True story here. I live in the US, and am poor. Starting about a week ago, I started feeling very ill. As I can’t afford any medical care, I just tried to ignore it and hoped it would go away. However, on Wednesday I was so weak and in such pain I hauled myself to the ER of the nearest hospital. From what I understand about the laws in my state, hospitals can’t refuse medical care in emergency cases even if you can’t pay. And as I was in such great pain and not medically trained, there is no way I could self-evaluate my medical status, so this could be called an emergency.
After I arrived, the doctors thought it might be serious and admitted me. They put me on a saline drip and an EKG, and ran a lot of blood tests. After a while, a doctor came in and explained the situation. According to the tests my electrolyte levels were WAY off, and the conclusion was that I was suffering from acute renal failure. And stated they wanted to admit me as an inpatient to treat this. I then explained that I couldn’t afford medical care, and asked if there was something they could just give me for the pain and go home where I could pray I got better? Not only is money an issue, but because of certain aspects of my real life situation I can’t just check into a hospital and have others tend to handling these other real life matters for me. I then asked the doctor if I refused further treatment what are the odds something seriously bad happening to me, like death? His response was that while I could legally refuse care, the odds of me dying were “very high”. No functioning kidneys falls into the medical category of “SERIOUSLY bad.” As I was in extreme pain, I just responded to the effect “check me in, and be quick about fixing whatever is wrong”.
After about 12 hours, the doctors informed me that medical tests seemed to indicate I might also have experienced a heart attack (the exact term the doctor used.) Oh joy! What they wanted to do is invasive surgey with some sort of scope to look at my heart, with the possibility that if they did find I had a heart attack possible surgery for that. I refused, commenting that my real life situation was such that I couldn’t be in the hospital that long. I just wanted them to deal with the renal failure issue, and gamble that the tests about my heart were wrong because my blood chemistry was shot to hell.
Apparently they found my case interesting. At one point a couple doctors and about 8 residents (this is a teaching hospital) were in the room asking me all sorts of questions. I guess it must be that not every day a middle aged guy with no history of kidney problems walks in the door with acute renal failure with no obvious explanation. Thus I was a good example case for the residents.
After about 24 hours I was feeling just a little better and asked if it would be OK if I left? The response was that I was still in bad shape and unstable, and this was medically inadvisable. I decided to stay one more day.
At the end of the next day, while still not feeling great was much better. They said that while I was stable enough I could leave, they advised against it. I checked out, and they gave me a list of specific dos and don’ts. It turned out that my early attempts at self-treatment made things much worse. I just thought it was likely a virus or such, and didn’t realize my kidneys had failed. What I did wouldn’t have likely been bad if I had been in general good health. However, what I did was quite inadvisable as I had acute kidney failure.
What is so crazy is that while unless I am in really bad shape I couldn’t even get basic health care (like a physical to check out blood pressure, etc.), when things get really bad they are wanting to treat me for things I didn’t even come in for. Not only surgical examination of my heart, but even possible heart surgery if that showed I had a heart attack??? I just wanted to get well enough to be able to walk around rather than in such severe pain I couldn’t. Bizarre.
For those in the US surprised I got as much care as I did, I suspect it had to do with the luck I stumbled into a teaching hospital. The doctors couldn’t very well have given me the usual treatment I’d expect in the US. That being get me stable enough to walk out the door, hand me a few Tylenol #3s, and be told “best of luck, dude.” Hey, I even got in the mail yesterday something from the social worker at the hospital. If I go to the local welfare office and apply for Medicaid (which I already know I can’t qualify for), as my income is less than 140% the US Federal Povert Guidelines, I qualify for free care per the “Community Financial Aid Policy.” Dunno if this care would be much good (as in I might be able to qualify for a physical, but if I had high blood pressure I couldn’t afford the drugs to treat it), but I appear to qualify for something. Whatever this hospital is offering looks suspiciously like a “we are looking for guinea pigs to train our residents” program. However, this isn’t necessarily all bad. Residents have all kinds of motivation NOT to want me to die on them. Screwing up and killing patients doesn’t help toward being certified as a doctor. I wish I had the presence of mind at the time to get the business card of one woman resident I talked to. She seemed to think that she would be able to qualify me for at least basic medical examinations at the college med school clinic.
Such is life, possible death, and medical care in the US.