The initial visit had been prompted by me hitting my head against a residence hall after collapsing while opening the door, and passing out mid-conversation on a few separate occasions. These episodes disappeared while I was waiting to get results for my tests, but one night I began to see lights in the corner of my vision. The problem was that this occurred at 0400 in the morning, and, like most doctor's offices, Hurtado was closed. As advised by the doctor, I made my way to the local hospital, Robert Wood Johnson, and walked into the ER.
The man at the front desk asked me what the issue was, and I explained the lights and that my doctor told me I needed to talk to a medical professional. During the standard entrance questionnaire, I was asked about prior conditions, and current medications. At the time, I was being treated for Bipolar Type I (since been re-diagnosed as standard depression) with Lamotrigine (brand name: Lamictal). A few more questions and I was immediately taken into the back and given a room. Shortly thereafter, I had a doctor who explained they were going to do some standard tests, and that the results should explain the problem.
A chest X-Ray and urine test later, I was told that they were going to have to draw blood. I am EXTREMELY afraid of needles, and told the nurse that when people approach me with the intent of drawing blood, I black out and sometimes lash out without knowing. Naturally, she didn't believe me until testing her theory that I wasn't telling the truth, and after I took up defensive positions on my bed, she decided to dose me on Ativan and bring some back-up in case things went south.
It did seem weird to me that she left a nurse behind after she got the blood, but I didn't question it because of the anxiolytics, and I waited until the doctor came. The doctor explained that I was now on psych hold until a bed opened at Acute Psychiatric Services (APS) at Rutgers. I asked why my doctor saying I needed to come in because I might have epilepsy might lead me to being sent to APS, and the doc retorted that I was bonkers and this was standard practice for college nutcases. Reserved to my fate, I queried as to how long this would take, and was informed that sometimes it could take several days, but that I might be able to get in by that night (it was now close to 0800 or so).
At this point, everyone became super helpful. Most of the nurses making sure I wasn't going to kill myself slept or sat and played on their cell phones despite messages clearly indicating cellular service being prohibited because it might mess with medical devices and kill people. Of four nurses assigned to me, only one actually talked to me (she was actually nice. I can't remember her name, but she talked to me about struggling with her own mental disorder, so thank you if you ever read this). The Lorazepam eventually knocked me out, and I awoke around 1600. They didn't feed me, or even offer me food in 12 hours, but that was okay because I was about to be transferred!
At 1800 hours, I was finally released to an ambulance to be transported to APS. I sat in the back of the van, talked with the EMT's for ten minutes, and was dropped off. This part was pretty easy.
Then I walked in, signed some papers, and was stripped of everything not my pants and shirt (wallet, keys, phone, gum, belt, shoes, socks, cigarettes) and put in a room with a chair made completely of rubber and a bed with no sharp edges. Just in case I thought about getting creative to hurt myself, they locked me in, so I got to stare at the walls and notice that there were several newly Spackled spots. The yellow itself was depressing, but apparently they couldn't be bothered to make finish painting the new spots before I got there. In their defense, they did give me a microwaved breaded fish fillet and some vegetables that I got to eat with a spoon.
Eventually, I got to see another doctor, who asked me why I was there, because the hospital couldn't be bothered to brief APS on every single patient that they shipped over there because of some strange policy. After explaining myself, the new doctor actually knew my personal psychiatrist, and said that my questionnaires didn't indicate mania or depression (no questionnaire administered at RWJ), and that I would be allowed to leave. I arranged a ride, and left the building around 2000, 16 hours after I was originally admitted.
Why was I there?
After all this, there wasn't an official diagnosis or reason given, so this is speculation, but it looks like sleep deprivation. I don't sleep well, not because I can't fall asleep, but because I wake up throughout the night (middle insomnia). When I asked Hurtado doctor what to do, he said talk to psychiatrist. Psychiatrist just upped my Lamictal to 400mg daily. At RWJ they didn't even ask about sleep, even though I arrived at 0400, and the doctor at APS said she couldn't do anything unless I stayed overnight. The anxiety medications helped me sleep in the ER, so when I was released I bought three 1mg Klonopin for $10. For three nights I used one each night, and slept soundly. By day four, I wasn't having any problems.
Those Klonopin were pretty expensive.
Well it would seem so, until you look at the bill I received. See, I normally didn't handle this sort of thing at the time, but my father thought that a stiff dose of reality would fix my mental affliction, and let me know that the whole bill was going to be my responsibility. At the time, I was unemployed, but insured through him with Horizon Blue Cross & Blue Shield PPO. Because I saw that one Denzel Washington movie, I knew that PPO>HMO, so I was set. Then the bill arrived for right around $2k, split nearly evenly between the ambulance company and RWJ. Apparently, a 10 mile drive with no care is worth $1000. Even if the ambulance only gets 1 mi/gallon of gas, you get to pay $100 per gallon. Comparatively, a taxi would have cost $20 if you were completely drunk and the cab driver realized he could take advantage of you.
Also, I got to pick whether or not the Klonopin was what I wanted, and the price was upfront. The treatment by the hospital was part of a policy that they had to use, meaning non-compliance would have resulted in release Against Medical Advice, which you typically pay out of pocket anyway. I also like how no one ever tells you the price of health care until they already have you, tantamount to trying to renew your license and being allowed to fill out paperwork and take pictures, until you go home and receive a bill for a few hundred a week later. Health insurance Klonopin costs less, but I don't have to sit around for a day, be deceived, or get rooted by deceitful pricing disclosure policies...
...even if my dealer is a dick for overcharging.
You do drugs/have a history/other immaterial arguments.
Believe it or not, I expected fair treatment, reasonable practices, and a fair cost, but I guess *whatever you are talking about* discounts me. If it were up to me, general douchery would discount people from being allowed oxygen, but the bill is stuck in Congress.
What is your status now?
After they sent me the bill, I sent them my insurance information several times. Eventually, I was sent to collections, and began to call people and figure out different details. It's a good thing I like computer prompts and Alanis Morisette, because I spent most of my time on hold. I got to talk to two people from three companies (hospital, collections, and insurance). I gave up on the insurance company, because a full hour of Alanis is too much even for me. I have since started taking collections calls by saying, "I'll see you in court," but instead of going to arbitration, they have just tanked my credit.
Thankfully banks in America don't care about these sorts of things, so it hasn't stopped me from getting loans.
Lessons learned
- Get a good drug dealer early. They are faster, quicker, and cheaper than going to a doctor, even with insurance.
- Don't have chronic illnesses. If you have a mark on your health that can be blamed for anything, it will be blamed. Real work is hard, looking at a chart is easy.
- Sleep. Seriously, deprivation is no laughing matter.
- The courts would be your best friend, but money talks. If I went to court, I feel like it would be clear that they're trying to fuck me slow, but it won't come to that because the rules are in their favor. Unless I can hire a lawyer and pay for the processing costs, I get to be billed by them. Even going to court is no guarantee when you have a better lawyer than I, so it's win-win.
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