THE ER PART I / by Nora Logan

I spent over 26 hours in the ER at Weill Cornell. They didn’t have a bed for me on any of the wards (and didn’t know what was causing my liver failure so were not sure where to put me). At that point they had yet to rule out an infectious disease. The 26 hours (not that I was counting) were a test of my patience, which at that point was a small thimble compared to the deep well I’ve had to dig since. If you think of a hospital in the way you would any hierarchy, the ER is at the very bottom rung (A&E for my UK people who never watched the extremely popular TV show ER - it's understandable if you missed it, it was only on for 15 years). No one really wants to be in the ER: the patients, the doctors, the nurses – it’s a hellfire like few others in the world. I may be exaggerating, but only slightly. In my extensive research on the ER, the only person I've met who didn’t mind it is a sweet friend of mine who was a volunteer at the hospital at the same time I was there (the second time round) and would come visit me when she had a shift. We would discuss the flaws in the system, and her reverence for being witness to the inner workings of the ER always struck me. There is something to be said for being in the thick of it, in the place people come when they're in dire straits Unfortunately in this country, where our healthcare is in such disarray, where we currently have 28 million uninsured people – people who go to the ER often as a last resort because it’s easier to walk away from the bill—or because they have no other options. 

If you're in a situation like mine, where you'd be very lucky if you even get to leave, your best bet is to hope that they want to get you out of there as soon as possible, and let it all wash over you. Before they really knew the full extent of my liver failure, they gave me morphine to take the edge off. I look back on that short-lived morphine moment as a warm bath of narcotic reverie. I remember, so vividly (well, I'll admit that it's not a crystal clear memory, but I have a fuzzy, opiate-laced general idea about what was happening), when they picked me up to transfer me on to a gurney and wheel me from my little bed to my first MRI. I looked up at the ceiling and had the distinct sensation that I was being rolled through a jungle. I could hear the sounds of the busy ER. The beeping of machines, the moaning of patients, the chatter of doctors, the nurses shouting back and forth to one another about bringing this piece of equipment or that syringe or this medication, it was all there in the background. But there were also more ethereal sounds triggered by the drugs (I believe they were a hallucination, although this can only be confirmed by my eardrums and imagination which unfortunately do not have their own spokespeople, so it's essentially up for debate). 

I was wheeled through a ward filled with murals, presumably for children (although I grew attached to them with each passing MRI or ultrasound), replete with cartoonish tall grass, butterflies and other animals. The pastel colours made me dream of a canopy of green, while the loud sounds of crickets and other high-octane noises bubbled up. A persistent buzzing—like a heart monitor flat lining—formed a helmet around my head. None of it was real, and yet there I sat. I associate my time in the ER with an escalating sense of panic, a similar experience to a comedown off drugs. And hey, it was. At a certain point, the offer of morphine stopped (just as the expression on just about everyone's face got more grim). The information increased in seriousness. New doctors kept coming, and although I kept the jokes going with my friends: 

"I'm never going to sleep it seems but that works out for me because you know I love to party. I am going for an MRI and hopefully having a blood transfusion cancelled because it's unnecessary [keep that dream alive, Nora of the past]. Sorry for the massive group chat but a lot of you are asking and since all the doctors love me so much and want to find out what this weird place called Bali is and where I picked up whatever the fuck this is it's easier to explain here rather than lots of texts. For now I basically know nothing but still have all the same symptoms and will hopefully know as some point in the next day or so. Love you bye. X".

Looking at the texts now, I'm amazed at my optimism, which would (sort of) last more or less all the way through to being listed for a transplant in the step-down unit on the 5th floor, when the grave reality of my situation set in (even then I was convinced I wasn't dying and kept saying things to the effect of "honestly everyone, I am definitely reversing this liver failure, don’t mind me! Is the F train running today? Need to get home later.")

When the silent stop order on the drugs went down it became all too clear that this was not a joke. But it was a lot easier to pretend like it was, especially since it's near impossible to get any sleep at all in the ER. They wouldn't even let me take an aspirin. Are you familiar with the feeling of your liver rapidly deteriorating at break-neck speed without pain or anxiety medication or anything whatsoever? It's sort of like nails scratching a chalkboard repeatedly 24/7 for 10 days. It's chill. The experience was so unbelievable, I was sure I'd be waking up from a low-rent badly-lit nightmare at any moment.  And If I hadn’t been the one who experienced it, I wouldn't actually think it bearable. 

During my time in the ER, I saw all manner of bizarre sights reserved only for the preternatural setting of a room that is essentially a holding area for any and all manner of illness. Think about it. Whether you’re coming in for stepping on a nail in a warehouse party or a building site, your kid fell down in the park and split their lip, you’re a drunk who comes in weekly, you’re an elderly person who lives alone and you’re scared because you don’t feel well and don’t know where else to go, you’re seeking pain medication for some phantom back problem, you just had a brain hemorrhage, you got into a fender bender, you have food poisoning or, like me, your liver is failing (the list goes on, and on), it all exists together, in this ground floor vacuum. You can witness the best and worst of humanity in an ER. The stakes can be really high so everyone is tense—from the patients to the nurses to the doctors to the aides to the janitors. Everyone reacts differently—someone could be completely distraught over a sprained ankle or worryingly calm about a massive heart attack or vice versa. On top of that there are so many variables to everything. It's hard to keep your head above water as a patient. I can only begin to imagine what it must be like as a health professional.

The really weird stuff happens either very early in the morning or very late at night—it’s when the zombies come out to play (or nervous parents come in with toddlers with temperatures). I clearly remember a wasted guy in his 40s come in around 3am screaming at the top of his lungs (which isn't so out of the ordinary, we've all heard a story like this), the staff at once wearily pleading with him to settle down but also completely ignoring him, because they've seen it all before. He would not leave and he would not shut the hell up. The woman next to me was wailing in pain and she would also not shut up—she wanted to be seen by someone—anyone. She was indignant that she was so willfully ignored (and probably disgruntled that I was fast becoming the It Girl of the ER). She was being ignored. That's what happens in the ER. Once that morphine wore off and I no longer felt like I was a panther in human form in the Amazon, it was interminable. I had so many doctors come in and out of our little room, the only thing separating us a tiny, thin piece of material that passed as a curtain to come see me, asking me questions - doing their work, trying to solve the case of the mystery liver failure, which only increased her loud frustration (understandably). Even with the constant flurry of people, I felt ignored too—that’s just what it is to be in the ER. The moral of this particular ER story is to get as much morphine as possible when you're spending 26 hours in the vortex. Failing that, keep your phone nearby for jokes from friends and keep your interactions with the drunk guy at 3am to a minimum. Oh yes, and find the least used bathroom and use it exclusively.