Friday Afternoon in Emergency

The real life tale of an out of the blue and serious medical emergency that drives home the daunting notion of how one can feel when they are in pain and no one is around to help…

by: Marc Audet 

“Were you able to get in?” It was half-past noon on a Friday and my wife Catherine had called me during her lunch break just moments after dismissing her seventh graders.

“One-thirty this afternoon. I got lucky. Jody had an opening.” Jody was the receptionist at our doctor’s office.

“How’s the leg doing?” 

“The same, it still hurts when I stand up,” I said.

That previous Tuesday morning, my left calf had started to hurt, a pain akin to a bad charley horse that would not go away. As soon as I got out of bed that following Thursday morning, a cramp started in my left calf and ran all the way up through my hamstring. “Bloody hell!” I cursed out loud, gasping as if stabbed by a sharp object before crashing back down on the bed. As if by instinct, I discovered that the pain eased up as long as I kept my leg horizontal. I limped to the bathroom and started to shave, but no sooner had I lathered my face that I had to lie down again. After a few minutes, I got up again and continued shaving, taking deep breaths to distract myself as the pain flared up. I held out just long enough to rinse my face before rushing back to my bed. The harsh realization set in that I could hardly stand or walk. I felt a dread rising within me, similar to the fear that might overtake you if you were driving and suddenly discovered that your brakes were gone.

“I’ll call you when I get out,” I reassured her as we said goodbye.

I had spent most of the morning in the living room reclining on the sofa, first taking my breakfast on the laptop desk that I had purchased for Catherine when she started to teach remotely at the start of the COVID pandemic. I called my doctor’s office at ten o’clock and made an appointment, and then spent the rest of the morning listening to an audiobook and staring out the window at the bright sunlight. It was the last week in March, most of the snow was long gone, and the late morning temperatures were in the high forties, perfect for running. I wondered if my running days were over. The hands-on the travel clock on our coffee table now showed 12:45. I still had to put on a clean shirt, brush my teeth, and ease myself down the stairs to the garage, and then into my car. At least I was still able to drive. I was giving myself plenty of time to get across town, park, climb the two flights of stairs, and finally, hobble the length of the long, quiet corridor leading to Dr. F’s office.

“Hold this,” said Dr. F, handing me his iPhone. He held my calf steady with one hand, and with his right, positioned an ergonomically shaped probe that reminded me of the cordless hair trimmer that my barber uses to clip necklines and sideburns. Thin copper cables, sheathed within a soft, pliable synthetic rubber tube, connected the probe to the iPhone relaying a digital stream of data which the video chip embedded on the iPhone’s circuit board converted to an image, an image that made me think of a black and white negative: a mostly black space within which soft-edged clouds of pixels rendered in various hues of gray, ranging from milk-white to midnight charcoal. As he moved the probe, the image jerked and reformed, like the flicker of vintage newsreels that you might see on a history documentary.

I was propped up on the examination table, my left leg askew and bent. Dr. F was adjusting the handheld ultrasound scanner up and down and sideways to get a clearer view of the veins passing behind my knee. “You see those two black holes there,” he said while pointing at the image, “those are your veins. This is above your knee. Now look here.” He took the iPhone, touched a few buttons on the screen, and handed it back to me, showing me another view similar to the first. “You see the vein on the right, that white area, that is a blood clot.” He demonstrated how the vein would collapse if he pressed the probe down on my leg. “It looks like a large clot, running from the knee down to the top of the calf,” he paused for a moment, then added, “the probe can’t see any deeper into the muscle itself.”

Dr. F disconnected the probe then wiped the acoustic gel off my leg. “You can get dressed now, I’ll be back in a few minutes,” he said, closing the door behind him.

“A blood clot,” I said to myself, “deep vein thrombosis,” repeating the formal name that Dr. F used a moment earlier. I now had a plausible explanation for the pain that gripped my left leg whenever I stood up. The sheer force of gravity caused blood to rush into my legs, and upon reaching the obstructed veins in my left calf, my muscles would swell as the backflow sought alternate routes to bypass the now occluded venous passages. By lying down and keeping my leg level, less blood flowed into the affected calf, relieving the swelling and the pain.

Dr. F reappeared with some paperwork. “I booked you into Emergency at St. Raphael’s to get a full ultrasound to confirm that it is indeed a clot. Go there right now, they’re expecting you. Also, make an appointment for next Monday, we need to talk, this is serious. It’s a good thing that you came in today and not next week. Blood clots can be very dangerous. If they break up, they can get into your lungs, then your lung collapses. You are lucky, I just got this device the other day, this was my first chance to use it.” The intonation and pace of Dr. F’s voice revealed two genuine emotions: a sense of medical urgency due to the seriousness of my condition accompanied by a sense of personal satisfaction one gets when mastering cutting edge technology for the first time. Even with my leg throbbing with pain, I had to admit that I was impressed.

It took me about five minutes to drive up the street to St. Raphael’s Hospital. The parking lot by the Emergency entrance was nearly empty. I limped through the door, negotiated with the parking attendant, and introduced myself to the receptionist who found my name and referral on her laptop. She looked at my cloth face mask and ordered me to replace it, handing me a fresh disposable surgical mask from the box on her desk next to a sign that said, “Masks Must Be Worn!” The waiting area was nearly empty at three o’clock on this sunny afternoon, and I took a corner seat away from the other two people in the room. I reached over and dragged a nearby chair to prop up my leg and started to breathe more easily as the pain faded away. I took out my cell phone and called Catherine to tell her what was happening.

“At least we know what it is,” she told me. 

The waiting room was quiet, no background music, no chatter from the front desk. I opened my backpack and took out an article to read, something that I printed out a few days ago from the New York Times. Two pages later, a young woman appeared at the sliding door across the room and called out my name. I waved to her, and she watched me gather my backpack, jacket, and walking stick. My walking stick, ideally suited for climbing mountains, was of little help in the hospital. Whenever I braced myself, the stick would give way as the metal tip slipped on the hard ceramic tiles.

The woman’s name was Hannah, a physician assistant, and she worked with a Dr. B, a bubbly, optimistic doctor who was the attendant physician, the gatekeeper to the inner sanctum. He directed me to a chair, felt the swelling in my left calf, and with an air of solemn certitude, declared that I had a blood clot, but quickly added that the collective medical community that he referred to as “they” would have me better in no time. Dr. B wore a layer of masks and round aviator-style glasses that had little side shields. He asked me a few questions. Had I been on long plane flights? Any recent surgeries? Do I smoke? None of the above, I answered, then added that ten days earlier, I had received the first dose of the Pfizer vaccine.

In contrast to Dr. B’s gregarious manner, Hannah hardly said a word as she took my vitals. Unbeknownst to me, my chair was rigged with sensors that determined my weight, and I was taken aback when I spotted the reading on the monitor a few feet in front of me. Though I was not self-conscious about my size, I felt slightly uneasy, as if my privacy had been invaded. I was quickly given a final blessing from Dr. B as he led me to the next room where a technician by the name of Brian hooked me up to an EKG machine that produced a fully digital chart of the electrical signals coming off my heart and samples of my blood were extracted using hollow needles. Brian wished me a good day and sent me back to the waiting room, where my seat was exactly the way I had left it thirty minutes earlier. The two people waiting there before me had not moved and they hardly glanced up as I walked by.

Around four o’clock, my life became a lot more interesting. I was readmitted into the inner sanctum through a double door that opened to a wide corridor where numerous beds were parallel parked along the wall. I was assigned to an empty bed next to the nurse’s station. Various professionals passed by me: nurses, technicians, the occasional doctor, all wearing laminated identification tags. Armed guards were making their rounds, moving slowly up and down the hallways, greeting everyone with a smile and a nod.

Suddenly, out of nowhere, Sam appeared, as in Samantha, a young energetic mid-twenties type whose job was to push wheeled beds around the building, taking patients to their various destinations. Sam was skilled, she knew no speed limits as we whizzed down the halls, through a set of automated double doors, and then into a darkened room that had the solemnity of a small chapel that you might find in a convent school. Sam disappeared and left me in the dark, but not for long, because Nicole appeared through the door on the opposite side of the room, back lit by the hall lights such as to evoke a scene from a Gothic novel. She introduced herself and instructed me to undress in preparation for the ultrasound, all while positioning a massive machine next to my bed. She asked me if I was cold and would I like a warm blanket. I thought about what my wife would say: “Never refuse a warm blanket!” 

Nicole was the sonographer on duty, and we chatted a bit while she went through a procedure similar to what Dr. F had done a few hours earlier, except the probe that she used looked a lot more sophisticated. Her machine had a full-size screen and there was a sound system that allowed me to hear the Doppler effect as my blood pulsed in my veins, an eerie sound that transformed the religious ambiance of the room into that of a modern, sci-fi movie. Unlike Dr. F, Nicole did not offer to let me see the images, and I decided it was best not to bother her too much, after all, she had provided me with a rather comforting, warm blanket. When finished, she told me to get dressed and reminded me to gather all my belongings. Then, swift like a fleeting apparition, she vanished from the room.

I was wheeled back to the waiting area where a young male nurse, David, came over and introduced himself and asked me questions about my symptoms. I was given a standard issue gown and told that I could change in the restroom around the corner. I looked at the precarious twenty feet between my bed and the door and wondered if I would be able to negotiate the distance without falling. 

It was now five o’clock and the ward seemed busier as more people were brought in. I wondered if there was something special about Friday evenings, the end of the workweek when people were more tired and their nerves frayed, whether this time was more prone to mishaps, accidents, or injuries. In the bed parked right behind me a woman was moaning in obvious pain, pleading for someone to help her, lamenting that she was dying. She went on for a while, then went silent because no one paid her any attention. I took a quick look in her direction as I rose from my bed. She was hooked up to a patient monitor that tracked her vitals such as heart rate, blood pressure, and so on. I imagine that these modern machines were WiFi-enabled and networked to a central dashboard such that somewhere, unknown to her, someone was looking after her.

I made it to the restroom and slowly changed into the gown, my muscles searing every time I flexed my leg. I was told that I could keep my undergarments on, which was just as well because the gown opened in the back, and it would have been hard to maintain any sense of decency otherwise. I was now back in my bed, waiting, and I was glad to have the warm blanket that Nicole had given me. Someone named Taje, a polite, well-spoken man, came over and introduced himself, then took a scan of my insurance card and other personal details. He represented the business side of the hospital.

A young Black man had appeared sitting in a wheelchair across the hall from me. He presented a comical figure because he was thin yet he was sitting in an extra-wide wheelchair, a type designed for very obese people. The young man took up, at best, one-third of the width of the chair. His hair was braided, his attire nondescript except for his Nike sports shoes, whose polished white canvas uppers popped in sharp contrast to the dark grays of his street clothes. He appeared a bit bored if anything, but he was also alert and spent most of his time looking at his phone, checking messages. A few minutes later, two police officers came to talk to him.

Because there was little privacy in my hallway, I overheard that this young man was driving in the Westville area of New Haven, somewhere along Ella Grasso Boulevard, when he was sideswiped by a vehicle that had suddenly turned right on red. The passengers in his car fled from the scene, cutting through someone’s backyard where they jettisoned a stash of street drugs, all in view of various witnesses. The police, quick to the scene, had taken statements and recovered the drugs. The young man stated that he knew nothing about the drugs and would not say who the passengers were. The officers rephrased their questions several times, but he remained silent having no intention of grassing on anyone. There was something not quite right with his license and he was given two months to sort it out. The two officers looked at each other and then left. I guessed that the young man may have hit his head during the accident and had been brought in as a precaution.

Vinney, a physician assistant, came over to see me, asking me a few questions to confirm my details. A radiologist was reviewing my scans and I would be given some results at some point. I tried to read but I was too easily distracted by all the people teeming around me. Instead, I took out my notebook and tried to capture snippets of the movements and conversations playing out before me. I called Catherine and got her voicemail. Later, she told me that she was talking to Gerard, one of her brothers over in Ireland, telling him about my situation.

I was losing track of time. Vinney came back to say that I would be prescribed a blood thinner. The good news was that I would not be kept overnight, and I would be sent home later after meeting the radiologist. When I looked up, the young Black man was gone, he had been discharged a few minutes earlier.

A man named Eugene had appeared, sitting in a straight chair in the spot previously occupied by the extra-wide wheelchair. Various people came to see Eugene, and each in turn, took down his personal information and the details of how and why he came to Emergency. All of this took place within earshot, so by the time the third interview finished, I had learned that he was born in 1953 and that both his mother and uncle were still alive. Eugene had some form of cancer and had been on his way to his chemotherapy session when he slipped and fell in his apartment building, injuring his left wrist. He raised his arm to show the bruised hand with abrasions partly covered by a hastily applied bandage. I think one of his neighbors drove him to the hospital. Eugene sat and waited, staring out vacantly across the hallway. After a few minutes, he made eye contact with me and asked me how long I had been waiting. I tried to offer a brief explanation but even that took too much effort, and so we both withdrew back into ourselves. This was neither the place nor the time for light conversation.

Dr. B came over to see Eugene and examined the injured wrist. He spoke to him with a calm, reassuring voice that suggested an underlying gentle and compassionate nature. A medic came over a few minutes later and rebandaged Eugene’s wrist and then gave him a tetanus shot as a precaution. An ambulance had been called and would be here soon to take him back home.

It was nearly seven o’clock and things were quieting down at the corner of A9 and A16 (all the corridors in the hospital were labeled, and like a small city, divided into smaller neighborhoods that had names like “Ambulatory Building 1082”). I wondered about that descriptor, “ambulatory,” and I imagined a building with insect-like legs crawling through the neighborhoods of New Haven. The digital readout on the wall read 6:50. A physician assistant named Lionel introduced himself as covering for Dr. B, and after scanning the barcode on my wrist band to verify who I was, handed me two pills and a plastic container of ice water. Lionel explained that I was being given the first dose of a blood thinner, then added that a prescription had been called in to my preferred CVS pharmacy on Dixwell Avenue. I was to take the blood thinner twice a day starting the following morning. At this point, I just wanted to get home. It had been a long afternoon. Lionel told me that my discharge papers were being processed, and before I could say anything, he had rounded the corner and disappeared. 

As I waited, a young, thin-waisted Black woman emerged from room A16 saying thank you to someone left behind in the room. She talked on her smartphone as she exited the door marked “Exit Only: No Re-admittance.” A text message appeared on my flip phone. It was CVS pharmacy notifying me that my prescription was now ready for pick-up. I called Catherine, to tell her that I would be home soon, and asked if she would mind picking up my meds. She said she would do it right away.

Someone came over with my paperwork, repeated the instructions about the blood thinner, how many pills to take, and when to take them. I was free to go, but first, I braced myself and hobbled to the bathroom to re-dress myself. I had been told to get into a gown so that the doctor could examine me, but the doctor never came to visit, and for a lonely moment, I felt a mixed sense of disappointment and abandonment that reminded me of the feeling that you get when a friend promises to meet you for coffee then finds himself too busy to show up.

I passed through the door marked “Exit Only” and found myself back by the main lobby where I had come in about five hours earlier, when the sun was brilliant and the day looked cheerful. Even though the reception area was aglow from the numerous arrays of LED spotlights sprouting from the ceiling, the interior space felt somber, overwhelmed by the deepening gloom of the night, as if the exterior blackness was spilling through the glass walls and invading the space that was meant to be a safe haven for those individuals who were brought here either by mishap or accident, two of whom sat in the far corners of the room before me, keeping a silent vigil with their smartphones.

There was a final ordeal waiting for me, the parking attendant. I gave him my parking ticket which he took and looked over, slowly, as if he did not recognize it. Within seconds my left leg started to throb. I began panicking since there was no nearby chair on which I could sit down and lift my leg. The attendant had resorted to using an iPad to figure out the fee according to some elaborate scheme that a third-party company, to whom the hospital had outsourced the management of their parking lots, had determined was appropriate. 

I looked over his shoulder saying to myself, “Come on! This is not rocket science, hit the green button!” My leg was screaming and I was tired and irritable. Finally, by a small act of grace from above, the attendant announced,”Two dollars,” and by pure chance, I happened to have two single dollar bills in my pocket. I said thank you and did not ask for a receipt, but I did curse the MBA who decided that this small parking lot should be turned into an income stream.

The parking lot was nearly empty except for two or three other cars, and I was reassured to see my car waiting for me in the far corner, just as I had left it earlier in the day. As I looked around I realized that I was alone and I grasped how lonely one could feel when they are in pain and there is no one around to help. It should have taken me less than a minute to cross those twenty wards, but I could hardly bend my leg, and instead of sporting my usual confident stride, I felt like an invalid, wobbling with an awkward gait, deliberately slow lest I should slip and fall. 

I stowed my backpack and walking stick in the trunk, and gripping the door to support myself, lowered my body into the driver’s seat, relieved to be sitting again. Since car seats are lower than regular sitting chairs, there was almost no pressure on my left hamstring, so for the moment I was comfortable, the pain in my leg ebbing away. After a few deep breaths, I called Catherine to let her know that I was fit to drive myself home. She told me that my prescription was on the kitchen table and let me know a bowl of soup would be awaiting me. Her voice was echoing in our kitchen, emptier because of my absence. She told me that she loved me, soothing words after all I had been through. I replied, “Yes, I love you too.”


Marc Audet lives near New Haven, Connecticut, where he is self-employed as a web application developer. Marc enjoys reading literature and history. He has traveled and lived in Canada, England, and Ireland. Over the years, he has kept journals and written personal essays about his travels. Recently, he has started to write short stories, creative nonfiction, and poetry. His work has appeared in Potato Soup Journal.

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