Emergency in 911 country
Coming face-to-face with the American healthcare system can be sobering in more ways than one, writes Virginia Fallon.
There’s a funny thing about calling 111 in America. It doesn’t work. New Zealanders know the American emergency number – we absorbed it through the television – but pressing that one button three times is a hard habit to break for a Kiwi.
For my family, our 911 moment came during the summer of 2012, in our hotel room, just as we were talking about visiting Graceland.
There would be no walking in Memphis, as it turned out.
We were in the States for six weeks, having abandoned the Aotearoa summer for the American winter.
It was a masterstroke in penny pinching. By the simple act of travelling during the off-peak season, we saved thousands of dollars and hours of waiting in lines at all the tourist must-dos.
We had the Bronx Zoo to ourselves and found that, other than freezing New York, most temperatures were redolent of our summers anyway.
Memphis was exactly halfway through our summer/winter holiday; one of the things I’ve always been grateful for is that we had visited New York before the accident.
We were discussing the merits of the Peabody Hotel ducks versus Presley’s former home when Jack screamed.
Most parents will know that when it comes to their children, there is screaming and then there is screaming. One type you can ignore and the other makes you run, pell-mell towards the bellower.
It was the latter that broke the silence in our Memphis hotel room and I sprinted to meet my 12-yearold son – and his partially severed toe – in the hallway.
There is a moment when you are faced with an injury so bizarre and gruesome that time stops still.
I assumed the classic horror pose, hands clapped to my cheeks, eyes wide, mouth gaping and screamed: ‘‘What is this?!’’ My brain couldn’t compute what I was seeing.
Jack was hopping on one leg – toe flopping – screaming that we had to go back to New Zealand and stop our holiday. In the lounge my daughter started screaming she wouldn’t go home until we had been to Disneyland.
There is a certain mum-gene, the one that can find the lost shoe, know when the teenager is lying, and smell cigarettes half a mile away that kicks in at times like this, and I began first aid.
Between the arterial blood spray, Jack’s twin sister’s screams and my boyfriend fleeing the room in search of a plaster [I kid you not], my eldest son picked up the phone and called 111.
‘‘Mum, maybe they don’t have ambulances here.’’
Here’s the thing, even when we dialled the right number the phone drama wasn’t over.
The dispatcher couldn’t understand a word my son said.
We reverted to sounding out our emergency and address in syllables and letters until we were assured help was on the way.
Jack, by this time, was in deep shock and I had him lying down with a tea towel tourniquet on his toe, elevated above his heart, and another towel over his eyes.
Again, most parents know half the treatment of children’s injuries involves making sure they can’t see them. [Jack did not look at his toe for the next six hours.]
We heard the sirens getting closer, it sounded like there were a lot of them and there were. As it turned out, two ambulances, a police car and a fire engine responded to our call. To this day I don’t know if that is standard practice or whether Josh sounded out the wrong thing on the phone.
Later, we were told Jack must have tripped and broken his toe. While that would have been a simple accident, albeit distressing, it didn’t stop there.
After the bone broke, the momentum of the fall forced it through the skin, almost amputating the toe, the surgeon explained.
It had taken a fair while to see the surgeon. Other than a new emergency number, the accident had brought home one other thing we weren’t used to: insurance.
The initial emergency response was brilliant but we were taken to a hospital we nicknamed Limbo.
There, Jack’s bed was left in a corridor alcove and staff would not give him anything – no pain relief – until our insurance was confirmed.
Once that happened, the change was immediate and remarkable. We were transferred to Le Bonheur Children’s Hospital in an ambulance complete with PlayStation, where Jack was seen and operated on by a plastic surgeon. He was then given a private room, also with a PlayStation – I was sensing a trend – and a 24-hour phone line to the kitchen.
Our holiday wasn’t over. Jack was kitted out with a half-leg cast and pain relief and we were on our way. We would check in with our surgeon weekly – astoundingly we were given his cell number – and see our doctor when we got home.
The insurance had removed all worry of cost but it hit me when we stopped to pick up antibiotics and I had to use the credit card; it cost $180 for a two-week course. We would claim this back once home.
All in all, the cost of treating Jack’s partially-severed toe was about $20,000. Two ambulance rides, one surgeon and a night in hospital sure added up.
Our summer/winter holiday was still a success. Insurance paid for a wheelchair and our wha¯ nau discovered the secret of Disneyland and Universal Studios: wheelchairs skip lines.
Jack’s cast was covered in the American military colours – god bless insurance – and throughout our trip he was high-fived by the returned servicemen, also in their wheelchairs.
In San Francisco, many of these men had official identification, they were begging on the streets, their signs listing the injuries they suffered.
In New Orleans I pushed my boy past two veterans in wheelchairs. ‘‘God bless America, I lost my leg fighting for you,’’ one sign read.
‘‘These people are tourists,’’ one man said to the other. ‘‘They think America is cool.’’