posted on Apr, 1 2012 @ 10:48 PM
I can't see this as an isolated incident due to recent events in my life.
My husband and I are intelligent, articulate, assertive, somewhat medically knowledgable, and gainfully employed as well as Caucasian. Additionally,
I'm in the VA network which is a whole 'nother (good) thing.
However, I have a .. let's call her a "friend" due to HIPAA and confidentiality issues .. who has developmental disabilities and is functionally a
young child. She's also diabetic, bipolar, has seizures, and IED (Intermittent Explosive Disorder). Being permanently disabled, she's on
medicare/medicaid. Due to other behavioral issues, she lives waaaay out in the country, and when emergencies arise we usually have to go to the ER at
the small, local, area hospital which I'll refer to as CAH.
Now, CAH is not a bad place per se. When I took my husband there with acute appendicitis (had already ruptured), he was diagnosed, cared for, given
morphine, and shipped off via ambulance to a major hospital in the nearest large city for surgery in a totally appropriate and timely manner.
But .. about six weeks ago on a Saturday afternoon my 'friend' Susie fell while getting into another girl's car, and was thereafter unable to walk.
She was taken to CAH, where they took an x-ray, said it looked like a hairline fracture possibly on the site of an older fracture, gave her an air
splint, and sent her home on OTC ibuprofen. Sounds ok so far, right?
But .. over the weekend in spite of elevation, ice application, and ibuprofen, the ankle got worse and swelled even bigger. Finally on Monday evening
she was taken back to CAH where they did an ultrasound or CT scan or something (not clear on those details) and suddenly decided it "might be a real
break" and "might even need surgery" and referred Susie to an orthopedic center in the big city. They wrapped her ankle in cotton padding and
gauze, advised that she should not put any weight on it in the interim, and again gave her no pain meds.
Here's where I enter the story. On Tuesday morning I accompanied Susie to the ortho clinic, where they unwrapped her foot and took about 5 x-rays.
When the PA entered the room to see us, she sat down at the computer, took one 2-second look at the first x-ray, and then turned to us and said "this
is bad. She'll need surgery." It was a trimalleolar fracture with displacement and spiral fracturing. The PA was horrified when I gave her the
history. She said that one of the bones was jutting into another at an odd angle and was perilously close to a major blood vessel. Susie could have
done serious damage to her ankle, or even damaged that blood vessel and potentially lost either her foot or her life, at any time since Saturday
afternoon had she just put weight on that ankle a bit wrong.
The thing is, I know that Susie DID walk - or try to walk - on that ankle several times over the weekend. Even after six weeks in a cast she never
really achieved a good understanding of the fact that her ankle was broken, and even in terrible pain she was non-compliant about not putting weight
on that foot. (I don't mean that in a derogatory way to her, she just couldn't understand what the problem was, and sometimes with her every day is
a new day and she seems to have forgotten some things that happened yesterday.)
Now, I ask you - how in the HECK did CAH do an x-ray and not "notice" a severe trimalleolar fracture with significant displacement and spiral
fracturing? Susie could have DIED - or lost her foot - anytime after they sent her home with a plastic air splint and OTC ibuprofen.
But, you know, as others have alluded to in this thread, Susie is medicare/medicaid, disabled, sometimes combative, and generally a bit unpleasant for
strangers to deal with - especially when she's in pain. She's a valueless, "throwaway" citizen with no living competent family members and no
"worth" to the system.
I guarantee you they wouldn't have sent ME home with an air splint if I had a fracture like that, but, as I said before, I'm intelligent,
articulate, and able to explain things like what happened and how much pain I'm in...
It seems to me to be another example of how those who have no resources and are not adequately capable of convincing health care professionals to give
them the care they need, don't get it.