dismissed him. Her job was done.

Tracy had finished parking the car and came up to him. ‘What's happening?' she asked expectantly.

‘I have to take a seat and wait.'

They sat in plastic chairs not far from the reception. Daybreak was colouring the sky with its pretty hues of pastel pinks and yellows, but the light struggled to overcome the perpetual cold fluorescent daylight of the Emergency waiting room. Jonathan was distracted by the television set, which blarged a Christian preaching program. A bright-blonde woman, who appeared to have a permanent smile due to botched plastic surgery, was quoting a verse from the Bible:

Why is it that they're always American?
he thought.
And why am I sitting here listening to this stuff?
The scriptures brought back memories of a strict upbringing and filled him with revulsion. He turned his mind to his board meeting later that morning, and he felt he should be at the office by now, putting the finishing touches on his presentation.

‘Did they say how long it was going to be?' Tracy interrupted his thoughts.

‘She said a nurse will see me soon, but, honestly, I'm feeling fine now. When I bumped my back yesterday on the kitchen cupboard, I must have hurt my kidney. It'll settle down. Let's go home.' He was hoping that he could get out of the hospital and prepare for that meeting.

‘You leave here before you've seen a doctor and I'm leaving you!' Tracy had a playful smile at the corner of her lips, but Jonathan could see she meant business.

He sat back. The plastic chair was already beginning to get uncomfortable. Looking around, he realised there were about 30 people in the waiting room. He was gasping for a cigarette but knew that this would enrage Tracy, so he resisted.

Opposite him sat a fat woman with a child who must have been about a year old sprawled in her arms, deeply asleep. The child had a small plastic tube coming from his nose, which made him look almost like a baby crow, to
Jonathan's eyes. The mother was staring blankly into the distance.

Jonathan looked at the mother's dirty cotton dress and wondered whether she had a job. Maybe she was one of those people who lived off government handouts – sponging off everyone else to get her medical treatment, her bills paid, food vouchers. Tracy could see the faint disdain upon his face and almost read his thoughts. She squeezed his hand, as if to say,
Stop staring
. He looked away.

Not far from where they were sitting was an old man who looked yellow and had very scaly skin. His gut was swollen, but his arms and legs, face and neck were emaciated. He looked like a pregnant yellow stick insect. Jonathan was staring at the man's stained towelling robe when he heard a sharp scream. The double plastic doors to Jonathan's right that read ‘No Admittance – Staff Only' flew open and a young man, perhaps in his early 20s, ran out, immediately chased by three security guards and two nurses.

‘Fuck off! Just fuck off! I just want to go home. Go fuck yourselves, all of you.' He was hoarse with the screaming. His face was creased with deep lines; there were sores up and down his arms and neck, and he was tattooed with Gothic letters around his neck and upper arms. Several bits of metal had been pierced through his eyebrows, nose and lips.

‘Come on, mate. Calm down. We're just here to help you. Just calm down.' One of the security guards was edging towards the young man with his arms held out in front with the palms facing down in a calming gesture. The young man was looking around him, eyes darting this way and then that, looking for an exit. The other security
guards were circling around him slowly. Suddenly, all three of them lunged forward and grabbed his legs, and they all fell to the ground.

The man started screaming his lungs out again. A nurse holding a syringe with clear fluid in it shouted, ‘Have you got him secure?'

‘As good as he's going to be. Go for it!' yelled the first security guard at the top of his voice.

She reached forward, took the safety cap off the needle and plunged it into the man's thigh. The screaming reached a crescendo now. It could best be described as wailing. The security guards used their full combined weight to keep him held down.

‘Bloody ice,' said one of the guards. ‘Why do you do it to yourself, mate?'

But the young man was now sedated and unable to respond. A trolley was brought over, and the team lifted the man onto it and wheeled him back inside.

‘That's a bit of excitement,' said Tracy.

The blood he had passed a couple of hours earlier seemed to fade in significance as Jonathan sat in the Emergency department confronted by humanity at its sickest, humanity gone astray, humanity on drugs, humanity at its smelliest. This was not where he belonged; he was a different cut of person. He was revolted by the sights and smells. How did these people get to be this way? Jonathan's life had not exposed him to the world's underbelly. He believed that if you worked hard, you made it. People who failed, failed themselves through a lack of effort. This place was filled with human failure, and he did not like it one bit.

‘Let's just go. Honestly, I'm fine now. I don't need to see anyone.'

‘No,' replied Tracy emphatically. ‘Let me check how long before you're seen.' She went up to speak to the clerk behind the glass, but she just said something about being busy. The clerk was experienced enough to know herself that Jonathan's symptoms were unlikely to be immediately life-threatening, so the triage nurse could just get round to him in her own time. How important his board meeting was did not enter the equation.

Two hours later, the triage nurse came out and called his name.

‘Can I come in, too?' said Tracy.

‘Why, can't he speak for himself? I only need him for a moment.' The nurse was not to be messed with. She was a big woman with cropped hair and skull-and-crossbones earrings. Tracy sat back down as her husband was led to the triage office. The nurse waved for him to sit and, without a word, dragged Jonathan's arm forward to take his blood pressure. She unfurled the gadget from a hook on the wall and wrapped it around his upper arm. The pressure started to rise. He panicked for a moment that it was going to crush his arm.

‘So, what brings you in?' she asked. She still had a stethoscope on and was letting the pressure down and taking his blood-pressure readings.

Jonathan related the events of the early morning: his bloodied urine, the clot, the second, slightly less bloody urination. He was halfway through the story when she rose and dismissed him from the room. She had gathered all the information she needed and had noted it down.
‘Haematuria. Vital signs OK.' Now it was time to go and triage the next unfortunate. Jonathan could wait. There were far sicker cases to attend to.

He went back and sat next to Tracy. ‘She just took my blood pressure and said we have to wait.'

Tracy nodded, looking resigned. The morning show was now on the television. They were about to interview the health minister over the dramatic increases in waiting times to have elective surgery.

‘State health system in crisis' read the title at the bottom of the screen. The minister came on and reassured the public that a task force would be established to look at the state of the health system and to make recommendations to the government on how to fix the problems. The minister was vitally concerned that all citizens must have access to a good, safe health system, one that met the needs of the whole population. Then it was on to an ad break.

Two nurses and a doctor had stopped to watch the interview. They looked disgusted by what they'd heard.

‘Classic buck-passing. Form another bloody task force. Can't everyone see it's just to get this issue off the front page? When are we going to have a minister with some spine?' the doctor said, shaking his head with disbelief. ‘Look at these poor bastards in the waiting room. Not one of them is going to be looked after the way that bloody minister would expect to be if he came in here sick.'

‘What did you expect?' said one of the nurses. ‘He wants to be re-elected. He's not there to bring genuine reforms to the system. And even if he did, you doctors wouldn't let him. Remember last year when I got that grant to improve
the patient's journey through the health-care system? You doctors torpedoed it.'

‘The doctors didn't torpedo your project. Nobody understood what the hell you meant when you said you wanted to “improve the patient journey”. It was airy-fairy, hand-holding bullshit. The money all got frittered away on useless reports.'

The nurse shook her head with disgust.

Tracy got up and said to her, ‘Excuse me.'

‘Yeah?' the nurse replied.

‘We've been waiting quite a while. Do you know when a doctor might see my husband?' As Tracy spoke, the doctor edged away and the other nurse departed with him.

‘You'll just have to take your turn, love,' said the nurse, and she walked away rapidly to join the others.

Tracy turned around to see looks of quiet satisfaction on the faces of the patients who had been waiting all night.
No one has any special rights here, lady,
their expressions seemed to say.
We all get treated like shit.
Though Jonathan felt individual, he was but one of an ocean of patients using the Emergency department that day, and every day, in every hospital, in every part of the world.

From the time Jonathan gave his name at reception, he waited a total of eight hours before being seen by an Emergency doctor. By lunchtime, he had been beside himself with impatience. He had got up to complain several times about the wait. Each time, the clerk had said, ‘I'll see what I can do,' then she had got on with her work without a second's thought about Jonathan. Tracy had called to cancel
her clients and that night's dinner. Jonathan had rung work to say he wasn't coming in. He had tried to simply leave a message, but the receptionist had insisted on putting him through to his boss, Paul Carter, who'd been concerned about making sure his presentation could be handed over to someone else. Jonathan had suggested delaying the meeting, but Paul had insisted that this was not an option. If Jonathan was unable to be there, then Jake – Jonathan's arch-competitor – would do the presentation for him. Jonathan had asked to be put through to his secretary and had given the necessary instructions somewhat reluctantly.

The board meeting was going ahead without him, and Jonathan was no closer to being seen by a doctor. He was tired of waiting, distressed at Jake stepping into his shoes and impatient to leave. On top of it all, everywhere he looked there were more off-putting smelly patients.

Tracy had sensed what he was thinking. She'd quietly placed her hand in his lap in a reassuring gesture.

It had been a further two hours before he was sitting on a trolley in the non-acute end of the Emergency department of the Victoria Hospital.