Roomful of Pain

San Diego — One of San Diego's busiest emergency rooms is Kaiser Permanente in Grantville. At 7:30 on a Tuesday night, the parking lot is illuminated by an arcade of food vendors under bright neon signs. Inside, there is almost no place to sit.

William Dabney's stoical expression has not changed since he sat down. He sits alone, seeming not to notice anyone. "I live downtown. I'm 60. I got 'old folks' syndrome.' My head is spinning and I can't remember anything. I'm dizzy and weak. I've been feeling this way for the last few days now. I was here two months ago for surgery, but I think something went wrong. They had to remove a big cyst on my butt. They treated me great. Right now, I just feel stupid. And I got blood in my urine every morning, so something's wrong." In spite of his illness, Dabney is confident he will receive quality care. "I love Kaiser. They treat you good."

Margaret Vlach, 81, holds a bloody towel against her forehead. She is laughing with two friends, a man and a woman, who appear younger than she. Vlach, a College Area resident, has lived in San Diego since 1938. She's an active senior, and her injury proves it. "I fell over one of those speed bumps. I was down at the VFW and walked out and didn't see it -- I have night-blindness. I've been with Kaiser for 40 years. I used to work for them! They treat me very well. I have asthma, and I'm in here quite frequently. I never have to wait very long. I'm very satisfied with them. I've been offered other facilities. My husband was a major in the Marine Corps, so I'm qualified to go to the military hospital, but I prefer Kaiser over them." She lifts her towel to show a nasty gash on her forehead.

One person who is not laughing is Alex Michael, 14. Sitting in a wheelchair, he winces with pain as he holds his injured leg up. Agony fills his voice as he describes his accident. "I got hit by a car this morning. It just got worse as the day went on. I was going across the street to Mira Mesa High on my skateboard, and a guy turned right on the red light and didn't even look at me. The bumper hit me right here--" he touches his leg just above the ankle -- "it's either a bad sprain or it's broken. I've been here about an hour."

His mother, Tammy, explains. "I got home from work about 5:30, and it took about 40 minutes to get here. A lady went and looked for this wheelchair because, at first, they didn't have one. I've always liked Kaiser. I've never had a problem here. I was here Sunday with my husband!" she laughs.

Alex: "The pain is sharp and constant. I can't put [my leg] down. It hurts just to touch the skin. They haven't even looked at it yet."

Curtis Milyard and his wife, Rusty, are the saddest-looking people in the waiting room. They take turns holding their two-year-old daughter, Merhae, on their laps. Merhae has a severe cut on her thumb that will not stop bleeding. A dirty Band-Aid soaked with blood covers it.

Curtis is disgruntled by the wait. "We've been here about an hour. There's about six or seven people that went in before us after we came in, but they said that it was because of the bed availability and whatnot. I guess the nurses decide whether our case is as severe as the other people who went in."

Curtis laughs nervously as he describes his daughter's accident. "She got a hold of a can! If it doesn't stop bleeding, she'll need stitches. She keeps moving it around."

His wife Rusty is less reserved about the wait. "She cut herself about 4:00 this afternoon. All the people in the waiting room have changed. It's all different people since we first got here. I don't like it. I don't think it's fair. Not fair at all."

This is not their first experience in the ER waiting room at Kaiser. "Yep. We've been here before," Rusty groans. "It's just waiting and waiting and waiting and waiting."

Curtis: "There was one time I was in a motorcycle accident and feeling pretty bad. My buddy had to help me in here. A guy went in before me who had a sprained little toe," he laughs. "I guess he was here first. Sometimes the order seems good, but there's other times -- if they've lost blood and stuff, they should be priority. There were a couple of kids in here after us and we couldn't see anything visually wrong with them and they've already been in and out.

"Our health care is through Kaiser. If we took her to Children's they would add on a $30 charge. They say they can't treat cuts in their Ready Care. They can only treat sprains and broken bones. I guess they don't have anybody that knows how to do stitches there. We came here from Lakeside, because this is the only emergency room that Kaiser has."

Curtis's appraisal of Kaiser is less than enthusiastic: "I guess they're okay." Rusty is not happy with Kaiser: "I had so many problems when my child was born. They tried to give me an epidural three times. Couldn't get it the first time, second time they got spinal fluid squirtin' out, and the third time they finally got it. They moved me from three or four different rooms. I just wish the emergency room was faster."

On Thursday night, the ER waiting room at Mercy Hospital in Hillcrest is more subdued. Smaller than Kaiser's ER waiting room, Mercy has one couple watching COPS on the television, while most of the other people stare into space. One woman is sleeping across three seats. It's 8:00 p.m.

Janet Tirado, 25, is waiting with her husband. "I'm in here for pain. My back hurts, my head hurts, my ovaries hurt, my lungs hurt, and I've been in pain for a lot of hours. I have no idea what it is. I've been here for three hours already. They told me it's full back there, and they're not taking anybody.

"This is my first time at this ER. I just moved here, to Golden Hill, from El Centro. It's the same way there; they take forever. They need more doctors. There's a lot of patients; this room is full. I have five children, and my neighbor's watching them.

"I hope they can run some tests and find out what's wrong with my head. The nurses aren't too nice here. Some of them are rude. This emergency room is nice, but it's very slow."

Anthony Flach, 41, looks and sounds miserable. He speaks slowly, betraying the physical pain he has learned to live with. "I have kidney disease -- I've had it since '86. I came in for kidney stones. I've been here two and a half hours now. This is my fourth time in the last month.

"I came here on a Thursday night in September, two months ago. I was to fly out to England the following Tuesday. The doctor I saw didn't do anything. They did a UA, a urine test. He said, 'Yeah, you have kidney stones,' and I thought, Duhhh, I know that. Then he said, 'Okay, you can go.' I said, 'Aren't you going to do some tests like they usually do?' They usually do x-rays and different tests to look at the stones and see if they can get rid of them or what. He said, 'Oh, no. We're just going to send you home with pain pills.' He gave me a prescription and sent me away. I couldn't believe it -- he did nothing.

"Four days later, Monday, I came back with the same problem. By then, my fever was so high that I felt I had to come. I was going to England the next day, so I really didn't want to come to the hospital, but you know when it's serious. My fever was almost 105; 107 is dead. They said they were going to admit me, but I said, 'No! I'm getting on a plane tomorrow and I'm outta here.' If they were going to give me that first doctor, I would have just left. I didn't realize how sick I was until the next day when I got a real doctor and he explained it. He said he was going to follow up on this first doctor, and I'm going to follow up on him too. I've got a real good doctor now -- Dr. Keiller.

"All my other experiences have been good here. When I came in that Monday, they were excellent. I spent three days here, and they pumped me up with antibiotics, pain pills, and got rid of the infection so that I started feeling better. I think the ER here is good, and that's why I came back. But that one doctor...he basically came to my bedside, asked me how I was doing, left, and returned sounding so happy, like, 'Oh we're going to send you home with pain pills!' I thought, Isn't that wonderful! My problem is still here! That's not what I came here to pay hundreds of dollars for. I could go to another ER with my insurance, but I've got a good doctor here now. Very thorough. I'd highly recommend him to anybody."