The Unforgiving Moment

Again, I feel very fortunate. The ER personnel offered tales of lesser bike falls where the victims ended up paralyzed, or with cranial bleeding -- or dead.

But when you are lying flat and cannot read or talk or eat, your mind wanders into retrospection and memoriae temporis acti -- dreaming of the sort that one must be careful about, lest it devolves into the depression of should have, could have, would have done this or that.

I offer a general thought from the ER and subsequent last five days: we live in a weird postmodern/premodern world. Never have Americans been so blessed and never so ungracious.

The ER trauma center was postmodern: even a plastic surgeon was on duty, who did wonders with my hanging lip and crushed nose. The triage team was top-notch. The equipment, nursing staff, and regimen were stellar. Without them I would be infected, disfigured, and bedridden. (Though I may hold off entirely on that optimism until May 30th,  when I am back and the gambit of not canceling has been proven wise. How do you tell your guests that you were stupid enough to endanger their entire trip?)

For five hours, I watched the worst imaginable cases wheeled in -- the wages of burns, wrecks, shootings, stabbings, falls, drug overdoses, heart attacks, shock, etc. -- all met with an upbeat, can-do staff professionalism.

The clientele, however -- metal detector required for entrance -- was premodern. Many were foreign nationals. Some appeared to be gang-bangers. Police were ubiquitous (not all the injured were virtuous or harmed by accident). English was rarely spoken by the patients. It was a world away from the ER crowd of rural California circa 1960.

Gurneys were parked in hallways that were almost blocked with sick patients, most of them texting in boredom. Relatives were arguing with other outpatients’ relatives. It reminded me of the bottom floor of the Evangelismos Hospital at Athens about 1973, where I once had a sliced finger tendon; on another occasion a shock reaction to a bad Greek plague/ typhus/yellow fever/small pox/typhoid all in one vaccination. Or Luxor circa 1974 (a case of malaria) or Libya 2006 (ruptured appendix). What was different in the American hospital circa 2014 was not the chaos, or the swarms of violently injured, but the superb quality of the care.

In a word, some of the most violent gang-bangers on the planet are accorded some of the most sophisticated trauma care in the world, and for free. I say that not so that it should not be that way, but note it only in hopes that there is some gratitude offered to our health care providers. Do any of our leaders in their various grievances against the society ever express thanks that a man can cross the border, get into a knife fight, even while committing a crime, and in extremis receive free health care of the sort comparable to that accorded to our president?

Only in America? And as it should be.

Spending five hours with those who clean up the mess of one too many beers or a drug OD gave me a strange sense of tragedy. The more spectacular the efforts of 21st century America to ensure equality, the more the effort is expected and critiqued than appreciated as an object of wonder.

Other reflections from five days on my back: Almost half of the patients around me in the ER seemed to be suffering from moribund obesity. Diabetes is a California epidemic. Latest reports suggest that well over 40% of Hispanics, to take one especially at-risk group, admitted to the hospital for all causes are diagnosed with it,  higher than the general rate in other populations. Given huge influxes across a porous border, health care in California in the next 10 years will largely center on diabetes. It will have far more social effect than even the AIDS epidemic of the 1980s. It will kill more people, more adversely tax the health care system and require a Marshall Plan-like effort to enlighten the population about diet and exercise.