One Monday in December I was admitted to a major acute hospital in Dublin through its emergency department, after my GP referred me there. The numbers on trolleys countrywide had yet to reach 600, as they have in recent days, but even on that weeknight, for a moderately ill patient, the experience was uncomfortable and sometimes unnerving. This is what I observed from my trolley.
7.20pm Three hours ago, after having had a scan in another part of the hospital, I walked through the main part of the emergency department – a noisy maze of beds, trolleys and 93 patients – out to reception. Now I am back there, this time sitting on a trolley with my handbag, coat, notebook and just-in-case overnight bag. My trolley is alongside the central desk. Seventy-three people are here now. Behind me, on a bed next to a lift, an elderly man dozes, snorting occasionally. He wears pyjamas. His feet are bare. Next to him is a young man wearing a bloodstained shirt, which he removes every time he wakes up. His feet are also bare. From another bed around the corner poke another pair of bare feet. Loudly but kindly, a doctor asks this man how he is feeling. He promises that he will return very soon to listen to his chest. (He does.) The man next to me is fully dressed and sits on a chair beside his trolley.
7.40pm “Tea?” says a man from the catering staff. I haven’t eaten. I am not hungry, but I would love tea. He brings it in a paper cup and, with an apologetic look, also gives me a cheese sandwich. Its wrapper says “Real food”.
8.20pm A doctor arrives with a clipboard. She is skilled and sensitive. Somehow she finds an empty treatment room and examines me. Other people are undergoing procedures in the middle of the corridor, which is full of beeping, shouting and trolleys. At least four people are brought in by ambulance.
8.40pm My bum is numb. I wonder whether trolley sores are a medical phenomenon. I have a blanket but no pillow. A porter promises to find one for me. It will be 10 hours before he brings one (and apologises profusely for forgetting). I roll my jumper into a lumpy ball and lie on it. No one is telling anyone what to do. Everyone seems to know their job.
11.10pm I realise I am going to be here all night. I change in the bathroom. 1am A woman screams beside me that she has not taken an overdose, that she loves her children and that she has been robbed, assaulted and denied her medication. Medical staff explain that they need to treat her in an adjacent room. The shouting stops, and I open one eye. The woman catches it, and roars “And I’ll have you, too, you scabby little bitch!” She shouts, struggles, and screams “Rape!”
1.30am I am afraid of rolling off my trolley. I have a knot in my stomach.
2am A doctor examines the man on the chair. He tells her that he is 77 and that after falling off his ladder he got the bus to the hospital. He also tells her he gave up smoking at 11.15am on April 25th, 1985.
2.30am There is a jolt. The porter is moving me, and the man in the chair, away from the shouting. He parks me beside the photocopier, which people use all night. Whirr, flash. Crumple, whirr, flash, shuffle.
3.30am The cupboard beside me rattles and a nurse removes her bag and coat. She is trembling. After she leaves, her colleague tells me that the shouting woman had pinned her against a wall and tried to choke her.
4am A nurse comes to take my blood pressure. She asks me my name, and I have to think for a second. The woman is still shouting.
6.45am There are seven trolleys in the corridor and eight more in cubicles. A maintenance man tells me the department is almost deserted compared with one night the previous week, when 122 people were here. He manoeuvres backwards around my trolley to put his ladder in another cupboard.
7am This morning’s doctor reassures me that they will do everything possible to cure me. I ask him why it is considered better to have kept me there, taking the place of another, sicker person, when I could have gone home at 7pm and come in now. He explains that once the decision is made to admit someone, this is what happens. And, no, he doesn’t think it is the best use of time, space or staff, but that is the system.
I am fit, strong and young, not frail, vulnerable or elderly. I am not in much pain. I am not afraid to ask questions, nor to speak up for myself. I know I am in good hands. But many patients in emergency departments all over the country may not have moved from their trolleys for days. And the people who are treating them are doing their heroic best in the face of impossible odds.
