INCOMPETENCE IN MEDICINE or HOW TO HAVE A HEART ATTACK AT NO EXTRA CHARGE

I had a heart attack at 47.

Yeah, no big deal, especially since I'm still around to talk about it, but it did reveal some interesting personal quirks and a whole heck of a lot about our health care system - especially one hospital in particular.

In order for anyone to appreciate the entire comedy of errors that this event in my life actually was, I've got to fill you in on some details.

I smoke, I drink coffee, I don't get enough exercise and I probably have too much salt in my diet. Nevertheless, I've been healthy. Probably amazingly so. The last time that I had a checkup under a formal regimen, my blood pressure, cholesterol and everything else were just fine, thank you. Since I was identified as 'type A', this was pretty surprising. The doctors at least expected to see elevated blood pressure.

I can't say I know too much about my recent health since I've been without a healthcare plan for over 20 years; for half that time I was playing competition paintball (good enough at it to be pro, so even if my health wasn't actually good, it had the appearance of beinig so.)

Anyway. On the night in question I awoke about 3 am with the typical arm pain associated with heart attack. I'd been experiencing increasing bouts of this for about a year, figured I was maybe headed for a heart attack, but also thought it might just be stress, as my body has a way of expressing stress in all kinds of different physical manners and over the years I'd grown accustomed to putting any such down to that, taking some tylenol if it was bad and ignoring it until it went away.

So there I am at 3 am and my left arm is hurting, not really pain so much as a constricting pressure around the bicep and down the length of it. Then my right arm starts to do the same trick, which had never happened before.

I laid there for about fifteen minutes, waiting to see if it would diminish or not. Then I decided to go to the bathroom and see how I felt when I got back into bed. This activity distracted me for a bit until I looked at myself in the mirror. My face was pasty white.

I decided to get back into bed and try to ride it out. The arm pain increased to real pain levels and traveled into my chest. And then the cold sweats broke out. My whole body was suddenly a river of clamminess. Not a little sweat - rivulets running down my face, chest, arms and back.

I waited another five minutes, internally debating whether I should just go back to sleep and see how I felt in the morning or waking up my wife and having her take me to an ER.

The debate was running 50/50. Stupid maybe, but I honestly thought there was a good chance that sleeping it off would work out just fine. I'm still not sure exactly why I didn't choose that course of action.

I woke my wife up, told her I thought I was having a heart attack and to drive me to the ER. If I hadn't believed that waking up in the middle of the night with me gone wouldn't have set her off, I woudld have driven myself.

We stumble around for a few minutes getting dressed and then head off. Pain is now discomfort and pain, agitated by wondering how much I can't afford this is going to cost.

The wife drives faster than she ever has before. Five minutes from the ER I tell her to just blow through a red light and we get pulled over by a local cop. In front of the county courthouse. Figures.

Its now about 3:15 am. The cop sits in his car, lights flashing. I sit in the front passenger seat, curled around myself, trying to stay relaxed. My wife leans out the window and screams, repeatedly, that her husband is having a heart attack.

The cop sits in his car.

He waits a good five minutes for "backup". Then the discussion ensues. No, we can't just keep on going to the hospital, they'll call an ambulance. They give a wrong location to the ambulance. Fifteen minutes later a second ambulance finally arrives, followed closely by the first one called.

No one seems to believe me as they walk me from the car to the ambulance. My wife leaves for the ER, granted a pass by the cops. I lay down on the gurney in the ambulance and we sit by the side of the road as the EMTs give me baby asparin, oxygen, hook me up to an EKG and ask me 'on a scale of 1 to 10, how would you describe your pain?'

"7 or 8" is my answer, as I'm thinking that this whole Q&A is really stupid because they have no base reference for my pain levels. I played paintball for years and enjoyed the rush of getting hit multiple times, from up close. I'm a pain slut. My "1" is probably most people's nine.

I've got one attendant at my feet and another behind my head, watching the EKG. I can see the face of the one at my feet and he's confering with his partner using lifted eyebrows, forehead wrinkles and head tilts. Its obvious from the expressions and their actions that the verdict is 'no heart attack'. The ambulance takes off for the ER, no siren, no speed, just tootling along at about 35 mph.

My pain begins to diminish. I tell this to the EMTs. It seems to confirm their prejudices. This, despite the fact that I can hear the beeps from the EKG and they are anything but regular - three quick beeps, a long beep, nothing, rapid beeps, slow beeps, nothing.

The pain returns with a vengeance. I inform the EMTs. They patronize me. The EKG goes nuts, sounding like an epileptic on a telegraph. The EMT behind me says "WHOA!". The EMT at my feet takes the printout and his eyebrows crawl up over his forehead. The siren goes on, the ambulance jumps to lightspeed.

We get to the ER. My wife has been there for at least twenty minutes already, anxiously awaiting my arrival. She's already been informed that its "good news, he's NOT having a heart attack".

Stereotypical scene: EMTs crashing a gurney through the double doors. Non-stereotypical scene: an ER admitting nurse stopping them in their tracks and insisting that they take me into Examination Room 1. Argument ensues as I lay there staring at the ceiling. The EMTs want to take me "IN THERE". THERE is Rescusitation 1. They must not want to upset me...

The EMTs win. Good thing because that move just saved their asses from a lawsuit brought by my widow. They plug me into a new EKG, give me two tabs of Nitro, put the blood pressure cuff on and ask me to take off my shirt. Which means the blood pressure cuff and EKG leads have to be removed...

They get this all straightened out and then stick two enormous rubber pads on me, one on the chest, one on the back. Each has a small metal post sticking out of its center. I think "pretty cool, no need for paddles, just plug me in." Then I think "Hey, wait a second, they hooked me up cause they think they might need those things..."

Some kind of technical nurse (male) comes in, followed closely by my wife and a hospital administrator. The tech is calm, controlled, authoritative. He explains that I am having a heart attack and that they're going to give me a clot-buster drug. This entails a very large needle and the fact that it will burn.

The administrator bitch has a clipboard. I'm having a heart attack and she's pestering my wife (who does not handle medical things well and who, additionally, has gone from panic to relief to panic all in the space of less than an hour) to fill out admissions paperwork. She's well drilled in not signing anything without reading it first. She begs off filling out the paperwork and, since they've just finished administering the clot buster, I announce that I'll fill it out.

I take the clipboard. The tech tells me that he has to give me another injection in half an hour. I start crossing out contract clauses I refuse to agree to. My blood pressure spikes. The tech chases the administrator out and takes the clipboard away from me. "You can do this later," he says. Yeah, much later.

Things finally begin to calm down. I ask what the situation is and am informed that I've had a major heart attack; they'll put me in ICU until a cardiologist looks at me in the morning and most likely put a stent in me.

So far, I've yet to see a doctor of any kind.

I get wheeled upstairs to the ICU.

***

Stay-tuned for part two when I walk out of the ICU trailing rivulets of blood...