" Hello, everyone." "You won't hear your names being called." "It's noisy already." "Please talk soft, but keep talking." " All that was here before was her, them." "Not him." "Not them." " Don't even talk to me about that." "No." "There's no way." " There's only two staples on his head." " It's stapled into his head." " Married?" "Single?" " I'm married." " No, not you." "Her." " Married." "Marry, marry." " We need her to talk." "Can she talk?" " Oh, no English speaking." "I'm here to interpret for her." " Oh, man." "I'm trying to get some, uh-- trying to get some help for my knee, man." "But my insurance ran out, so I'm in here today." "But it's a process, though." "You feel me?" " You go to school with him?" " I used to." " Go say hi." " No, because I don't remember his name." "NURSE (OFFSCREEN):" "Sanchez, last call." " No, you can't make an appointment." "This is-- you have to wait for the same day in emergency services." "No appointment." "[speaking spanish]." "FEMALE SPEAKER (OFFSCREEN):" "Going to be up here all day." "FEMALE SPEAKER (OFFSCREEN):" "Don't say that." " I'm just saying." "You have a long wait." "You have to bring your blankets, your dinner, your lunch, and all that." " Everything, honey." "[music playing] [music playing]" "NURSE (OFFSCREEN):" "Hey, guy." "Come on, sit with me." "You want to see the doctor today, huh?" "How long has it been since you've taken diabetes medicine?" "MALE SPEAKER (OFFSCREEN):" "Uh, like two days." "NURSE (OFFSCREEN):" "Two days?" "Why haven't you taken it in two days?" " Because I ain't got none." " Well, why weren't you here before you ran out, sweet pumpkin pie?" "You know you need your medicine to live." "You tripping." " I am tripping." "NURSE (OFFSCREEN):" "You know it." "You got to love yourself better than that, baby." "Come on, now." "We got plenty of medicine here for you." " My dad even got on me this morning when I woke up." "He said, what you doing?" "I say, I'm injured." "I'm going to shower, get dressed, and I'm going to the doctor." "Because these spasms is hitting so hard." "My chest is killing me." "NURSE (OFFSCREEN):" "Yep, the way you walking in here, you know you need to have been here." "There you go, baby." "Now, tell me your last name." " Escoval." " Don't you spell it for me, I can spell." "You know, I get hundreds of names a day, and I take pride in being able to spell every one of them, no matter from what country." "You know I can't spell everything." "I try." "OK, Mr. Escoval." "From what?" " A gunshot wound." "NURSE (OFFSCREEN):" "What was it-- where did it go in?" " It came out." "It went here and came out my mouth." "NURSE (OFFSCREEN):" "Wow." "It missed your carotid artery?" " Yeah, it missed everything." "NURSE (OFFSCREEN):" "Woo." "Do you give testimony to somebody?" " Mm-hmm." "NURSE (OFFSCREEN):" "Mm-hmm." "Yeah, you do." "God had a plan for you." " I haven't had a drink in 10 years." "I've had two sisters and a brother that died." "My dog, I got from a puppy, that was 15 years old died." "My grandmother just died." "My mother got ran over." "Even without that, I've had anxiety." " Hi, baby." " She can't speak." "Her tonsils are too" " Her tonsils are" " Swollen." "Swell all up?" "MALE SPEAKER (OFFSCREEN):" "We don't know what's wrong." "It's some kind of infection because I can smell her breath real bad." " Oh, is it back way back here?" "MALE SPEAKER (OFFSCREEN):" "Mm-hmm." "So do they-- they don't have to do any tonsil work on her, do they?" "NURSE (OFFSCREEN):" "I don't know what they have to do." "You don't even know what's wrong yet." " I know." "I'm so nervous, I don't know what to do." "NURSE (OFFSCREEN):" "Because you're papa, you be nervous." "It's OK." " I'm so nervous." "NURSE (OFFSCREEN):" "That's what daddy's do." "They're nervous because they take care of their loved ones." " I know." "I just wanted her to get seen as soon as possible." "That's why I was concerned." "NURSE (OFFSCREEN):" "They will." "There always is some wait." "MALE SPEAKER NARRATING:" "It's the first time I've gone almost a year without a job." "I'm used to having those benefits, you know?" "That's how important a job is, to be able to have somebody look at her as soon as possible." "And it just seems like-- it just seems like a letdown when you have to just depend on somebody to help you out when you're not having the means to do it yourself the right way." "It's just, OK, I'm glad that there's a way to provide to help out." "But I wish there would have been another way for me to do this." "NURSE (OFFSCREEN):" "The heart rate is really high." "MALE SPEAKER (OFFSCREEN):" "Yeah." "It's pounding, like that." "NURSE (OFFSCREEN):" "Because she's full of fever." "I can feel it." "You got a whole radio station, 103.4." "See, they got a radio station in there, girl." "You are really hot." "MALE SPEAKER (OFFSCREEN): 103?" "That's scary." "NURSE (OFFSCREEN):" "No." "Say, young lady." "She's going to be OK, big papa." "MALE SPEAKER (OFFSCREEN):" "When they say 105, 106, you got to worry, right?" "NURSE (OFFSCREEN):" "How are you going to stand there and talk about it like that, over her little head?" "MALE SPEAKER (OFFSCREEN):" "Oh, OK." "All right." "NURSE (OFFSCREEN):" "You be cool with it." "You supposed to be the, the shield, OK?" " I'm a little nervous." "[chattering]" " Highland Emergency." "This is Veronica." "Because this is an emergency department, doctors can't write prescriptions without actually seeing you as a patient." "I know." "I know, but like I said, our doctors rotate, you know, daily." " All right." "So starting off from the top." "Room 1 is a 35-year-old female." "Came in a long time ago with flu-like symptoms." "2 is going." "Bed 3, 61-year-old female who comes in off her meds for 3 days and chest pains for 3 days intermittently." "Bed 10, room 11, room 15." "22 is signed out to me." "Sore throat that I just need to say hi to." "DOCTOR NARRATING:" "People who got into the ER back when it was first starting chose ER because of the TV show, or the media portrayal of it as an intense, high adrenaline, nonstop action world." "I think yes, the gunshot to the chest where you get to put in chest tubes and do all the critical care stuff that really gets your heart pumping." "But I'll tell you what, refilling someone's diabetes and high blood pressure medicines is also a tremendous opportunity to prevent serious sickness." "And if I refill someone's medicines, he might not come back and sit in the waiting room next month." " So these." "That's empty." "Empty." "Empty." "Empty." "Got something in there." " I came here last week and I was in pain." "They gave me the pain medication, and then they told me I had the osteo-- bone spurs on my spine." "So I'm coming back now." "I've had back pain for years." "And I just lived with it." "I just worked with it, but the last six weeks it started growing." "And I thought it was my kidney, so I googled it and it said to drink cranberry juice." " So" " So I'll probably see a doctor today?" " Oh, you will see a doctor." "They'll help you with some pain management." "MALE SPEAKER NARRATING:" "I did the cranberry thing for about five days, three gallons a day, and it didn't help at all." "So that's the reason why I came in here last week." "And then they did x-rays and they found out that it was bone spurs." "I'm relieved it wasn't my kidney." "But at the same time, the pain isn't going away." "So I said, I'm going to emergency." "I'm ready for surgery or something." " Well, you'll see the doctor." "They'll take you to next phase, I guess." "I don't know." " Because they said they were going to have a doctor see me, but they never called me." " Well, it's just been a week?" "Oh, they won't call you within a week." " Oh, they won't?" " Oh, it may be a month before" " Even though I'm hurting and extreme pain?" " Well, sometimes-- yes." "NURSE (OFFSCREEN):" "Does she have a cough?" " She has a small cough, just very, very little." "NURSE (OFFSCREEN):" "For how long?" "FEMALE SPEAKER (OFFSCREEN):" "She hasn't actually had any cough." "NURSE (OFFSCREEN):" "No cough?" " No." "MALE SPEAKER (OFFSCREEN):" "I guess I did get it wrong." "NURSE (OFFSCREEN):" "Does she take any medications?" " No." " Any medical problems that she has?" " No." "MALE SPEAKER NARRATING:" "Nothing's going right right now." "Nothing at all." "I have visitation with my children." "I was supposed to show up yesterday for them." "I didn't even have money to get out there to come see them." "Then I get out here today and find out now my baby's sick and got all these problems." " You sure on Saturday if you were going swimming you didn't get stung by any bees or anything, right?" "DOCTOR NARRATING:" "You always try to make sure that you, as a parent, let them know about good things that are out there." "Don't pick up everything and dig through everything, because you're the one that looks over them." "You're their protection." " The knot." " This is something-- this is not swallowing." "This is something else." "She's got a fever and her heart race is racing a little bit more." "I'm going to get her back as soon as I can." " And what was the plan after you left?" "What did they tell you to do?" " They told me to follow-up with this hospital." " OK." " They released me without any type of medicine." " OK." " I asked them, could I at least have something until I get some?" " What kind of medicine are you talking about?" " My high blood pressure medicines." "But there's one I get this-- since I don't have insurance, they cannot provide that." "I have to get it on my own outside." " Got it." "Did they tell you whether you had a bleed stroke or a clot stroke?" "MALE SPEAKER (OFFSCREEN):" "A clot" " Clot stroke." "MALE SPEAKER (OFFSCREEN):" "On my brain." " OK." "And then, what problems are you having now?" "You having a hard time moving your hands, your feet?" " I've been falling." "DOCTOR (OFFSCREEN):" "You've been falling?" " Yeah." "I fall about 10 times today." "DOCTOR (OFFSCREEN):" "Oh, boy." " Sometime make me laugh because" "DOCTOR (OFFSCREEN):" "I'm glad you have a sense of humor about it." "Do you have a doctor that you see on a regular basis?" " No." " No." "OK." "What medical problems do you have besides this stroke and the high blood pressure?" "Any other medical problems?" " No." " Nothing?" "OK." "Any surgeries?" " This is my first time being in hospital." " All right." "Well, congratulations." "Everyone gets their first." " Yes." "DOCTOR (OFFSCREEN):" "There's another patient that came in that's pretty sick, but I'm going to come back and talk to you some more, OK?" "FEMALE SPEAKER (OFFSCREEN):" "And what's wrong with you today?" " I have a testicular tumor and I need to have surgery on it as soon as possible." "NURSE (OFFSCREEN):" "Where were you diagnosed?" " Over at Kaiser." "FEMALE SPEAKER (OFFSCREEN):" "Do you have any paperwork from that?" " So they did all the tests." "Do you need to see it now?" "FEMALE SPEAKER (OFFSCREEN):" "I just want to know if they-- did they" " We have an ultrasound, a CT scan, a chest x-ray." "FEMALE SPEAKER (OFFSCREEN):" "You did?" "Excellent." " And all the blood work." "So basically, we went through all the tests and the surgery was supposed to take place today." "And they let us go through all the tests and they canceled the surgery yesterday." "FEMALE SPEAKER (OFFSCREEN):" "At Kaiser?" " Yeah." " We're not members." "FEMALE SPEAKER (OFFSCREEN):" "Oh." "MALE SPEAKER (OFFSCREEN):" "I don't have any coverage and I don't have any insurance right now." "FEMALE SPEAKER (OFFSCREEN):" "So why didn't they tell you that before they scheduled it?" " Well, they were asking us all along whether we're members, but we always said no." "FEMALE SPEAKER (OFFSCREEN):" "So surgery was scheduled today, canceled today." "Then they said, oh, you don't have insurance." "Go to Highland?" " They didn't refer us over here." "FEMALE SPEAKER (OFFSCREEN):" "To reschedule." " But when the surgeon discovered the tumor, he told" "Eric that it's very urgent and that it needs to come out ASAP because we didn't know the nature of it." " Now, are you having a lot of pain with your tumor?" " I'm not having any pain necessarily, in the tumor." "I would try to self-diagnose and think that it was my diet or I'm like, partying a little bit too much." "Or, you know?" "I'm a vegetarian so maybe that has something to do with it." "FEMALE SPEAKER (OFFSCREEN):" "You taking any medicines on a regular basis?" " No." "Finally, I told her about it and she's like, there's no way" "I'm not going to take you to a doctor." "I never had anything happen to me." "It was like my invincible 20s, so this is kind of like a major wake-up call." "MALE SPEAKER NARRATING:" "I've been laying carpet since 1974." "I'm self-employed, but I work for Sherwin Williams." "I was making $3.50 a yard for about 30 years." "It never went up." "And my boss said, well, we have a influx of illegal immigrants down the street and they're able to cut the prices way down and be real competitive." "So guess what?" "We have to cut your wages." "Do you want to work here?" "You got to take the wage cut." "Ever since then, that's when my" "I couldn't afford my mortgage anymore." "I'm one of those people that my house is worth far less than I owe on it." "DOCTOR (OFFSCREEN):" "I need medical records for 15." "He's diagnosed with a stroke and kicked out the door and sent here." "FEMALE SPEAKER (OFFSCREEN):" "OK." "15?" "DOCTOR (OFFSCREEN):" "We need all of his records." "EKGs, CTs, MRis, discharge summary" " EKGs, CTs, MRI and discharge" " Labs." " DC summary." "DOCTOR (OFFSCREEN):" "All labs." " OK." "DOCTOR (OFFSCREEN):" "And ED note." " Mm-hmm." "DOCTOR (OFFSCREEN):" "Thank you." " Mm-hmm." "I mean, if I-- when I got him to walk, I was actually kind of hoping to see that he couldn't walk so that I had a guaranteed admission." "But he can walk, so I can't force that on the medicine team." "Well, the problem is there's no general medicine appointments till next March." "So I can't let this guy slip through the cracks until next March." "I mean, this is obviously a problem in our system, but someone needs to take responsibility for him." "He had a stroke a couple days ago and he's 44." "He's got the rest of his life." "So, um, any suggestions?" "You know the internal medicine side of the world better than" "I do, as far as employments and stuff." "There's anything you can think of?" "Would you be willing to take him?" "That's fine." "That's-- that's fine." "Oh my god, you're the best." "Unfortunately, we see a lot of patients coming in with very treatable conditions who don't have access to a regular doctor." "I know that I can make someone better in the short term, but the ER is not the place to manage someone's overall health." "It's going to require a heck of a lot more follow-up that I can't provide." "So no medical appointments for the next couple months." "So I just played, basically a guilt trip on the neurology team saying, someone has to take care and him." "So she's going to take him in her private clinic in a month." "That's the best we can do." "We have to take what we can get." "FEMALE SPEAKER (OFFSCREEN):" "But you guys are not Kaiser patients?" " No." "It just seemed like a cheap doctor appointment option." "MALE SPEAKER NARRATING:" "All I was looking for was just to have a basic checkup as to why I'm having these symptoms." "We got rejected after many calls to many doctors." "And finally, called the HMO and they were going to see us even though we didn't have insurance and were paying by credit card." " Because we didn't know what was wrong with him." "MALE SPEAKER NARRATING:" "So going into the first visit, we just wanted to have the doctor tell me, well, maybe you need to take antibiotics or something." "It didn't occur to us it was an emergency." " I was hoping we see a urologist today." " That's what we're hoping, too." "That we can probably get the procedure done today." "Because he's been in a lot of pain." "And he can't really do much." " We were just on the phone, and then they just kind of defer, you know?" "They'll like, well, talk to this person, talk to that person." "Yeah, that's why I told them, like I was tired of being passed around." "You know?" "They said it should be expedited, but nobody called." " From here?" " Yeah." "So that just kid of put things in perspective, like maybe how long you guys could be waiting." "I mean, even with our referral, we've been waiting for like three days, four days." " Can you meet me on Broadway in about an hour?" "Work with me, OK?" "Meet me downtown in an hour." "I'll call you right when I'm leaving." " He's just here to get some Tylenol." "I told him, go to Walgreens." "It's acetaminophen, 500 milligram." " Is that all he" " That's all he came for." "I said, you've been waiting here for seven hours to get Tylenol?" "FEMALE SPEAKER (OFFSCREEN):" "You here to see a doctor today?" " Yeah." "She has a back problem." "It's a lower" "FEMALE SPEAKER (OFFSCREEN):" "Back?" " Yeah." "FEMALE SPEAKER (OFFSCREEN):" "She been to Highland before?" "FEMALE SPEAKER (OFFSCREEN):" "Yes." " She got any ID?" " So could you meet me or you don't want to sell none?" "Because I got a gang of Vicodins I don't even use." "I got bus tickets." "I have a $10 card for Safeway to buy food if you want that for like three packs." "FEMALE SPEAKER (OFFSCREEN):" "Can you tell he's in pain?" "Yeah." "I told you I'm not bullshitting." "It's like every single time I get a little bit of sleep, mom and day say that, oh, he don't feel good." "And then, we just run back to the emergency room." " OK, go ahead and have a seat." "She'll call you through triage." " OK." "FEMALE SPEAKER (OFFSCREEN):" "Hi." "Do you want to be seen today?" "Do you have your ID?" " No, because I've never been here before." " OK." "But do you have ID?" " Oh, yeah." " Photo ID." " Yeah." " Just ID." " I'm sorry, I thought" " Yeah." " That's what I'm trying to use to get a Highland card." "I was just laid off my job in March, so all I have is unemployment." " That's fine." " So I don't have a job." " I just need an ID." "You'll discuss that with financial after the visit." " What I mean is just-- that's why." "Other than that, I would have went to Alameda Hospital." "OK, this picture's horrible, but here it is." " Good morning." " Good morning, all." " Good morning." " You OK?" "You got to tell me if you feel weak in your legs, baby." "Don't drop on me." "You got to let me know, OK?" "What's wrong, baby?" "It's OK." "She's just scared when she gets to the doctor's." "It's OK." "They're going to make you feel better, babe." "It's OK." "I know, come on." "Come on." "It's OK." "You got to be seen." "Remember what I told you with the IV?" "You heard that word IV?" "Remember, it's the needle?" "I don't know where they put it for kids, but with the IV they would put mine right here." "Listen to me, everything that they're doing is because they're trying to get you to be better." "So they're not doing it-- they're not just going to start poking and prying and doing all this other stuff." "They're only doing it because they have to put fluids in your body." "They don't want you to get dehydrated." "So you're going to be OK." "Remember, you is a big girl." "You got your ears pierced." "You can take a little shot, just a little pinch." "That's all it's going to feel, just a little pinch." "NURSE (OFFSCREEN):" "Your job is to hold perfectly still while" "I put this in." "FEMALE SPEAKER (OFFSCREEN):" "You cannot move, OK?" "Because you don't want her to have to do it over, OK?" "It's OK, baby." "It's OK." "NURSE (OFFSCREEN):" "You want to hold your mom's hand again?" "FEMALE SPEAKER (OFFSCREEN):" "Here, hold my hand." "It's OK." "NURSE (OFFSCREEN):" "This is just a little poke." "I won't go until you're ready, OK, Deja." "I won't go until you're ready." "FEMALE SPEAKER (OFFSCREEN):" "It's OK, calm down." "NURSE (OFFSCREEN):" "You did so good with the first one." "FEMALE SPEAKER (OFFSCREEN):" "You did." "NURSE (OFFSCREEN):" "You want to watch or do you want to" "FEMALE SPEAKER (OFFSCREEN):" "You want to watch?" "OK, well don't panic, OK?" "You can't move your hands." "So remember, when you feel a pinch, you pinch me, OK?" "OK." "NURSE (OFFSCREEN):" "Are you ready?" "FEMALE SPEAKER (OFFSCREEN):" "OK." "Big girl." "NURSE (OFFSCREEN):" "OK." "Little poke." "Little poke." "FEMALE SPEAKER (OFFSCREEN):" "Pinch me." "Pinch me." "Squeeze me." "Squeeze me." "Squeeze me." "NURSE (OFFSCREEN):" "Hard part's over." "FEMALE SPEAKER (OFFSCREEN):" "Squeeze me." "NURSE (OFFSCREEN):" "Hard part's over." "See how little that is?" "OK." "You're doing so good." "FEMALE SPEAKER (OFFSCREEN):" "What's wrong right now?" "NURSE (OFFSCREEN):" "Does it hurt to-- do you have trouble breathing right now?" "FEMALE SPEAKER (OFFSCREEN):" "What's wrong?" "Why you breathing like that?" "NURSE (OFFSCREEN):" "Why you breathing like that?" "FEMALE SPEAKER (OFFSCREEN):" "Deja, answer me." "Why you breathing like that, baby?" " Trying to take the pain." "FEMALE SPEAKER (OFFSCREEN):" "You trying to take the pain?" "Oh, OK." "God the Father, in the name of Jesus, we ask you to take his pain away." "This illness needs to go right now in the name of Jesus." "That this wound will line up and it will be healed and cleaned in the name of Jesus." "And it will operate and do what you cause this body to do." "And everything that you-- and the body the way you want it to work, Father." "In the name of Jesus, this pain is going to go." "It's going to cease and desist in the name of Jesus." "Father, we love you and we worship you." "We just call it done right now." " What's going on?" " Where he was shot at is starting to burn now." "And it's getting" " What's his last name?" "I didn't get" " Jackson." "A chance to look when you came over." " Last name Jackson." "He said the numbness is moving." " What I'm going to do is when one of the nurses are free," "I'm going to let them know." "But it just ain't no guarantee." "We got so many on the same acuity." "We go by-- that means the same level of-- their" "FEMALE SPEAKER (OFFSCREEN):" "Somebody just came in here throwing up." " But see, you don't know, you don't know the whole story." " I don't know." "I don't." "NURSE (OFFSCREEN):" "So we got them all-- they've been triaged." "They all the same level." "So I'm going to tell him that he's getting worse, he's feeling worse." "And then, that'll go from there." " I don't know the whole story, but I do know he got a bullet in him that they left in him two days ago when he was shot." "And he don't feel good and he numb." "NURSE (OFFSCREEN):" "Like I said, I'm going to pass the word along to one of the two nurses here and they can take a look and see what they can do." "There's just no place to put everybody." "There just not." "FEMALE SPEAKER (OFFSCREEN):" "Bad." " I know, but there just no place." "DOCTOR (OFFSCREEN):" "How we on beds?" " We've been getting some floors and floors with [inaudible]." "We're going to get one ICU." "So I was thinking of sending patient in 7 because they seem to be more viable than 8." "I don't know-- and we don't have orders for 8." "This patient has orders and would be ready to go as soon as we got a bed." "This person may have orders by the time we get a bed, and I'm not sure if they could take this patient because they may not have the staff." "That's how it's been." " All right." " And we've also-- we've had trouble getting the beds, plus getting the orders." "And you know, the house is full." "So we're going to put some people on hall 1 as well, and get them in, examined, and hopefully discharged." "OK?" "DOCTOR (OFFSCREEN):" "All right." "FEMALE SPEAKER (OFFSCREEN):" "So that's that." "DOCTOR (OFFSCREEN):" "We'll do what we can." " They got to wait for a bed or something?" "Or" "what, what, what's the hold up?" "They can take me back there, clean this shit out, see what the hell the problem is." "You know what I'm saying?" "X-ray it or something." "And do what they go to do." "The bullet got to be moving." "Gots to be." "Go ahead, miss." "God, take this anger away from me, please." "MALE SPEAKER (OFFSCREEN):" "32-year-old male, gunshot wound to the lower left [inaudible]." "Blood pressure of 170 over" " When's your birthday?" " OK, we got 16 gauge right arm, 16 gauge left mac." " We have three level one's that just came in with gunshot wounds to the chest and abdomen." "MALE SPEAKER (OFFSCREEN):" "Where's radiology?" "Missile wound to the mid-thoracic spine." " That's a problem." " OK, 124 over 63 is the new pressure." "FEMALE SPEAKER (OFFSCREEN):" "It looks like the bullet went paraspinous muscles and up sitting right next to his liver." "I think he might have a diaphragm injury." "The next guy, he's got a hemopneumo and he's getting a chest tube placed right now." "We're going to auto-transfuse him as well." "The third one is the one that I'm most concerned about and will probably have to go to the OR first." "[TRAUMA ROOM MEDICAL CHATTERING]" "DOCTOR NARRATING:" "When we get the ring down from the paramedics that a trauma's on the way, literally 12 to 15 people stop whatever they're doing to focus on this one trauma." "If several traumas roll in at the same time, that is a huge impact on the rest of the waiting room." "People with legitimately serious illnesses get bumped over and over and over again for the trauma service." "FEMALE SPEAKER (OFFSCREEN):" "OK, can we get a chest tube?" "FEMALE SPEAKER (OFFSCREEN):" "Did we finish?" "So Rachel's going to put in a chest tube." "[TRAUMA ROOM MEDICAL CHATTERING]" "FEMALE SPEAKER (OFFSCREEN):" "Make sure we're getting our labs when we do this." "FEMALE SPEAKER (OFFSCREEN):" "Is someone getting labs?" "MALE SPEAKER (OFFSCREEN):" "Are you almost there?" "We're almost there, OK?" "FEMALE SPEAKER (OFFSCREEN):" "Rate, 120." " They're almost, OK?" "FEMALE SPEAKER (OFFSCREEN):" "167 over 87." "MALE SPEAKER (OFFSCREEN):" "We're getting there." "You're doing great." "MALE SPEAKER (OFFSCREEN):" "You're doing good, buddy." "You really are." " I don't know if they called my name or not." "I went downstairs to the cafeteria." "MALE SPEAKER (OFFSCREEN):" "That's why you got your food?" "FEMALE SPEAKER (OFFSCREEN):" "Huh?" "MALE SPEAKER (OFFSCREEN):" "That's why you got your food?" "FEMALE SPEAKER (OFFSCREEN):" "Yeah, from the cafeteria." " I got into a car accident a few months ago and the trauma team, like they're-- they're really good." "I had a plate in my arm and in my leg." " What?" " My far flew down the street." "It was a head-on collision." "Flew down the street, they were wrapped around a pole." " You truly blessed, girl." " Yeah, I am." "Thank god to them, though." "They put me back together." "MALE SPEAKER (OFFSCREEN):" "He's bailed out the brokerage companies." "He's bailed out the realty companies." "They should-- the ones that should have gone bankrupt and gone out f business should have been allowed to do so." "Small business-- [phone ringing]" " Hello?" "No, I went to a school." "Yeah, I'm at the doctor's." "All right." " Ahinde Jose?" "Hose?" "That ain't nice." "You know I do my best." "Ahinde?" " When I was about seven years old, I got like 80 mosquito bites on my body." "And I'd just eaten a lot of watermelon." "From that-- and I got really sick, you know?" "From that point on, I couldn't eat anymore watermelon." "And it's good." "I like cantaloupe, you know?" "I like papaya." "But watermelon?" "Nope." " I'm saying, look." "That's a week." "That's a week old." "It was open heart surgery, 10-hour emergency surgery." "That's God." "God is good." "MALE SPEAKER (OFFSCREEN):" "Amen." " All the time." "You get your hip surgery, man." "Take care of yourself." "MALE SPEAKER (OFFSCREEN):" "I'm trying." " Always." "God bless you." " Amen." "FEMALE SPEAKER (OFFSCREEN):" "What was the diagnosis they discharged him with?" " He was just shot, that's all they said." "But he's going numb now." "So on them papers, on the instruction papers, it states if you're going numb, fatigue, or any of it-- they're in my car-- to come right back to emergency." "We're here and nobody is doing anything." "FEMALE SPEAKER (OFFSCREEN):" "Being that it's an emergency department, we don't take people in based on when they arrive." "Just because you get here first doesn't mean that you go back first." "People with more emergent or urgent situations go back to an emergency department first." "There's people that have been out here waiting for a really long time." "The emergency department is completely full." "The beds in the department in the hospital are full, so nobody moves." "So unfortunately, it's not just you guys." "There's people come in from the ambulance as well." "FEMALE SPEAKER (OFFSCREEN):" "He said he had a couple of beers last night and some marijuana." " Where did you find him exactly?" "FEMALE SPEAKER (OFFSCREEN):" "At 6th and [inaudible]." " In a house?" "FEMALE SPEAKER (OFFSCREEN):" "Corner." " No, on the street." "FEMALE SPEAKER (OFFSCREEN):" "On the side of the road." " Got it." "OK." "FEMALE SPEAKER (OFFSCREEN):" "Passerby called 911." "DOCTOR NARRATING:" "We have patients that we see on a very, very regular basis." "After a certain point, we know them." "We know them by first name." "They know us by first name." "Carl, hey." "Open your eyes." "Open your eyes." "MALE SPEAKER (OFFSCREEN): 128." " Look at me." "Look at me." "MALE SPEAKER (OFFSCREEN): 86." " What happened last night?" "Not sure?" "CARL (OFFSCREEN):" "I'm not sure." " OK." "Did you get attacked?" "CARL (OFFSCREEN):" "I don't know." "No, I don't think so." " Does it hurt when I push your head?" "CARL (OFFSCREEN):" "It does a little bit, just a little bit." " Is it like a hangover headache or like something hit you in the head headache?" "CARL (OFFSCREEN):" "It's like a" "MALE SPEAKER (OFFSCREEN):" "Sometimes it's hard to tell." " Fair enough." "CARL (OFFSCREEN):" "It's hard to tell." " OK." "I'm just going to push" "You may know that it's from marijuana and alcohol or other substances, but regardless, anytime someone presents out of it, that's really, really concerning." "No scalp tenderness." "No chest tenderness." "No belly tenderness." "CARL (OFFSCREEN):" "Ow." "DOCTOR (OFFSCREEN):" "Tell me, what hurts?" "You do everything so that you do not miss a serious life-threatening illness or injury." "MALE SPEAKER (OFFSCREEN):" "There we go." "DOCTOR (OFFSCREEN):" "All right, let's do an EKG, chest x-ray," "MAOs, drugs, alcohol level, neutox." "Ooh, CK." "Put a CK in there." " You make the best ponytails, darling." " Yeah." " You giving me a fountain or a bun?" "Yeah, a bun." "Thank you." " Yep." " Down to one." " Well, this is where I come from." "See here, this is me." "I arrived from here all the way here to your home." "Look." "Then I have to catch the J, and then I have to go to the next bus, which is JPX." "And then I stop right here." "Your house is right there on the corner." " The line." " Yeah, this is what happens when you guys get the car." "And I get no car." "Then I catch this one here." "My kids want to do so many things right now." "My son wants to get back in baseball." "Since I've lost my job, I haven't been able to pay for any of the baseball or my daughter's hip-hop dance that she wants to get into." "And it's just a heavy week for me having to tell everybody, well, I won't be doing it this week." "I won't be being able to pay for this, this week." "I won't be able to do this, this week." "It's just hard for me as a dad, just being the guy who provides for everybody and not being able to do it right now." "FEMALE SPEAKER (OFFSCREEN):" "And then yesterday, she woke up and I just seen this being swollen." " You saw visibly that her" "FEMALE SPEAKER (OFFSCREEN):" "Yeah, I could physically see it." "I could touch it." "And I was like, ooh." " OK." "Hey, mama, can you look at me?" "Over here." "How far can you open your mouth?" "Ah." "FEMALE SPEAKER (OFFSCREEN):" "Open as far as you can, Deja." " Ah." "Is that as far as you can go, sweetie?" "We're seeing cautious because she's not able to really open that mouth and ensure that it's not something deeper." "So we're going to get the CAT scan." "If that's negative and she's able to eat and drink, she'll be able to go home." "If she's having problems eating or dehydrated, then we're more cautious and want to keep her." "FEMALE SPEAKER (OFFSCREEN):" "Oh, yeah." "Definitely." "DOCTOR (OFFSCREEN):" "OK?" " You want me to contact someone for you?" " Yeah." " OK." "Who would you like me to contact for you, Mr. Connelly?" " Contact my pastor." "FEMALE SPEAKER (OFFSCREEN):" "What's the pastor's name?" " It's, uh" " Take your time." "CARL (OFFSCREEN):" "Pastor Boswell." "FEMALE SPEAKER (OFFSCREEN):" "And would you like me to tell them that you're at the hospital?" "CARL (OFFSCREEN):" "Yes." "FEMALE SPEAKER (OFFSCREEN):" "OK." "Is there anything else you'd like me to tell them?" " Yeah." "FEMALE SPEAKER (OFFSCREEN):" "Hm?" "CARL (OFFSCREEN):" "Pray for me." "I love them." "FEMALE SPEAKER (OFFSCREEN):" "I didn't understand you." " Tell them to pray for me and I love them." "FEMALE SPEAKER (OFFSCREEN):" "Pray for you, and you love them." "OK." "I will let them know, OK?" "You know what, Mr. Connelly?" "I'm going to go ahead and have them update your information to make sure we list your brother as your next of kin." "Is that OK?" "And the pastor, you want his phone number as a" " Yes." " OK." "Oh, you're getting sad." "You're going to be OK." "The doctors and nurses are going to take real good care of you." "All right." "You going to be OK." "You were just at the hospital last month, huh?" "Yeah." "You're going to be OK." "I'm going to let them know that you want them to pray for you, that you love them, OK?" "You want them to come visit you?" "Yeah." "What was you doing out this morning?" "Hm?" "CARL (OFFSCREEN): [moans]" " Say?" "CARL (OFFSCREEN):" "I wasn't doing right." " You wasn't doing right?" "OK." "Thank you." "I'll talk to you later." "I guess my question is, since he has-- you say he's been gone for three days and this is a-- you said transitional housing program." "Is he able to return there?" "OK." "So just so I can make sure I document appropriately, upon discharge, is he able to return to your facility?" "So is that yes or no?" "[alarm sounding]" "MALE SPEAKER (OFFSCREEN):" "I can't sleep at night." "When I turn it over, it's like a sharp knife." " I understand." "What I'm telling you though, is like I said, there's really not much I can offer you for this." " I lay carpet, you know?" "I have to work." "So what am I supposed to do?" "DOCTOR (OFFSCREEN):" "Well, like you said, I can look to see what was done last time, to see if you were referred to the orthopedic doctors." "Those are the doctors that talk to you about surgery as a potential option." "If surgery turns out not to be a potential option for you, then the only other option is pain medications at this point in time." "Often, for our clinic though, it's several months before you can see a physician." "So it's not an immediate thing." "So you only were here six days ago, essentially." "MALE SPEAKER (OFFSCREEN):" "Yeah." "And the pain's not going away." " Well, like I said, you have chronic bone spurs." "That's not something that's going to go away." "MALE SPEAKER (OFFSCREEN):" "But the pain just is unbearable." "I can't sleep at night." "When I turn to the left, it's just horrible." "And the muscle relaxers help, but they only help till like 3 o'clock in the morning." "DOCTOR (OFFSCREEN):" "They wear off." " And they wear off." "And I don't want to take another one because I won't be able to wake up for work in the morning." "DOCTOR (OFFSCREEN):" "Got it." "OK." "MALE SPEAKER (OFFSCREEN):" "So that's why I didn't want to take anymore." "Can I get disability for this?" " That you have to talk to your regular doctor about." "MALE SPEAKER (OFFSCREEN):" "I don't have a regular doctor." " I can get you a list of physicians in the area that can talk to you about that." "MALE SPEAKER (OFFSCREEN):" "Because they were supposed to-- they were supposed to set me up with the doctor here." " OK." "MALE SPEAKER (OFFSCREEN):" "They never called me." "And that's why I came back, too." " OK." "All right." "I mean, that often doesn't happen quite that way." "Usually we end up" "MALE SPEAKER NARRATING:" "I'm down to zero right now in my checking account." "I got about $80 in my pocket." "And my daughter moved in with me two months ago." "She's going to go through a divorce." "She's got a year and a half child." "So that's another two months to feed in the home, and I don't know what else to do, really." "I bought a few lotto tickets is what I did." "Other than that, I don't know what I'm going to do." "I'm going to keep working laying carpet, is what I'm going to keep doing." "I'm going to keep taking the pain pills is what I'm going to keep doing." "Thank you." " So the doctor has written for you for some Vicodin." " OK." "DOCTOR (OFFSCREEN):" "OK, thank you very much." "MALE SPEAKER (OFFSCREEN):" "Thank you." " Good luck now." " I need it." " All right." "Thank you." " If there is such a thing as luck" " Well, the issue is you also know that he needs a treatment program." "And so as you shared, he's been through a host of programs throughout Oakland." "And you also know what the demon of substance abuse is." "So he was tearful." "He was tearful when I spoke to him." "And-- well, I would hate" "I hate to think that you think that way." "But everyone's experience is different." "And you know that as a pastor and you know that as a program administrator." "It sounds like you are frustrated with his cycle of leaving and going out to use and coming back and things." "Mm-hmm." "Right." "And so as a social worker, part of our role would be to discharge plan." "So I just need to know, is your facility still a discharge plan where he can return to?" " If you get to leave, where would you go?" " They called my pastor." " Do you think he'd take you back?" " Huh?" " He'd take you back?" " Yeah." " OK." " Did you call and get the number, right?" " Yeah, the social worker's talked him." "He's not too pleased with you." "He doesn't know if he wants you to go back or not." "CARL (OFFSCREEN):" "That's what the social worker said?" " That's what he told the social worker, yeah." "Pastor Boswell." "He says, I don't know-- he's like, I don't know if I want that guy back, because you don't seem to do well for him." "So it sounds like we have some ironing out to do." "If you didn't get to go back there, where would you go?" " I don't know." "DOCTOR (OFFSCREEN):" "OK." "All right." "Not everyone has a place to go and there are oftentimes where" "I don't want to send a patient out into the cold with bad lung problems and no access to get medicines that night." "I can't just send them to the street." "So there's no movement on that bed and nobody in the waiting room can use that bed until that patient has a place to go." "If I was a patient in the waiting room, knowing that there was somebody who was completely stable and didn't need to be admitted, but there's nowhere else to go and" "I was stuck waiting for that bed, I think I would be pretty darn frustrated." " Has it been busy all day like this?" "FEMALE SPEAKER (OFFSCREEN):" "Oh, yes." "All day." "FEMALE SPEAKER (OFFSCREEN):" "She's been here all day." "I just got here." "So if she says yes, then" "FEMALE SPEAKER (OFFSCREEN):" "It's been nonstop." "FEMALE SPEAKER (OFFSCREEN):" "Nonstop." " Oh, stop all that cussing." "You don't-- that don't make no sense, young man." "I don't care what's going on in your life, you be more considerate of other people." "I don't want" "I'm tired of hearing you cuss." "And I don't deserve that." " Pain." " I know that, but I'm sick of hearing you cuss." "You're disrespecting everybody, yourself and certainly me." "I'm old enough to be your grandmother." "And you keep cussing at me, I'm just going to break you off something." "That's all I got to tell you, young tender." "Because I know you was raised better than that, weren't you?" " Yeah." " Yeah." " It's just" " I know you in pain." " When I be telling people, shut up, I can't hear." " But you can't tell nobody to shut up." "You don't have no right to tell nobody to shut up." "You can ask them to hush." " I be saying be quiet, but then they be like," "I don't want to." "And then I'm like, shut up when you here." " But it just don't work like that." "You going to make yourself upset, because people ain't going to do what you say, especially in the manner that you trying to make them do it." "You get a grip." "Are you a Scorpio?" " Sorry for not coming yesterday." "I'm really sorry." "Ah, babe, babe, babe." "This is how I spend my daddy day, huh?" "At the hospital." " I'm sorry." " Huh?" " I'm sorry." " I know, I'm sorry." "I'm not trying to cry." "I'm just so nervous." "After Dejon, Daddy just gets so nervous when he comes to the hospital, you know, right?" "10 years ago, our two-year-old had a seizure." "I lost him at home with me." "And then we go to the hospital and then they said he wasn't going to make it." "After you lose a kid, it always changes you." "Everything is-- every little thing is so serious." "FEMALE SPEAKER (OFFSCREEN):" "This is Deja." "I guess mom and dad are switching." "Mom was here before." "FEMALE SPEAKER (OFFSCREEN):" "Do you want to get a soft tissue lato?" "DR. FREEMAN (OFFSCREEN):" "That would be better." "FEMALE SPEAKER (OFFSCREEN):" "Just to screen?" "DR. FREEMAN (OFFSCREEN):" "Yes, I'd be happy with that." "I would be happy with the soft tissue." "Yeah." "I like that." "I'm sorry, I'm Dr. Freeman here." "MALE SPEAKER (OFFSCREEN):" "I'm just listening." "I'm like, OK, you guys." " I met your wife earlier and I examined your daughter." "And I'm just talking shop with her in medical terms." "We're going to explain everything." " I'm very concerned about what's going on." "You guys said it was a foul odor." "And what is it?" "Do you guys know what the odor may be?" "DR. FREEMAN (OFFSCREEN):" "Yes, it looks like she has strep throat." "She definitely has an infection on her tonsils." " So it is an infection?" "DR. FREEMAN (OFFSCREEN):" "And that's what I was telling your wife." "We wanted to make sure that her infection wasn't spreading because that could affect her airway." "MALE SPEAKER NARRATING:" "I think that's the scariest feeling of all, when you lose a child in a hospital and they don't come home to you." "So when you're in here and you're worried and you're concerned, sitting her watching them do things and waiting for them to come tell you something, you kind of feel helpless in the process of it happening." " Just relax." "This is almost over." " We don't have beds for these poor folks, is that our issue?" " No, we don't have any floor tele beds." "We have one SDU bed that's going to go to 10 pending a discharge." " Oh, this guy's going to be able to go." "Yeah, this guy." "I just need to scan his aorta really quick with ultrasound and make sure he doesn't have AAA, and then he can go." "So this guy" " All I need to do." "OK, so 3's going to the hallway, and your DKA is going to 7 and 7 is going to 3?" "DOCTOR (OFFSCREEN):" "Yeah." "And I've got people I will discharge for you soon." "And I've got a hall 1 patient I can also discharge with shoulder pain I need to reassess real quick." "But he got lost in the shuffle." " So I'll get you hooked up to the monitor in this room, too." "FEMALE SPEAKER (OFFSCREEN):" "So we're putting your DKA in 7." "We're putting 7 in 3." "We're putting 3 in the hallway." " Yes." "5's going to be unit." "And then you're going to get your transesophageal" " Echo." "Echo in" " In 5." "In 5." " Correct." " And 6 will come out as soon as you discharge somebody else?" " Correct." " Hi, sir." "Are you in this room?" "MALE SPEAKER (OFFSCREEN):" "I need a blanket." "I'm freezing in here." " You're cold?" "All right, we can get you a blanket." "All right, the nurse is going to grab you one." "What brings you here today?" "I'm Dr. [inaudible], one of the residents." " They told me to come here for my dialysis." " For your dialysis?" "And then, you have had dialysis here before?" " Yeah, this makes the third time." " The third time?" " And every time I come here, I'm having the same problem." "Call Reno." "I don't know" "I don't know why they told me to come here." "Ask them." "I can't answer the question." " Where do you normally get your dialysis." " I just started this shit." "Do you understand?" " No, that's why I was asking you." " This shit is very fucking frustrating for me." "DOCTOR (OFFSCREEN):" "I understand, sir." "It sounds very frustrating." " You're asking me the question." "Ask Reno." "Call up there and ask them." "Ask the goddamn Reno doctors." "I don't know why I got to come here." "DOCTOR (OFFSCREEN):" "OK, this is just an unusual situation." "You're the only person I know right now that's coming through to do this." "So when this happens, we're not used to it." " Well, I tell you what." "Tell them-- tell them to take this goddamn catheter out my chest and I'll just make it on my own." "DOCTOR (OFFSCREEN):" "OK, that wouldn't work." " That's what I really want to do." "I want this damn thing out of my chest and I'll be able to make it on my own." "DOCTOR (OFFSCREEN):" "All right." "Why don't we talk to dialysis, so they can come here and do this." "They're already aware." "If we take that out, you would eventually die." " Well, so fucking what?" "We all going to die." "You, too." "DOCTOR (OFFSCREEN):" "That's true." "But if there's something that can keep you alive and treat you" " If I got to go through this shit every time I fucking come here" "DOCTOR (OFFSCREEN):" "This is only for a period of time." " I'm sick and tired of it." "I'm just sick and tired of it." "Take the motherfucker out and I'll just go on, on my motherfucking own." "Very simple." " I'm really nervous." "I hope he just looks at this today." "You going to talk?" " Huh?" " You going to talk?" " Yeah." " You want me to talk?" " No." "FEMALE SPEAKER (OFFSCREEN):" "Well, you know, how when they canceled the other surgery, how we completely freaked out." "But now they said that we're in the process." "MALE SPEAKER (OFFSCREEN):" "Yeah." " Hopefully" "MALE SPEAKER (OFFSCREEN):" "Yeah, hopefully." " I just don't know how long it will take." "MALE SPEAKER (OFFSCREEN):" "Yeah." " It's really scary." "Do you know if we wait here a long time?" "Did they say?" "MALE SPEAKER (OFFSCREEN):" "Uh, no." "I got the "I'll be right back." So you never know." "We had suffered a miscarriage in February." "And going through all that was really intense." "Our sort of decision-making process on whether or not to keep it, and then finding out it was a miscarriage anyway, that was really hard." "My fertility rate is going to be like nothing after the surgery." "So we set up an account at a sperm bank in California." "We sent out a fundraiser to raise the funds." "And a lot of our friends and people that we know sent in enough to make about three to four deposits." "So we've got, like a decent amount of stored sperm to be able to possibly get pregnant." " Now, this is going to be all free, right?" " Oh, absolutely not." "There's very few things in life that are absolutely free." " Ah." "Why not?" " Now, we may be able to give you a break on the price, but there is a cost." " Put me at the lowest, lowest, lowest cost, OK?" "And then I'll take out an installment plan." " Oh, OK." " Like take 30 years." "See, these bills." "These bills, these money bills, I try not to worry about them." "Put them to the back of my mind." "Just try to go to work." "Yeah, last time I came here they said I didn't qualify because-- by $400 I didn't qualify" " Oh, I see." " For the" "I don't know what it's called." "What do you call it?" " The country medical services program?" " I think so, yeah." " OK, all right." "So you still don't have proof of your income just yet?" "We're still going to have you as a full-pay patient pending you returning with your proof of income." " Oh, no." "Not a full pay." " Full pay." "See, that's your incentive to get you in here." "See, you get the reduced rate once you bring the information that we need." " And what is that, 40-- 60% off?" " It would be if you qualify for our charity care program, then the most that we would write off is 60% and you would be responsible for 40%." "But if your income does not qualify you for that, then the only other program would be the patient paid discount." "And so it would be an estimate of all your charges minus 50% and you would be responsible for the other 50%." "MALE SPEAKER (OFFSCREEN):" "So I'm going to be responsible for 50%, right?" " Possibly." "It depends on what you're" "MALE SPEAKER (OFFSCREEN):" "I'm not going to get the charitable one." "I know that already." "FEMALE SPEAKER (OFFSCREEN):" "OK." "So then it would be-- it would more than likely be the patient paid discount pending you bringing in verification." " I have to make a certain amount of money to make that one, too?" "Or is that just" " Right." "Everything is on a sliding scale based on your income." "Now, you're going to return with those papers, right?" "I just want to make sure that we get this taken care of for you as soon as possible." " Yeah, I will." " OK." "All right." "Thank you your time," " Thank you very much, Kim." " All right, I wish you the best." " Thank you." "DOCTOR (OFFSCREEN):" "Do you have a regular doctor for her?" " We don't, and I need to get one." "DOCTOR (OFFSCREEN):" "OK, well, what I'm going to do is I'm going to call our-- do you live in Oakland?" "FEMALE SPEAKER (OFFSCREEN):" "Yeah." "DOCTOR (OFFSCREEN):" "OK." "I'm going to call our pediatrician and tell them what's going on." "Because I think it would be good" "FEMALE SPEAKER (OFFSCREEN):" "To have a little checkup afterwards?" "Yes." " I'd like to actually see in the next 24 hours, have her get rechecked." "FEMALE SPEAKER (OFFSCREEN):" "Oh, OK." "Definitely." " So I'm going to call them and we'll get something set up." "FEMALE SPEAKER (OFFSCREEN):" "OK, that would be great." "That would be great?" " Sound like a plan?" "FEMALE SPEAKER (OFFSCREEN):" "Yes, it does." " OK, I'll be back." "FEMALE SPEAKER (OFFSCREEN):" "Thank you so much." "Thank you." " You're welcome." " Yay." "Everything's going good." "It's just strep throat." "It's a bad strep throat." "I'm going to switch with daddy again and tell him." "So I can call grandma, tell her how you are." "But I'm so glad." "I'm so glad there's not a cyst in your throat." "I'm so happy." "I'm so happy." "[airplane noises]" "Little fly by." "[airplane noises]" "It's so funny feeding you food." "I ain't fed you since you been" "I remember the last time I fed you, you were like four." "Four?" "Four?" "Yeah." "Four years old." "NURSE (OFFSCREEN):" "You guys ready to go home?" "MALE SPEAKER (OFFSCREEN):" "Yeah." "NURSE (OFFSCREEN):" "That's what I figured." "MALE SPEAKER (OFFSCREEN):" "Yeah." "As long as she's OK." "I'm not ready to go anywhere unless she's all right." "NURSE (OFFSCREEN):" "She's OK." " She's good, then we're ready to move, huh?" "You ready to go, momma?" "You know what a strong little girl you are?" "I would have been crying." "NURSE (OFFSCREEN):" "I'm telling her, most adults do not do this well." "MALE SPEAKER (OFFSCREEN):" "I do not do well at all, and I'm one of those guys." "Your dad would be in here crying, talking about" "I can't take it." "They have to hold me down when they give me a shot." "NURSE (OFFSCREEN):" "And we do that." "MALE SPEAKER (OFFSCREEN):" "Lady's like, how old are you, sir?" "Does that matter?" "Pain is pain." "Oh my goodness, what is your daddy doing?" "Sit up, baby." "I hope I'm doing your sandals, right." " Did you page the nursing suit?" "FEMALE SPEAKER (OFFSCREEN):" "Mm-hmm." "Maria." "Hey, a couple things." "So I have three going." "I have a couple discharges." "I have like one, two, three, four." "So I have about 10 people leaving." "If we can move all the people upstairs and discharge the people who are flagged for discharge, I might be able to skate by for a while." "[chattering]" "MALE SPEAKER (OFFSCREEN):" "He has-- did have originally on scene." "He was in Brady rhythm." "MALE SPEAKER (OFFSCREEN):" "Is Jeff over here?" "[interposing voices]" "MALE SPEAKER (OFFSCREEN):" "Have we checked pulses yet?" " I'm going to start that other IV in his other side." "Go, go, go." "MALE SPEAKER (OFFSCREEN):" "Take the suction out, please." "MALE SPEAKER (OFFSCREEN):" "We giving him fluid?" "MALE SPEAKER (OFFSCREEN):" "We got it." "MALE SPEAKER (OFFSCREEN):" "Someone want to grab the head of the board?" "Ready?" "Your count." "MALE SPEAKER (OFFSCREEN):" "One, two, three." "MALE SPEAKER (OFFSCREEN):" "I looked at his airway." "It's really clean." "FEMALE SPEAKER (OFFSCREEN):" "No respiration." "MALE SPEAKER (OFFSCREEN):" "Change out the CPR." "FEMALE SPEAKER (OFFSCREEN):" "Right here." "Go." "MALE SPEAKER (OFFSCREEN):" "OK, change." "[beeping]" "[beeping]" "MALE SPEAKER (OFFSCREEN):" "Hold CPR." "Continue CPR." "We're not ready." "MALE SPEAKER (OFFSCREEN):" "Let's check our ultrasound, look at the cardiac activity." "MALE SPEAKER (OFFSCREEN):" "Which one do you" "MALE SPEAKER (OFFSCREEN):" "Stop CPR." "Let's check cardiac activity." "MALE SPEAKER (OFFSCREEN):" "[inaudible], please." "[inaudible]." "Neck, carotid pulses." "MALE SPEAKER (OFFSCREEN):" "He doesn't have electrical activity." "MALE SPEAKER (OFFSCREEN):" "No, no pulses." "MALE SPEAKER (OFFSCREEN):" "I got nothing up here." "MALE SPEAKER (OFFSCREEN):" "Let's roll him before we call it, make sure there's nothing in back." "No." "I got to call it." "Time of death." "MALE SPEAKER (OFFSCREEN):" "Time of death is 20:16." "MALE SPEAKER (OFFSCREEN):" "Can we get an age on this kid?" "MALE SPEAKER (OFFSCREEN): 15." "FEMALE SPEAKER (OFFSCREEN):" "15." "MALE SPEAKER (OFFSCREEN): 15?" "Jesus Christ." " Have you had little or no experience at doing that?" " Not in this facet." " It will be grim." " Um, do typically, we let them come in and see?" " Typically, in a coroner's case, we are not allowed to let them come in and see." "The gunshot wound of most traumas that are treated by the coroner as a crime scene and the body is evidence until released by them." "And maybe later, they might possibly allow the family to go down and look at the body through the window into the morgue room downstairs." "DR. HARRY (OFFSCREEN):" "OK." "DOCTOR (OFFSCREEN):" "But generally, no viewing of traumas." "DR. HARRY (OFFSCREEN):" "No viewing, OK." "DOCTOR (OFFSCREEN):" "So you haven't had any deaths on trauma up till now?" "Wow." "I guess you're been leading a charmed life, because this is an especially grim one." " Yeah." "Uh" " Dr. Harry, there's things I would be sure to say." "Right, everybody did everything that could be done." "He didn't suffer." "He wasn't aware of what were doing to him, and he died." "These are precise, unequivocal or like it-- died or dead, not went to a better place, expired, or some other strange stuff like that." " OK." " Here's the situation." "We had a big lobby earlier." "We decompressed a little bit." "But now, it's like this again." "If you look at the entire board of everybody waiting in the lobby, we have 40 plus patients that need to be seen." "The question is, with more potential ambulance traffic, do we go on diversion now or do you want to wait till later?" "So my inclination is to do it now, but I thought I'd ask you." " Max ambulance traffic is probably going to be the next three, four hours." " Right." " So do it now." "Try and stave off, at least ambulance traffic." "And work on the lobby and get the admits up." " Well, that's all you can do." " I don't know." "I wouldn't talk about what we think happened, just how he came in." " Yep." " I'll go with you." " They're parking the car, though." "Five minutes." " OK." " See you later." " Yeah, dude." " When I was in the hospital back there, they're able to give us sandwiches." " Mm-hmm." "FEMALE SPEAKER (OFFSCREEN):" "Can you see if you can get a sandwich for me?" "I left Alice's today and came straight here." " OK." " And I just want a little something to eat." " So wait a minute, you want a lobster sandwich or steak?" "What you want?" "FEMALE SPEAKER (OFFSCREEN):" "You've got a snack?" " What you feeling?" "I've got turkey." " Turkey is fine." " Turkey and cheese?" " Yes, that would be fine, maybe." "I'm just hungry right now." " You don't have diabetes, do you?" "Yes." " Well, I'm going to bring you some water then." "No juice, huh?" " No juice." "FEMALE SPEAKER (OFFSCREEN):" "So whether it's benign or not, we call it cancer." " Typically, how it works is they do need to do the surgery." "And that's how they would find out 100%." "I'm not sure what they saw that would make them automatically say this and refer you here." "I know they're trying to get you into this clinic as soon as possible." "So if they're using this term to get you in, that might be part of the reason." "FEMALE SPEAKER (OFFSCREEN):" "OK." "MALE SPEAKER (OFFSCREEN):" "OK." " Yes." "Yeah." "And he came with-- like in a CD, like a" "CD of all his imaging." "He's had a CT, abdomen, pelvis." "He's had an ultrasound." "He's been fully screened and worked up at Kaiser." " I cried and you just kind of sat there." " Yeah." " It was just like no one was listening at that moment." " So you were all set up for surgery, and then?" "MALE SPEAKER (OFFSCREEN):" "Then-- yeah." "So then they're like, you have no coverage, so we have to cancel the surgery." " When's the first time you went to the doctor's for this?" " Two weeks ago." " Did you go to the emergency room at Kaiser?" "FEMALE SPEAKER (OFFSCREEN):" "No, just made a regular doctor" "MALE SPEAKER (OFFSCREEN):" "No, we just made an appointment at internal medicine." " They recommended coming here to see, like" "FEMALE SPEAKER (OFFSCREEN):" "They didn't recommend." " They didn't recommend anything?" "MALE SPEAKER (OFFSCREEN):" "Yeah, we just figured it out." " OK." "So you don't have any insurance and stuff and come to Highland?" " I'm very surprised that they allowed you to make an appointment without being a member of the Kaiser system." "MALE SPEAKER (OFFSCREEN):" "Well, they gave us a number so that we could get in and get rolling, but we had no membership." " When we saw the urologist on the same day after doing the-- what-- ultrasound, he told us that this is normally an emergency situation that needs to be taking out as soon as possible." "So at that moment, we just kind of went with the program of, what do we need to do in terms of tests to get it done there?" "DOCTOR (OFFSCREEN):" "I see." "OK." "Well, I'm very" " And we have the CD with all the images of the ultrasound." " OK." "I'm sorry that it's been so frustrating navigating the system." " OK, lady." "Come on." " This way." " We're going here." "You're going out the double doors." " OK, this place is busy." "Make sure I don't get to any steps, baby." " No." " No steps." "Do I have to climb" " No, no steps." "We're just going to walk a little, a little hill." " They said something about the bus doesn't come up this way?" " No." "He said, isn't coming down inside." " OK." " The horseshoe." "But he meets us at the bus stop." " No steps up here, baby?" " No steps." "Now listen, didn't I tell you, Ms. Johnson, that there was no steps?" " OK." "Maybe it's a hill." " OK." "I'm guiding you here." "We going to go to the left." "To the left." " OK." " Make a deep turn." "There it is, it's already waiting for us." " Oh, the bus is waiting on us?" " Are you making a good left?" "No." "Turn this little cart to the left." "Here, come on." "I'm going with you." "There we go." " Thank you, sweetheart." " Let's walk together." " You feeling any better?" " What time is it?" "My neck." " Your neck's hurting you?" " Yeah." "My lungs too." " Say again." " My lungs feel bad." " Your lungs feel bad?" "Well, the chest x-ray looks fantastic." " It do?" "DOCTOR (OFFSCREEN):" "Yeah." "No pneumonia, no broken ribs, no nothing." "You're just washing out from the crack and your meth." "It sounds like a rough night." "And your alcohol." "It sounds like you had a lot of stuff on board last night." "But your chest x-ray, your head CT both look fine." "That's good." "So this is our gentleman that came in, found down." "Apparently he doesn't take his medicines that would help him stay out of the hospital." "He comes in." "I mean, I'm just looking back." "He's come in a dozen times this year." "Sorry, August, July, June, June, May, May, May, March," "March, February, February, February." "Alcohol level's positive as well as amphetamines and cocaine." " That'll do it." " That'll do it." "So he got the million dollar workup for a rough night out." "He's basically been denied by his Pastor" "Boswell, Borden Care." "I've admitted him for increased work of breathing, but it's more of a-- it's actually more a social mission." "Nice." "Good job." "Big deep breaths through your mouth, OK?" "We never know the right answer on this one." "There are times I have to admit people to the hospital, keep them overnight, just as much for their social conditions as for their medical ones." "It's not ideal, but we're a public hospital." "We're the safety net in society." "We're an institution of last resort for so many people." " How do you feel, baby?" " I feel like more relieved that everybody knows the story or the situation." "And, um-- we know that they know for sure what's going on." "We're going to get the appointment, and it sounds like it's going to happen." " I wonder how booked the operating rooms are." "MALE SPEAKER (OFFSCREEN):" "Yeah, that's the next hurdle." " Well, he said that it's up to the urologist." " Right." "Yeah." " I can't imagine them saying no." " I guess you never know at this point." "But, you know?" " John Jones, JJ." "Come on." "Come on." "Come on, let me give you some last loving before I go." "My last bit." "Come on, little baby." "Don't want to let me out of here." "Want me to stay till tomorrow, huh?" "DOCTOR NARRATING:" "End of the shifts are kind of bittersweet." "Sometimes they're just amazing." "You have a concrete plan for every one of your patients, then you did a great job of clearing the waiting room." "You saw as many people as you physically could." "Unfortunately, there's oftentimes where you have patients that you're still not exactly sure what you want to do with and you're waiting for one more exam to reassure yourself that they're safe to go home." "And then, you're going to be sticking around for an extra couple hours charting and wrapping up loose ends." "FEMALE SPEAKER (OFFSCREEN):" "So how was the shift?" "DOCTOR (OFFSCREEN):" "Shift was good." "We had some really sick people and had no beds to put them in." "So it kind of slowed our role a little bit." "FEMALE SPEAKER (OFFSCREEN):" "How's the waiting room?" "DOCTOR (OFFSCREEN):" "Waiting room is a little bit better than when I got here." "That's kind of all you can hope for." " This can be cleared by the morning." " This is your first time coming to Highland?" " Yes." " OK." "Do you get paid every week, every two weeks?" "MALE SPEAKER (OFFSCREEN):" "Bi-weekly." " What does your income look like bi-weekly?" "Gross income?" "MALE SPEAKER (OFFSCREEN):" "It's bi-weekly." " Oh, you have a check stub?" "OK, yourl income is less than your rent." "How are you coming up with the difference, or how are you supporting yourself?" " I am-- how am I?" "Well, I had some student loans left over." " OK." " And I've had some help from my family members." " OK." " Yeah, I mean, I'm probably going to get more bills, too." "More than I thought." "Because it was only-- we just raised money for the sperm bank." "So we didn't really ask for medical costs." "But uh, you know." "We'll see." "FEMALE SPEAKER (OFFSCREEN):" "OK." "So what we can do is we can sign you up for the county program to take care of your medical bill." "You're not going to have any co-payment." "This program is going to be good for a year, OK?" "I'm going to make a copy of your paycheck stub and your ID." "I'll bring it right back to you." " OK." " I need that one." "I just need one." " You're going to need monthly checkups after the surgery." " Yeah." "FEMALE SPEAKER (OFFSCREEN):" "Do you have any medical costs in the last couple months or so?" "Have you seen a doctor in the last couple months beside today?" "FEMALE SPEAKER (OFFSCREEN):" "Kaiser." " Yeah, I was just at Kaiser two weeks ago." "FEMALE SPEAKER (OFFSCREEN):" "Yeah, Kaiser is private, so this program only covers county hospitals and clinic." "Unfortunately, it doesn't cover Kaiser." "What I would advise you to do is talk to a financial counselor in Kaiser and let them know your situation and your income level and all that." "And see if you can get on some kind of charity program with" "Kaiser to see if they can help you with the bill there." " What are we going to do about getting home?" "MALE SPEAKER (OFFSCREEN):" "I don't know." " Do you guys know if it's safe around here?" "[music playing] [music playing]" " You look like you may need a little help." "You need a little help?" "MALE SPEAKER (OFFSCREEN):" "A little help." " Can't do it alone." "You don't remember that record by James Brown." "You knew him." "MALE SPEAKER (OFFSCREEN):" "I got to see him live before he passed." "Oh, what a show." "NURSE (OFFSCREEN):" "Well, just like a year before he died, he was at the Paramount." "He did everything he did, just a little slower." "[laughter]" " Don't make me laugh." "It hurts when I laugh." "FEMALE SPEAKER (OFFSCREEN):" "You're going to go ahead and have a seat anywhere." "And they're going to call you at that door." "So just listen for them." " OK." "Thank you." "Ready for another day?" " Oh, yeah." "Because the alternative is not good." "NURSE (OFFSCREEN):" "Be a long wait today." " How do you define a very long wait?" " Well, I just want you to turn around and see all the beautiful people here." " I did see that." " No, thank you." "You always make me shy." "Come on, sit with me." "I knew it would happen." " You knew it would happen?" " Yeah." "You remember me, right?" " Who could forget you?" "[music playing]" "[music playing] [music playing]"