"A Deep Wound"

A young man walks into the emergency room with a blue washcloth wrapped around his left middle finger. He’s slightly overweight, unshaven, and sullen. It’s almost 11:00pm. The first thing they ask him to do is fill out a form. Luckily, he’s right-handed, and he writes his name, what happened, and a couple of other pieces of information on the strip of photocopied paper and hands it to one of the two women manning the desk. They were talking when he walked up, and it took them a few seconds to recognize he wanted anything.

He’s instructed to sit in a chair at the far end of the kiosk with a small, low table built in. He has no insurance, and he’s unemployed. “I just want someone to look at it and tell me if I need stitches,” he says. “I hope the answer’s no.” A man with a vaguely Asian-looking face-perhaps he’s Latino?-sits down across from him to have a look. As soon as he removes the washcloth, the young man knows he’s made a mistake in coming here. A single drop of blood oozes slowly out, where only ten minutes before it had run in a steady drip, too much to get a band-aid applied over the sink, where it had splattered and pooled as the cat watched. Now it has almost stopped.

With white rubber gloves on his hands, the technician squeezes the area around the slice, and the blood begins to flow a little more freely as he smears it across the finger. The cut is about a centimeter long. “The doctor might use one or two,” he says, explaining that the palm side of the hand is full of little veins or arteries-he says one, then corrects himself with the other, leaving the young man confused as to which it is-and one may have been hit.

A nurse walks up as they talk and fastens a plastic bracelet around his right hand. He explains that he was standing over the sink and dropped a glass mug, which shattered as he grabbed for it, slicing his finger. It was over in a split second, and all he could think was, “Please don’t let me have to go to the hospital for this.” And here he is.

A nurse leaving her shift leads him through a maze of doors and halls to a room, washcloth reapplied. Another nurse or technician, a quiet black woman wearing glasses, wheels a computer terminal contraption over to him to get his information. She has trouble with the name of his mother’s town, who he’s listing as an emergency contact. He doesn’t have the patience for her, as all he can think is “This is going to cost me so much money.”

The doctor comes in a few minutes later, young and smiling. He looks Indian, but is obviously American by his accent. He asks “When was your last tetanus shot?” but the young man doesn’t remember. The doctor looks at the finger and wavers over whether or not stitches are necessary. The young man says he'd like to avoid it if possible, and explains his situation. The doctor says he could use “steri-strips”, but he’s hesitant because of the location of the cut. Without stitches, it could be torn open easier. He decides if the wound does come open, the young man can always come back in to get stitches later. The doctor mentions that in cases like these, he usually takes x-rays to see if there’s any glass under the skin, but since the young man doesn’t feel any he lets it slide. But he still orders the tetanus shot, and after reading the laminated card explaining the symptoms of that disease, the young man doesn’t blame him.

Once he’s taken care of, he waits for his paperwork. Ten minutes pass, then twenty. He realizes this hospital has no smell, and wonders how they managed that. All the nurse did was put on the equivalent of a band-aid. They gave him the gauze and left over “steri-strips” as well, since “you’re paying for them.” At the dismissal desk, an overweight woman with long, dark, brown hair and a wide-eyed look calls for the estimate since they sent him on his way without the “blue sheet”. If it’s a level one, the hospital will be charging him around $200.00 including the tetanus shot. If it’s a level two, it will be more, she says.

The call comes in that it’s a level two, with a category one. If he pays it all now, he gets 20% off. Otherwise, he can pay the full amount over time. Even though he doesn’t have the money, he makes a quick calculation and decides to pay the discounted rate up front with his credit card, since the interest on what he can’t pay should not be more than 20% of the total. The hospital is charging him just under $400.00 for a shot and a band-aid. The doctor’s bill will come later. “He didn’t do anything,” he tells the dark-haired woman. “He’ll bill you anyway,” she replies. “If this is a level two, what’s a level one?” he wonders aloud. “When they look at it and tell you to go home.” Madness.

As he tries to make his way back to his car through the long halls and double doors, he remembers the voice of the Boy Scout in the back of his head as he watched his blood run down the drain. “Apply pressure,” it said, and he did. They’ve sent him to the wrong parking garage, so he has to walk to the street and around the building. It’s now 1:00am, and he remembers his father’s thoughts on the state of health care today. “They used to overcharge people with insurance to subsidize the ones without it. Now they overcharge the ones without it to subsidize the insurance companies, who simply refuse to pay half of what they’re billed.” As he drives home, he knows one thing for certain. The pressure’s on.