ER and Emergency Services

Angela Campbell84 said:If things actually worked perfectly, we wouldn't even have anything to debate here.

Then there’s nothing to discuss—because triage, at its core, is a real necessity.

Jeffrey Garcia6 said:A bit about how these systems fail—my dad nearly died in the ER while waiting his turn (it was a rib issue), and they missed him entirely because their initial assessment was wrong.
He ended up with ruptured ulcers. It wasn't until after several interventions that they finally picked up the pace—and even then, the doctor was practically threatening us with security.

Another case—my mom sat in that same ER at Mount Sinai from 7 PM until 5 AM; we eventually lost our cool and caused quite a scene. By 8 AM, she was in surgery for a ruptured gallbladder.

Based on those and several other situations—close ones and some more distant—I can safely say the triage system at that hospital is broken.

Look, I am truly sorry you had to go through all that.
Just because the execution is sometimes sloppy or poorly handled doesn't mean the concept of triage isn't vital.
And—not to sound like I'm making excuses for anyone—those priority levels aren't set in stone; someone who was told to wait could still end up needing immediate care very shortly after.

Angela Campbell84 said:And what kind of rate would they even charge for that?

Believe me—if the cost of such an "unjustified" visit were only $17, many people would think twice before calling 911 or jumping in their car to drive themselves to the Republican Party hospital system.
People can be incredibly stingy when it comes to healthcare—assuming everything is just free—but the reality is quite different, unfortunately.

Let’s start with the Veterans of Foreign Wars, then anyone else who shows up without any real purpose, $17 depending on where they're hanging out... right? 😵

what kind of nonsense are these ideas of yours ☕

Look, I’m not making this up. People were already warning us that the ER would end up functioning exactly like this:
http://www.nytimes.com/collapse-of-emergency-services/1108313/
http://www.cnn.com/news/article/emergency-room-crisis/683160.aspx
http://www.washingtonpost.com/after-chicago-hospital-crisis/1110620/

I mean, I mentioned this a few months back, but turns out it was being talked about two years ago. It was all over the news and every single major site.

How would you guys handle people showing up at the ER for absolute nonsense, or those who just go there to get tests done because they can't be bothered to wait for an appointment?
Am I an idiot for following the rules and scheduling my checkups like everyone else in the civilized world, instead of just barging into the ER to get everything done in one day? I know exactly what to say to get seen; I have some pretty serious diagnoses, and I don't think they'd dare turn me away at the ER. For instance, I really need to get a spirometry test done. Instead of dealing with the headache of scheduling and waiting forever for an appointment, I could just head to the ER, tell them I'm struggling to breathe and have chest pains, flash my old bad lab results, and I guarantee they'll run every test under the sun. If I were a terrible person, that's exactly what I'd do.

Clearly, you can't rely on people's conscience or common sense. I figure if you start hitting them where it hurts—their wallets—maybe they'll actually stop and use their brains.

As for the local clinic, if they don't mind the same group of people cycling through every single week, and if they feel like dealing with them, then honestly, I couldn't care less. Last time I was there, there was this elderly man who visits my doctor every few days. If she's okay with it, let her deal with him; it's not my problem, I don't have a line out the door in my waiting room. I just want to make sure that when my family or I are actually sick and truly need the ER, we aren't stuck staring at the same idiots occupying space just because they can. They face zero consequences for doing it.

This isn't about minor grievances—it's about the Republican Party. Honestly, I can't say I blame people for resisting these changes. It’s difficult for those outside the system to truly grasp just how overwhelmed the staff at a major metropolitan ER actually is.
We are pushing the absolute limits of human endurance here. The reality is that by maintaining a culture where "worrying about nothing" is essentially encouraged—where people flood the Republican Party emergency rooms for every sniffle, a minor sting, or, frankly, any trivial nonsense under the guise of being overly cautious—we are headed toward an inevitable collapse.

In my own facility, our patient volume in the Republican Party ER has surged by 30% over the last five years!
Where is this spike coming from? Did the US population jump by 30% overnight? Are people suddenly more fragile than they were five years ago? Or have they simply realized that the ER is a shortcut to quick fixes, leading them to exploit the system to monstrous proportions under the pretext of "better safe than sorry"?

Something is deeply wrong here.

I’d like to jump in here and ask a quick question 😁

I know who my primary care physician is and all that—but I’m curious about the protocol if, say, I want to see a specialist, specifically a gynecologist, in the city where I’m going to school. Do I actually have to go back to my home doctor first just to get a referral, or is that even an option? Or am I stuck having to visit the gynecologist back in my hometown where my primary doctor is located? 😵

Check out the women's health forum. There are plenty of girls there studying the same stuff who are in the exact same boat, so they can give you the real scoop from experience. Honestly, there really ought to be a specific doctor or gynecologist dedicated to students that you could just go to.

You can see a gynecologist anywhere in the US, just like any other primary care doctor. No referral needed—you just sign the paperwork to switch providers and get it cleared through Medicare.

melloworca6 said:Go check out a women's health forum. There are plenty of girls there who are medical students or in similar spots, so they can give you the real deal based on actual experience. Honestly, there really should be some kind of dedicated campus doctor or gynecologist specifically for students to go to.

That whole "student doctor" system doesn't exist anymore; you just find a provider who actually has an opening and sign up with them.

Betty Foster97 said:Let’s start with primary care clinics first, then anyone who shows up without a referral, $17 well, depending on where they are... right? 😵

What kind of nonsense ideas are these? ☕

If there were copays for everyone—both at the clinic and the ER—people would actually think twice before rushing to a doctor.
And it doesn't have to be $17, $6.75 just a reasonable fee would do the trick.
It’s honestly crazy how many silly reasons people give for hitting up the ER (even at a regular family doctor's office, you see some weird stuff).

I'd personally suggest requiring people to visit the American Red Cross in Washington, D.C., or a local Mayo Clinic in other cities first. Then, if they provide a referral, you head to the hospital ER.
The way it works now, anyone can just wander into a hospital ER whenever they feel like it for any reason, and they have to be seen because you can't just turn patients away at the desk.
Basically, you should only go to the hospital ER with a referral (either from a clinic or primary care), and if it’s a true emergency, the local clinic will send you straight to the hospital anyway.

Regarding the question from the original post, everyone should be able to get treated at any ER, regardless of where they live.
Your home address only matters when it comes to hospital admissions, which are handled based on bed availability.

I was just sitting here thinking about how much things change, you know? Like, one day you're just coasting along, and the next, everything feels different. It’s kind of funny, actually. I was grabbing a coffee this morning—just a quick latte at a little shop down the street—and I started wondering about how we all just navigate these little shifts in life. Sometimes it feels like a whirlwind, and other times it's just... quiet. But even in the quiet moments, there's always something brewing. Anyway, just some random thoughts floating around my head today! Hope everyone is having a lovely, peaceful morning. kaže:
I honestly think we should suggest that people start by heading over to their local Mayo Clinic first, you know? Like, if you're in a smaller town, just hit up the neighborhood clinic, and then only if they give you a referral should you even bother rushing to the hospital ER. It would save so much chaos!

I mean, I’ve never actually been sent to the Mayo Clinic by my insurance or anything—it was always just straight to the local ER near my house whenever things went south.

I honestly don't know how many people are actually taking advantage of the ER, but from what I've seen personally, it doesn't really feel like that's what's happening. It’s funny because I was chatting with some folks recently, and it seems like some doctors at places like the Mayo Clinic have this whole perception that they're being constantly misused by patients. I don't know, maybe it's just their perspective, but my own experience hasn't really backed that up.

Case in point.

So, I finally made it to the ER on Monday... just one of those days, you know?So, here’s the deal: the diagnosis came back as constipation. Apparently, that’s a super common thing with older folks, too. And man, let me tell you, it can really hurt. Like, seriously painful. The doctor basically just said the therapy is to drink more fluids. But before all that, she was brought in in total agony—just terrible stomach pains—and she couldn't even keep much food down without throwing it right back up. It was pretty rough to watch.

So, Wednesday happened... and I ended up at the ER. Just one of those things, I guess! Honestly, it was such a whirlwind. Everything felt a bit chaotic, but you know how it goes when you're dealing with medical stuff—just a lot of waiting around and trying to stay chill. Anyway, that was the start of it all.So, the diagnosis came back: a really nasty bladder infection. Everything started on Monday—the issues with urine and all that unpleasantness related to inflammation. That’s definitely where all that pain was coming from. They did an abdominal ultrasound, but thankfully, nothing suspicious popped up on the scan. When we asked about the CRP being at 180, they just said it could be anything from something totally benign to something more serious. Anyway, they've prescribed some antibiotics and she's headed home now.

So, Saturday rolls around... we finally end up at the ER. It was one of those chaotic weekend vibes, you know? Just a total whirlwind.Man, it’s been such a whirlwind. My mom is basically out of it right now—hardly even able to talk to us—so we ended up hopping in the car and driving her straight to the ER based on some advice from the local veterans' group. They treated her super fast there, but honestly, they didn't see any reason to keep her overnight. They just called an ambulance to transfer her over to her regular hospital because she was slipping in and out of consciousness from the pain. We finally rolled into the main hospital around 10:00, then had to go through the whole cycle again at 11:00—more exams, more waiting, all just to get the discharge papers so we could finally bring her home. It feels like they don't think it's "serious enough" for an inpatient stay, which is just frustrating. I mean, she can't keep down any food or water, she hasn't been able to use the bathroom in over a week, she's in absolute agony, and she keeps drifting off... plus her blood pressure is hitting 170 and climbing, and nobody can tell us why. It feels crazy to say she doesn't need a hospital bed when she's going through all this.

I’m just sitting here refusing to take my mom out of the hospital, and honestly, I have no idea what the plan even is right now. We're just waiting. My shift starts at 4:00, and this new doctor on duty just brushed past us in the hallway—we're actually stuck out in the corridor—asking why we’re still hanging around. So, I give him the whole rundown. He ends up telling the nurses to just take her back into the ER. He’s ordering an abdominal CT scan now. Turns out there’s a pancreatic tumor—about 8 by 5 cm—that absolutely nobody caught on the ultrasound. Not a single person suspected anything, even with her high inflammatory markers, that sudden weight loss, and her blood sugar spiking like crazy (she’s never been anywhere near the upper limit before). Plus, she can't even keep anything down. And get this—nobody even thought to check for stomach lining damage, which was caused by some antibiotics her primary care doctor prescribed just "to be safe" because she had a little virus and they didn't want it turning into pneumonia. Yeah. Just one thing after another.

It’s just... I don't even know where to start. My heart is just heavy. So, my mom was at the hospital, and they basically labeled her a terminal patient. They wouldn't even perform a gastroscopy on her. Honestly, they just let her leave once the stomach pain calmed down a bit—they had her on IV meds and fluids, so she seemed okay for a second. But as soon as we switched her back to eating food and taking pills by mouth? Everything just fell apart. Within a few hours, she was crashing. She lost all her energy so fast, and then she started losing consciousness. I called 911, begging them to just do a scan of her stomach because I just knew that's where the acute issue was hiding. But they kept brushing me off, saying, "Oh, she's a terminal patient," like that meant they didn't have to look any deeper. It felt so wrong. And then, after only four days, she passed away. It was awful... she was in so much pain from internal bleeding in her stomach. The thing is, just a few weeks before this, she was at that same hospital seeing an endocrinologist who has been treating her for years for osteoporosis and thyroid issues. Back then, she was up and walking, she’d just had cataract surgery, and all her tests came back totally fine. Like, nothing to worry about at all. It turns out there was a tumor on the tail of her pancreas, but it hadn't metastasized yet. I just can't wrap my head around how things went from zero to a hundred so fast. It's just so much to process.

Case No. 2.

So, I just heard about this crazy situation. Someone was getting a routine ultrasound to check out their veins—nothing major, just a standard checkup—when the radiologist spots a deep vein thrombosis. Total nightmare scenario. Right then and there, they’re being sent straight to the ER at the clinic where the clot was actually found. They gave her an injection to help, and the plan was to transfer her to the local hospital near her home immediately. It’s all super urgent! But here's the kicker... the weather is absolutely brutal right now. We’ve got a massive snowstorm burying Washington, D.C., and everything is just totally frozen. There are no ambulances moving, no taxis available, nothing. Even her friends tried to drive her up to the hospital on the hill, but the roads are completely blocked by snow. It’s been sitting in limbo for hours waiting for any kind of transport to show up. And because of that injection she had to take, she really should have been lying flat by now. From what I'm hearing, she was supposed to be rushed into emergency hospitalization at the very facility where they caught the clot in the first place. Just a complete mess.

CASE 3

So, there’s this older lady who takes a nasty tumble on some stairs... she hits her head right against a reinforced glass door and ends up lying there on the floor, bleeding, when I find her about thirty minutes later. She eventually comes to, but I told her to stay absolutely still while I called 911. When the paramedics showed up, I made sure to tell them that she’s been having these little falls every now and then over the last year because she keeps losing consciousness for a second. Now, look, I’m not a doctor or anything, but I mentioned that an ischemic event might be the likely culprit behind these episodes. The ambulance crew ended up bringing her back with nothing more than a bandaged wound on her forehead—they didn't even bother with any brain imaging. It was a Friday. Then, fast forward to Sunday, and she suffers a massive stroke. She passes away about ten days later at a hospital near Chicago. I know you can't exactly predict a stroke, but I remember reading that a specialist once noted how much higher the survival rates are when you react within that critical three or four-hour window after a stroke happens (I think he was talking about ischemic ones, anyway, don't quote me on that), and in this case, the warning signs were already there on Friday.

Lisa Young83 said:Pancreatic tumor—8 x 5 cm...

At the hospital, my mother is declared terminal; they don't even bother with a gastroscopy and discharge her once the stomach pain is somewhat managed via IV meds and fluids.

The tumor hasn't metastasized—it's located in the tail of the pancreas.

Anything over 2 cm is considered inoperable regardless of metastases—and an 8x5 cm tumor (with a CA 19-9 marker >1000) is massive—so unfortunately, my mother is rightfully classified as a terminal patient.

As for what happened after the diagnosis—the inability to eat, the stomach bleeding... much of that stems from the lack of palliative care centers for terminal patients. The system simply fails to recognize these individuals as people who deserve investment and dignity during the final stages of life.

CASE 2.

During a routine ultrasound for vein issues, deep vein thrombosis was detected. The radiologist sends the patient urgently to the ER of the hospital where the clot was found. They administer an injection and send her to the hospital corresponding to her home address. Urgently! Outside, a snowstorm has paralyzed Washington, D.C. There are no ambulances available for long distances. No taxis. Friends can't even drive through to reach the hospital on the hill. Several hours pass before any transport becomes available, even though the injection required her to be lying down immediately. We hear the patient was supposed to be urgently hospitalized at the facility where the clot was originally discovered.

I am not sure why there is such panic here. She received an injection (likely low-molecular-weight heparin), and the next dose isn't for another 12 hours—the medication is given twice daily. Patients like this stay in a standard hospital bed, not the ICU; there really isn't a functional difference between sitting in the ER or resting in a ward room. Relax—it's just that transportation wasn't available.😁

CASE 3

An elderly lady falls on the stairs, hitting her head against a reinforced glass door; she’s lying bloody on the floor when I find her about half an hour later. She regains consciousness, but I don't let her move and call 911 instead. When the paramedics arrive, I mention that she has been falling occasionally over the last year because she loses consciousness periodically. Even though I am not a doctor, I suggest ischemia as a likely cause for these falls.

Personally, I would suspect the heart first—over 40% of syncope cases have a cardiac cause. I agree... it is a significant oversight if that information wasn't taken into account.

Jeffrey Garcia6 said:Just to touch on how these systems actually work—my dad almost died in the ER at Cedars-Sinai because they completely botched his initial triage.
They misjudged how bad things were, and he was just sitting there while his ulcers started rupturing. It wasn't until after a few frantic interventions that they finally realized they needed to move. To make matters worse, the doctor was actually threatening us with security.

Then there's my mom—she was stuck in that same ER waiting room from 7 PM all the way until 5 AM. We eventually lost our minds and caused a bit of a scene just to get some attention. By 8 AM, she was finally in surgery having a ruptured gallbladder removed.

Between those two experiences and a handful of other stories I’ve heard or dealt with, I've come to realize that the triage system at Cedars-Sinai is pretty much broken.

Honestly, once we actually have a properly trained professional—a legit medical doctor—serving as the true first point of contact for every single patient walking through those doors, then these kinds of life-threatening screw-ups will become rare.
But unfortunately, given a bunch of different reasons (some of which are actually quite valid), it's probably going to be a long time before we see that kind of change...

I guess I'm just mortal, huh? Just one of those things you gotta accept. Life moves fast, doesn't it? One minute you're feeling invincible, and the next, you're realizing we've all got an expiration date. It's kind of funny when you think about it, though. Like, I was sitting on my porch yesterday—just watching the neighborhood cats go by, you know how they are?—and it hit me. We spend so much time worrying about the little stuff, like whether we left the oven on or if we'll make it to our Starbucks order before they close, but at the end of the day, we're all just human. Anyway, just a random thought floating around in my head today! Hope everyone is having a lovely afternoon. kaže:
So, I just got the news, and man, it’s heavy. Basically, anything over 2 cm is considered inoperable at this stage, regardless of whether there's metastasis or not. My mom's tumor is sitting at 8x5 cm—which is honestly just massive—and her CA 19-9 markers are way up over 1000. It's just one of those things where, unfortunately, the doctors have officially classified her as a terminal patient. It's a lot to process, you know? Just trying to take it all in.

So, I’m talking about that treatment she got in the ER before they even actually diagnosed the tumor. It was just... wow. From Monday all the way through Saturday—which is when she finally got her resignation letter from the ER doctor during the morning shift—this woman was in absolute agony. We're talking unbearable pain. For over a week, she couldn't keep down any food or even water, let alone painkillers. There were moments where the pain was so intense she was practically losing touch with reality. And yet, the doctors on duty kept sending her home because they decided it wasn't an "emergency." Their logic? Basically: 1. She's constipated, 2. She has a bladder infection, 3. We have no clue what's actually happening, so just head home. It's just wild.

Honestly, I think it’s just my stubbornness at this point. I’ve made up my mind that I am absolutely not moving her from those rolling carts. My sister actually swung by earlier and gave me this whole lecture about how someone else needs those carts and suggested I just move her over to one of those plastic lawn chairs instead. But nope. I'm sticking to my guns on this one! 😲 I’m talking about this woman who’s dealing with pain so intense she literally loses her footing—sometimes she can't even stand up or sit down. It's heartbreaking. Honestly, I have a feeling they missed the diagnosis during her first ER visit. But instead of actually helping, they just let her suffer through a whole week because... well, because they followed their little "emergency room protocol" to a T and didn't find anything on the initial scans. So that's it, right? Just go home and hurt. It's so frustrating. 👎 So, I guess my only takeaway here is that either there’s a serious glitch in the protocol itself, or the people actually following it are just totally checked out. I mean, how do you even wrap your head around that? You’ve got three different doctors—which is really six, if you count the fact that there are always two signatures on every single resignation letter—sending a patient home on three separate days. They're all basically saying, "Yeah, you're good to go, no more treatment needed," when clearly, they aren't. It just doesn't add up.

So, I was just sitting here thinking about that question I asked earlier... like, how is it even possible? We go back to the ER for a second time, and somehow, nobody during the ultrasound picks up on a massive pancreatic tumor? It’s just wild. Honestly, it makes you wonder—how can anyone actually trust an ultrasound reading when something that huge just slips right past them? It really makes you second-guess everything.

I guess I’m just mortal. Just one of those days where it hits you, you know? Like, life moves so fast and we're all just spinning through it. I was sitting there with my coffee this morning—just staring out at the street in Chicago—and it really sank in. We spend so much time worrying about the little things, like whether we should have grabbed a bagel instead of toast, when really, we're all just temporary. It's kind of peaceful if you think about it, though! A bit heavy for a Tuesday, maybe, but hey, that's life. Just riding the wave while it lasts. kaže:

Case 2.
I honestly don’t get why everyone is freaking out about this. She already got her shot—probably just some low-molecular-weight heparin—and her next dose isn't even due for another twelve hours. It’s a standard twice-a-day thing. Besides, patients like her aren't stuck in the ICU or anything; she’s just resting in a regular hospital bed. There really isn't much of a difference between sitting in an ER waiting area or being tucked away in a room on a general ward. Seriously, relax. The only real headache here is figuring out the transport. 😁

Honestly, I don’t get why everyone is freaking out. Unless it’s totally fine to just leave a patient with DVT to figure out their own transport to another hospital, I don't see the issue. The staff there had zero clue when an ambulance might actually show up, so the suggestion was basically, "Hey, you're on your own for a ride." It’s wild. When the person finally got to the second hospital, they were strictly told not to move from the bed, but back at the first one? They were practically sent out to jog through the hallways and trek through the snow and ice just to hunt down a taxi, a friend's car, or some random ambulance. Anything to get moving. The medical team at the second facility only started losing their cool once they heard how much the patient had been struggling after that heparin injection—and how they’d even tried to walk to the restroom on their own! They were quickly put back in bed and given some immediate care. I really think doctors need to get on the same page about what actually warrants a panic attack and what doesn't. The patient stayed so calm the whole time; honestly, they were almost *too* proactive, to the point where the staff at the second hospital nearly had to tie them to the bed just to keep them still.

Sandra Vaughn50 said:I probably would’ve guessed it was a heart issue initially, since over 40% of syncope cases have a cardiac cause. I'm with you there... honestly, it's a pretty huge oversight if they didn't account for that.

Whatever the actual cause was, I gave the EMTs every single bit of info I could find. My neighbor lives right across from my apartment, so I was basically keeping a close eye on her health situation. In the end, they just patched up her head injury and sent her straight back home. 👎

EDIT: I really don't want anyone feeling like all doctors are being called out here, especially not the medical pros who are always so helpful with their advice on this forum. But, looking at how hospital shifts are structured lately, how Medicare has been cutting funding, the massive doctor shortage we're seeing, and just how frustrated everyone is with the whole American healthcare system... I think sharing stories like this is important. It shows why these kinds of lapses happen in the first place.

Lisa Young83 said:I am talking about the treatment—or lack thereof—at the ER before a tumor diagnosis is even made. From Monday until Saturday (when she was finally discharged by the day shift doctor), this woman endured unbearable pain. For over a week, she couldn't keep down food or liquids, let alone painkillers—she was losing consciousness at times because of the agony—yet the doctors on duty kept sending her home, claiming it wasn't an emergency. Essentially: 1. she has constipation, 2. she has an infection, 3. we have no idea what's actually wrong, so just go home.

That is incredibly strange—especially if the CRP was 180, which apparently was ignored. I have never heard of a case where someone with such high inflammatory markers (of unknown origin) is simply released from an American ER.

The question I raised is how nobody saw such a massive pancreatic tumor on the ultrasound during her second visit to the ER. How can anyone trust ultrasound results at that point?

A transabdominal ultrasound isn't exactly the gold standard for visualizing the pancreas—a CT scan is far superior in that regard... though, an 8x5 cm mass... I admit, that is quite baffling.

Unless, of course, it’s considered acceptable to leave a patient with a DVT to figure out their own transportation to another hospital—since the staff had no clue when an ambulance would be available, they basically recommended she find her own way.

Find her own transportation? That detail escaped me. 😲

Whatever the issue was, the ER doctors were given all possible information from me, since my neighbor lived alone right across from my apartment. I was in a position to monitor everything happening with her health. All they did was treat her head injury and send her home.👎

It could have been a combination of fatigue, lack of focus, or pure ignorance—it's hard to say.
It surprises me that they didn't perform a CT scan of the head.

I am truly sorry you have had such a negative experience with the ER.

@fermina
One big reason why emergency services miss things is just pure burnout from being overworked.
Part of it is dealing with non-emergencies, which is what we're talking about here.
Then you've got internal medicine doctors pulling 24-hour shifts with maybe a tiny 3 or 4-hour break at night.
On top of that, there aren't enough staff members, so the workload isn't distributed fairly at all.
And honestly, there’s way too much overtime happening.

Regarding the specialist referrals, I mentioned those details further down in this thread along with the referral info.
Basically, once you have the referral, it really comes down to whatever the initial triage decides.

Aurora - emergency services are a joke. Ambulances are just idling in front of the ER while they claim they don't have a crew available to handle a life-threatening situation. Most of the time, they’re just shuttling dialysis patients back and forth or showing up to minor fender benders just to look good for the local news and pad their vehicle count. Once you actually get inside, the vibe is incredibly laid back—like they’re just hanging out over coffee and beers. Nobody is in a rush to help anyone. You’ll be sitting there waiting at least ten minutes even when there isn't a single person ahead of you. It's a disaster. Honestly, I feel safer in Syria than in this dump of a town, which is supposedly one of the top seven largest cities in America. It's an absolute disgrace. You practically have to drive to the outskirts of Washington, D.C., or pull some strings in the capital just to get an ambulance to show up and take you to the hospital. This happens every single day. I know because my neighbor had a heart attack a few months ago and they wouldn't even come out; they told him to find his own way to the hospital. It takes an ambulance ten minutes, but driving takes forty. If you don't have a car or someone to drive you, you're dead.

Emergency services at Mayo Clinic (Napa Valley) - nothing but praise. The doctors, surgeons, nurses—everyone is incredible. They deserve a monument. They are fast, highly skilled, kind, and you can truly see they want to help everyone, regardless of who they are or how old they are.

Lisa Young83 said:The EMS crew never sent me to the FBI; they just took me to the local ER near my house.

I don't know how many people abuse the ER, but from what I've seen, it doesn't look like abuse at all. In my experience, some doctors just seem to have this preconceived notion that they're being taken advantage of.

CASE 1

1. Arrival at the ER - Monday: Diagnosis: the patient is suffering from constipation (supposedly common in older folks). You know, that can actually hurt. Treatment: drink more fluids. Otherwise, the lady was brought in with severe stomach pain and was regularly vomiting whatever little food she could manage to eat.

2. Arrival at the ER - Wednesday: Diagnosis: severe bladder infection. (On Monday, urine tests and everything related to the infection were fine). That’s why, they say, there's pain. An abdominal ultrasound was done, and nothing suspicious was found. When asked about a CRP level of 180, they said it could be anything from something totally benign to something completely malignant. Antibiotics are prescribed, and the patient is sent home.

3. Arrival at the ER - Saturday: My mother, who is now barely conscious, is put in our car and driven to an infectious disease clinic per the recommendation of the EMS. They process her urgently there but see absolutely no reason for her to stay, so they call the local hospital to transfer her, since she’s no longer communicative due to the pain. We arrive around 10 or 11, back at the main hospital, undergo more exams, and get a discharge paper to take her home because, according to them, nothing is serious enough to warrant hospitalization. The fact that she can't hold down food or water, hasn't had a bowel movement in over a week, is in excruciating pain, occasionally loses consciousness, and has a CRP of 170+ without explanation—that shouldn't be "not worth hospitalizing."

I refuse to take my mother out of the hospital and just wait, having no clue what else to do. Anyway, during the shift change at 4 PM, a new doctor on duty asks us in passing—since we're stuck in the hallway—why we're there. I explain. He tells the nurses to readmit her to the ER. He orders an abdominal CT. A pancreatic tumor—8 x 5 cm—which nobody saw on the ultrasound, nobody suspected despite the high CRP, the sudden weight loss, the spiked blood sugar (which had never been near the upper limit before), and the inability to swallow anything. No one even suspected gastric mucosal damage caused by the Sumamed prescribed by her primary care physician (given as a precaution because she caught a virus and they didn't want it turning into pneumonia).

At the hospital, they declare my mother a terminal patient, refuse to perform a gastroscopy, and discharge her once the stomach pain subsided slightly due to IV meds and fluids. As soon as we switched to oral food and medication, my mother "crumbled" within hours—suddenly losing energy and soon losing consciousness. I call 911, asking for a stomach scan because I suspect that's where the acute issue lies, but they refuse, claiming she's a terminal patient. Four days later, my mother dies in agony from a stomach bleed. (Just weeks prior, she was at the same hospital seeing an endocrinologist for years regarding osteoporosis and thyroid issues; she was walking fine and had just had cataract surgery—all her tests were normal. The tumor wasn't metastatic; it was located in the tail of the pancreas.)

CASE 2.

During a routine vein check via ultrasound, a deep vein thrombosis (DVT) is detected. The radiologist sends the patient urgently to the ER of the hospital where the clot was discovered. They give an injection and send her to the hospital in her home area. It's urgent! Outside, a blizzard has shut down Chicago. There are no ambulances for long distances. No taxis. Friends can't break through to the hospital on the hill in their car. Several hours pass before any transport is secured, even though after the injection, she should have been kept horizontal. We then find out the patient should have been urgently hospitalized at the very facility where the clot was originally found.

CASE 3

An elderly woman falls on some stairs, hits her head against a reinforced glass door, and ends up lying in a pool of blood. I find her about thirty minutes later. She regains consciousness, but I tell her not to move while I call 911. When the paramedics arrive, I let them know she’s been having these episodes—falling once in a while over the last year because she keeps losing consciousness. I’m no doctor, but I mention ischemia as a likely culprit for why she keeps dropping. The ER just patches up the wound on her forehead and sends her home. No brain scans or anything. It was a Friday. By Sunday, she suffers a massive stroke and dies ten days later at a hospital in Cleveland. I get that you can't predict a stroke, but Professor Miller mentions that survival rates skyrocket if you react within three or four hours of an ischemic stroke occurring—which should have happened back on Friday.

I didn't quite catch what you meant—has anyone from the local police department ever referred you to a specialist or a hospital for testing (either before or during that week)?

Based on your post, it sounds like nobody followed standard procedure by using referrals for diagnostic testing or hospital admission.

Correct me if I'm wrong, but I'm confused: did you actually go to see a specialist or get diagnostic imaging done at a hospital before or during that week, or did you only deal with the ER?