The night had started off great. A few weeks earlier I had agreed to speak at the New York premiere of the American Enterprise Institute President Arthur Brooks’s forthcoming documentary The Pursuit. The invitation came from the think tank Conscious Capitalism, which was founded by Whole Foods founder John Mackey. Although I knew little about Conscious Capitalism or its agenda, the organizers kindly sent me a link to the documentary so I could preview it and gather my thoughts one week before the official screening. One of the discussants afterward remarked that The Pursuit tended toward the “propagandistic” in its didactic treatment of capitalism, but for me, listening to the film’s defense of free enterprise in the People’s Republic of Manhattan refreshed me like a breath of fresh taxi exhaust. My wife, Anne, had finally agreed to attend one of my public-speaking engagements, an occasion on her list of priorities that ranks lower than a mani-pedi but just above a visit to the DMV to renew her driver’s license. As we walked home she made a few cursory observations about the film and thanked me for not embarrassing her, or myself, by making inflammatory comments or wearing a MAGA hat.
If you are a regular reader of Chronicles, you can probably guess what I told the Conscious Capitalism audience. However, if this is your first time trapped inside a Mark G. Brennan screed, then I will summarize my remarks just for you. To leaven the ideological view of capitalism presented in the film, I warned the attendees about the dangers of political factions, but just a little less eloquently than James Madison did in Federalist 10; I suggested we repeal the payroll withholding mechanism to spark a taxpayer revolt next April 16; and I feigned ignorance, rather than donning my alb of lapsed reactionary Catholicism, when one attendee asked me, “Why don’t poor people just stop having so many children?” When Anne and I finally got home we each turned to our nightly tasks: I walked the dogs, and she turned down the bed.
But the question about the birthrates of the poor continued to bother me as I watched my dogs relieve themselves in the snow. I decided to ask my wife for an honest critique of my response in order to get some closure before bed. As I opened our apartment door upon my return I saw a look of absolute horror on her ashen face. She was pacing the living room while shrieking, “Something terrible happened!” In her arms she was cradling our fourteen-year-old, Abby. Abby’s screams of pain and flailing limbs caused my adrenaline to spike. My wife spoke again, this time slightly more composed, “Her leg is broken . . . she was caught in the curtain . . . she’s in excruciating pain.” The details made no sense. But I didn’t need an explanation of the accident. Abby’s cries of pain and my wife’s distress told me something truly awful had happened. My reflexes kicked in. Yet I knew I had to override my instincts in order to make a rational decision. We need to get to a hospital. . . . Ambulances take forever to arrive in New York City. . . . I’m never getting to sleep tonight. . . . I don’t care about the rough night I am about to embark on even with my own compromised health—this isn’t about me right now. . . . These screams make me want to scream myself.
I told my wife to stay with Abby while I summoned an Uber, likely the fastest way to get to the hospital. The car arrived in three minutes. The driver sped down the six cross-town blocks at near-record speed, most likely to minimize the amount of time he had to endure Abby’s wails. Soon enough we pulled up to the emergency entrance of New York City’s best private hospital. A janitor was sweeping the walkway at 10 p.m. when we arrived. He held the door open for us as we ran in, carrying Abby. A greeter directed us to the emergency room without even asking us why we were there. The howls made it that obvious. I had a book with me under the assumption I might have to spend the night at the hospital. The nurse who greeted us in the emergency room asked me if Abby had ever been to this particular hospital before. I told him yes, and he quickly found her in the system. As he was typing her name into the computer, all eyes in the waiting area fixated on Abby, whose screeches had only grown louder. Within three minutes of our entry into the emergency room, the nurse, without looking up from his keyboard, yelled “Triage Room 3!” and told me and my wife to take Abby there and wait for the doctor. The three of us entered. My wife got Abby under control, even though we expected her to pass out any second from the pain. I rushed back to the nurses’ desk to give the staff on duty Abby’s updated health history to be entered in the system. Two minutes later, my wife came running out of the room yelling to the nurse, “The doctor told me to tell you that I give the hospital authorization to stabilize Abby.” As my wife breathlessly granted permission, I saw the doctor, with Abby in her arms—still screaming—sprint through a set of swinging doors back to a room where they would sedate Abby and X-ray her dangling leg.
A mere 20 minutes had elapsed from the time we discovered Abby’s harrowing accident until the moment when the doctors finally explained the extent of her injuries and prognosis.
Perhaps I’m just lucky that I live only half a mile from New York City’s best private hospital. Or maybe I’m lucky that Abby hurt herself late enough at night to avoid the usual Manhattan traffic. Maybe I should thank my stars this all happened on a slow night at the emergency room. Or maybe I’m just lucky that Abby isn’t my daughter; she’s my cat. American medicine has now sunk to such an absurd low that cats who expend one of their nine lives receive prompter medical attention than humans receive, regardless of how loud humans scream or how far the bones stick out of their compound fractures.
If you have ever gone to an emergency room, you’ve likely thought to yourself during your interminable wait, “I might die of old age before I see a doctor.” I’m pretty sure cats don’t have thoughts. But if they did, I can guarantee you they wouldn’t have that thought. Cats, unlike you and me, have no reason to dread an emergency-room visit. Unlike the workers at human hospitals, medical staff in the feline world understand that cries of pain require immediate attention. Veterinary hospitals practice the courtesy of telling you exactly what they are about to charge you to ensure that you want to proceed with treatment. And nurses and doctors treat accompanying family members as respected customers instead of fools getting in their way and delaying their coffee breaks.
I’ve never wanted to be a cat. But next time I get hurt, I may just start meowing and hissing at anyone who comes near me. It could save me half a day in an emergency-room waiting area if I were to contract feline HIV or fracture my tail.
Just like Abby I recently had to go to the emergency room, on a Saturday morning this past January, a routine activity in my ongoing fight with cancer. The cancer center where I receive my treatment, a facility separate from the main hospital, runs a skeleton staff on weekends in case a patient needs an emergency hydration or other immediate procedure. I suggested to my friend who accompanied me there—Anne was partying in Chicago—that, rather than go to the main hospital’s emergency room, we should first try the cancer center since it has all my medical records. I knew I would not have to explain my cancer history to the weekend oncologist on duty, the way I would have to do with an emergency room receptionist, then an emergency-room physician’s assistant, followed by a clipboard-toting nurse practitioner, right before more pointless questions from a sleep-deprived resident, and then, maybe, an actual doctor. The weekend oncologist examined me and then sent me to the main hospital for a chest X-ray. I took a victory lap, reminding my friend Patrick how brilliant I was for saving us hours of waiting time, by predicting that very same outcome long before our arrival.
My victory quickly ignited in a fireball of insanity. Patrick and I hopped in a cab to drive the three blocks to the gargantuan main hospital. I went to the radiology department, as instructed, and gave my name to the nurses on duty. We heard a loud crash coming from the elevator as we waited for them to check me in. Patrick and I turned toward the commotion. An elderly man wearing metal leg braces and using crutches had done a face plant out of the elevator onto the landing. We rushed over to help him up as the nurses watched us and the floundering old man with condescending indifference. Patrick lifted one arm. I tried to lift the other but lacked the strength to do so because of my illness. Out of sheer frustration I screamed for help from the idle nurses as the man’s hand bled all over the floor. Sensing my distress the old man tried to calm me down, assuring me in his Irish brogue, “This happens all the time.” When two of the nurses finally decided to get their rumps off their chairs and relieve me of my impossible duty, I sat down, shaken by the blood and noise, annoyed by the nurses’ inhumane indifference, and, ultimately, angered by the American healthcare system.
After the nurses had finally settled the old man, they brusquely told me I was recorded in the system as an “inpatient” admittee but their department only did “outpatient” X-rays. They told us to walk to the other end of the hospital for “outpatient” X-rays and sarcastically offered me a wheelchair escort as we stormed onto the elevator. When we arrived at the “outpatient” X-ray department, the receptionist played the same work-shirking game. She told me they could not do the chest X-ray, either. On and on it went. Patrick and I waited two hours as the receptionist tried to figure out how to take X-rays of a patient whose status was recorded incorrectly in the hospital’s accounting system.
As my breathing became ever more difficult, I snapped. I stomped over to the receptionist. She had by now consulted with the blasé X-ray technician at least six times as he kept coming out to the waiting area to look at me and Patrick every 15 minutes under the false premise of checking with the receptionist regarding my immutable accounting status. Phone in hand and on the verge of throwing a punch, I bent over to address the receptionist. I could barely breathe enough to talk. She handed me her phone mid-conversation and told me to speak with her supervisor. I told her boss that I had just used my own phone to look at my record of visits to the hospital for the calendar year 2018. During that worst year of my life, I had spent 187 days at the hospital, undergone three surgeries, and completed 11 rounds of chemotherapy and 33 radiation sessions. I further reminded her that even after my treatments had finished in May, I went to the hospital every day in June and July for emergency hydrations, all as preface for my main argument: “I’m not trying to steal an X-ray from your hospital. How about if you take the X-ray and then you and your colleagues go argue with your accounting department about whether it should be recorded as an ‘inpatient’ procedure or ‘outpatient’ procedure?” I offered to pay for the X-ray, in cash, right then and there. Then I collapsed from exhaustion on the desk just as the omnipotent supervisor responded, “Oh my God, I’m so sorry. I just changed your status in the system. We’ll take your X-ray right now.” Ten minutes later my X-ray was complete. Patrick and I returned to the cancer center to get my diagnosis from the weekend oncologist four hours after we had originally departed from the cancer center.
Why can we X-ray an injured cat three minutes after it enters an emergency room, but it takes us four hours to X-ray a Stage 4 cancer victim? I’m glad my cat gets prompt treatment when she suffers. But I wish humans—insured humans, otherwise known to hospitals as their “customers”—were afforded the same dignity. Do the staff of veterinary hospitals understand suffering better than the staff of human hospitals? As children we all cried watching Bambi and Old Yeller. But we stopped crying later in life when we saw film of Nazis shooting Jews before pushing them into trenches during World War II’s “Holocaust of Bullets.” Was it our maturity? Or do humans have more sympathy for animals than they do for their fellow man? I often see protests when I walk by Central Park’s horse-drawn carriages. PETA types don’t like seeing beasts of burden at work. But I neither see nor hear even the slightest protestation whenever savage parents abuse and even murder their young children, an all-too-frequent occurrence in New York’s five boroughs. Instead of angry uprisings over this most despicable crime against humanity, we instead hear calls for more spending on the same foster-care and child-services agencies whose sheer incompetence contributed to these unacceptable deaths.
A debate has raged for decades about how to fix America’s healthcare system. George W. Bush figured expanded government payments of prescription drugs—Schedule D—would do the job. But I’m willing to cut him some slack. George W. was a foreign-policy expert and military strategist par excellence, so we shouldn’t have expected him to fix everything. Obama dreamt that if we could just insure every American, we would all live to be 110 or something. Dr. Trump has at least proposed medical providers be forced to exhibit menus that list services and prices, just as every other business does.
Chronicles doesn’t allot me enough space to present my solutions to the healthcare crisis. The editors need only ask. But here’s one place we can start. Look at what New York’s best private hospital—and, yes, it only cares for animals—does, and start doing exactly that. While Abby has no idea of the horrors she’s missing in the typical hospital emergency room, most Americans have no idea of the first-rate emergency care she and her feline cohort receive. And it only cost me $400.
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