How I overcame insomnia

GarfieldI used to love to sleep.

Way back in time, when I was living in the U.S., I remember as a late teenager, turning the ceiling fan on full blast, plus some form of air conditioning. Curling up in a fetal position, shivering, was my favorite sleep inducer. No better sleep! Continue reading

At the Emergency Room

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Last week, at about 5am, I was wripped out of bed by one of those son-of-a-gun clusters. I was completely out of the medication my GP (general practitioner) prescribed (doesn’t do much, anyways), and I could not cope with the nagging pain.

So, I walked to Brighton’s General Hospital, which is about a mile from me, perhaps 3/4 of a mile. I got there around 6am, birds weren’t churping yet and the dew was still fresh, condensation still on vehicle windows. I slightly escaped a moment of pain as I thought about having a nice box of warm donuts from Mèche’s in Lafayette. Back to reality. I had to take the bus up the hill, though, which burns the living daylights out of my shins.

And there I was, at General Hospital, at 6am, which was all boxed up. I mean it: the place was closed, doors locked, not a person in sight. As the pressure around my eye increased, my crying from the pain became more apparent, I swiftly and drunkingly (from exhaustion and inability to focus) perused the grounds for an Emergency Room, called A&E (Accident and Emergency) in the UK, to not find one. This I thought was a unique case at the Royal Sussex County Hospital I had been too last year this time for the same issue.

I finally saw a living soul and quickly staggered towards him. I must’ve looked like a mad man. He was standing at the entrace of the “hospital” whose doors were locked. I begged him to let me in, not knowing/caring whether he worked there, or not. He informed me that the hospital was an outpatient hospital exclusively, and that it would be closed for another hour, anyways. But, more importantly, there was no A&E; I needed to go to the Royal Sussex down the hill in Kemptown.

I thanked him and ran like a drunk fool to the one taxi I saw sitting out front, before anyone else would grab it. Jumped in. Final destination: the Royal Sussex County Hospital. By that point, I had reached the breaking point in the cluster episode, and the pain just simply lingered at a constant rate.

We arrive at the destination. And, the building is ginormous and confusing as hell. The main entrance is like a labyrinth with the Emergency Room is tucked away in the northeastern corner of the facility; hidden away from the street. It literally is about a 10 minute walk to the A&E from the main entrance. Anyway, an employee, likely a doctor, saw me confused and pointed to a quicker way: go out to the street, take a left, then another left on first street, then walk up the hill, take a left when you see the Accident and Emergeny red sign, then access that way. Right.

I entered. No admin personel at the desk. I waved my hands. I even silently shouted “hello.” The 2 clerks sat at a distance reading The Daily Mail and typing at the computers. Finally, I got one’s attention. She lazily and unenthousiastically made her way to the main desk. I didn’t wait for her to ask what I needed: I have cluster headaches, I am out of medication, my GP is unavailable until 9AM, I cannot cope with the pain and must see a doctor at once. As I spoke, she typed. She asked my name and some other detail then: alright, go and have a seat in the waiting room, which is around the corner, first corridor on your left at the end of the hall. I thought to myself: I’m getting dizzy from all the halls and doors, can’t it be easier than this?

I got into the waiting room around 6:45am. I waited. And waited. And waited. And waited again, until 8:45am. There were 4––maybe 5––patients before me. The waiting room was really quiet, then. By 7am, all hell broke loose and all the screatchy-pitch wives and grumpy husbands were arriving.

7:45am: Christopher Vannnnn (puzzled) Lawndry, is called. I don’t even have the strength to correct her; I just go. What brings you in? I repeat what I initially said to the admin clerk, verbatim. Which meds do you take: a subcutaneous dose of Sumatriptans, and Verapamil. I’m out of all. Ok. She takes off and, I can hear her being asked and repeating what I said to her, likely to a superviser/doctor, but the idiot told the superviser “he’s taking some meds that I have never heard of before and whose name I cannot recall.” Was she just writing hieroglyphics whilst I explained everything in detail? Anyway, some other dude came and took my BP and pulse, he seemed new, and walked off. The nurse returned with 2 pills, one a codeine tablet, the other, something else. She told me: these are pain tablets. Take them for now, then sit in the waiting area, as we’re too busy here. We’ll call your name in a bit.

photo9:55am my name was finally called again. This time it was a doctor. She asked all of the same questions all over again. The codeine and whatever had not had the slightest effect on me. And I was at exhaustion point. I would’ve fallen asleep in the waiting area had it not been for the lingering pain, which is simply annoying, by that point, but not excruciating. She, the doctor, plainly asks: what can I get for you to make the pain go away? I told her a bullet in the head! But I repeated the medication I had been taking, and told her that pure oxygen tends to help the most. She says: hold on. She dashes off then returns. Okay. We cannot get you the Verapamil, nor any of the Triptans; we simply do not have it in our stock of medication in the A&E pharmacy, and we’ve no way of getting them for you, either. We can put you on the oxygen and a drip to hydrate you, and then you can go to your GP and get the meds you need.

I thought it was so strange that an emergency did not have––and could not make/get––the meds that I needed acutely. Her explanation was that it was because it was “specialised medication and the A&E is only an outpatient type facility for accidents,” “and emergencies,” I added.

Later I was telling my friend Ahmed, a Radiologist for the NHS at the exact same hospital, about what happened. He told me that the NHS is a system in which each individual hospital has a particular speciality and, provided that one goes to the A&E and the situation warrants it, the patient would then be redirected in ambulance to the appropriate facility. The neurology department in the area is in Haywards Heath at Hurstwood Park’s Neurology Centre. That’s not that odd, actually, but I simply could not understand how an emergeny room was limited on medication for pain! I just could not wrap my mind around it.

There’s something else that was bizarre: Brighton & Hove is a city of some 300,000 inhabitants with one Emergency Room! My hometown, New Iberia, has 40,000 inhabitants and has had, since 1980, two hospitals both with Emergency Rooms, both of which have all the meds anyone can ever need in the immediate sense. The US medical system may not be affordable, but anyone can go to the Emergency Room and drugs, the ER, has!

I guess it’s another British thing that I will not ever understand. The conditions and time in the Emergency Room are for another entry, as it was no different from being in a hospital in Cairo or in Santo Domingo. Surprising for a system that prides itself on cutting edge medicine. As a patient, I only care about one thing: immediate care.

Long live effective medicine and swift services!