The human face of healthcare debates

A documentary chronicles "24 hours. 241 patients. 1 stretched ER"

A middle-aged man who lays carpet can’t sleep at night from bone-spur pain. He can’t afford insurance; he’s an independent contractor, even though he really works for Sherwin Williams, and his boss talked him into a wage reduction by pointing out an alleged abundance of illegal immigrants willing to work for less money. Muscle relaxers help, but they wear off by 3am. He can’t take more or he’ll sleep through work. He might be able to get on disability, but you need a doctor’s note, from a regular doctor, not an ER doctor. He doesn’t have a regular doctor, because he doesn’t have insurance. He doesn’t have insurance because he’s an independent contractor, even though he really works for Sherwin Williams….

A young guy has a testicular tumor. It was diagnosed at a private clinic, which rushed his surgical appointment; the tumor can only be diagnosed as cancerous once it’s out, so the young man could be a ticking time bomb. The day before his surgery, the private clinic found out he wasn’t a member and cancelled his surgery. They made no referrals or suggestions, so the man and his partner went to the county hospital. Nurses and doctors, over many, many hours, wonder that he got into a doctor’s office without being a member, but couldn’t get into an operating room.

A family prays together in the waiting room. Later, a woman approaches a hospital staffer and tells her, “Where he got shot is starting to burn now.” She warns the nurse, “The numbness is moving.” The staffer tells her, “When a nurse is free, I’m gonna let them know. But we got so many all the same acuity…” Later, the man fills the frame alone. “Am I waiting for a bed or something?” he asks of no one. “That bullet gotta be movin. Gots to be.” There’s a pickled resignation on his face. “Oooh, Lord help us. God, take this anger away from me, please.” Later, the same woman advocates for him again. “On them instruction papers, it states if you’re going numb, go right back to emergency. We’re here, and nobody is doing anything.” A secretary replies, “Being that this an emergency department, we don’t take people based on when they arrive…. People with more emergent or urgent situations go back first. There’s been people out here waiting a really long time.”

These and other stories loop in and out of each other in The Waiting Room, a 72-minute documentary from Emmy Award-winning director Pete Nicks that premiers Monday night, on PBS’ Independent Lens, at 10pm. And it’s a whollop.

Nicks and his crew spent 24 hours in Highland Hospital, a public hospital in Oakland, CA, with a waiting room of patients who’d come to the ER because they’re uninsured. And wait they do. There’s a man, one health worker tells another, who came to the ER just to get some Tylenol. “Acetaminophen, 500 milligrams,” she says. “He’s been here seven hours.”

It’s not just the Beckettian absurdity of this sitting around and hoping for help that the film captures. There’s also frustration, usually gentle, but sometimes angry. Couples trade stories about getting shuffled from one health facility to another, getting passed around on the telephone, hoping for procedures everyone agrees are urgent. A man on dialysis decides he’s had enough. He curses like a sailor, then demands of the doctor, “Tell them to take this goddamn catheter out of my chest and I’ll just make it on my own.”

“Um, if we take that out, uh, you would eventually die,” the doctor says.

“Well so fucking what?” he says. “We’re all gonna die—you, too.”

Most Americans can identify with healthcare system frustrations, even those with insurance. But for those without it, the ER is the often first—and last—resort. Forty-eight million Americans, about 15 percent of the country’s population, are uninsured, according to the Census Bureau’s latest count, released last month. A RAND study from last year found that more than a quarter of medical visits made for new health problems, known as “acute care” visits, are made to emergency rooms, and ER doctors, who make up only four percent of America’s doctors, handle more acute cases for the uninsured than all other doctors combined.

To many individuals, then, it’s not news that the ER is the only line of medical defense against everything from asthma and strep throat to testicular cancer or gunshot wounds. But it is, this documentary suggests, inefficient. And exhausting.

But this isn’t a policy-doc. And unlike medical dramas, it’s not all about the doctors, either. Instead, Nicks makes us fall in love with some of his characters by including, in short bursts, charming, human moments—a joking, motherly aide who chastises angry men for cussing too much and brings a sandwich to an old woman clearly having a rough go of her waiting-room stay; a father, whose daughter is getting examined for a tonsil infection, who’s been scared of hospitals ever since his two-year-old son died in one after a seizure; a doctor who, for the first time, has to tell a family that he’s lost their teenage son to a gunshot wound.

At a time when healthcare debates have paralyzed government, Nicks’ documentary clears the political fog and focuses us, if briefly, on the human side of a hot issue.

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Jina Moore was a 2013 New Media Fellow of the International Reporting Project