MUSINGS OF A SOLDIER’S SPOUSE

I have had my fair share of trips to Emergency Rooms, and the differences between military hospitals and civilian hospitals were a real eye-opener for me.

In 2009, we were stationed in San Antonio, Texas. I was new to cockroaches, and the little bugs were all over the apartment we rented. We had put baby gates up in the kitchen, and every night we sprayed pesticide in an attempt to rid the kitchen of the bugs. In San Antonio, I had the unexpected “privilege” of having to visit a military emergency room and firsthand got to experience the big differences between military medicine and civilian medicine.

While washing dishes in our little apartment kitchen, I fell. We don’t know if I blacked out or how long I was unconscious, but the last thing I remembered was that I was in the kitchen washing dishes, having left my kids in the living room watching television. When I woke up and found myself on the kitchen floor, I had two pairs of scared-looking eyeballs staring at me through the baby gate. I was home alone with a 2-year-old, a 1-year-old, and a 3-month-old (who was crying from his bassinet).

I immediately called my husband (who was on duty) and let him know what happened; we both assumed that I had somehow poisoned myself with the bug spray.

He rushed back from the base, and together we loaded the children in the car, and he dropped me off at the base’s Emergency Room. I was put in a “room” (curtained off area), and the nurses and doctors were there within minutes. They had a small machine with them that took my blood from a finger and spit out results almost instantly. We talked about what I had experienced, and the doctor performed a few bedside neurologic function tests. At first, he thought that perhaps I had passed out from “heat stroke” since we had come from a cooler climate and the temperature change was drastic. For safety reasons, he ordered an MRI of my brain.

It was about the time that they brought me back to my room from Radiology that my husband got back to the hospital. He was trying to get answers from the nurses, and within a few minutes, the ER doctor peeked his head in. He repeated a few more neurologic tests, having me touch my finger to my nose, balance on one foot, turn around, and sit down. The doctor sighed and said, “If you had come in with a broken bone or an open wound, I would be the right doctor for you. I am worried about some spots that I see on your brain MRI that you may have Multiple Sclerosis, and I am putting in a referral for you to see a specialist.”

That started my Multiple Sclerosis journey and the multi-state, multi-hospital, multi-doctor adventure to living with a chronic illness. It was the first time that I had been seen in an ER where the doctor was able to run tests without delay. I had a similar trip to a civilian hospital in New Hampshire almost a year later, with a very different experience.

My husband was in the process of retiring from the US Army, and I had moved myself and our children to our new home in New Hampshire while he finished up his tour of duty in Texas. I started a job, hired a nanny, and life was going smoothly and without stress, at first. Then, as inexplicably as the first time, some strange neurologic symptoms started happening again. At the time, I still did not have a confirmed diagnosis of MS, and since we had just moved, I didn’t have a doctor yet. I knew that being home alone with 3 toddlers and no idea of what was going on wasn’t safe, so off to the ER I went.

I swung through a McDonald’s drive-through, picked up 3 “Happy Meals” and headed to the local community Emergency Room. The nurses took me back to an examination room, and I waited. And waited. And waited some more. The ER did not appear to be crowded, but it seemed like an eternity before an ER doctor finally came in to see me. He ordered a handful of blood tests and then left without performing much of an exam. After waiting some more, a phlebotomy team came in to draw some blood. I was thankful for the kind nurses who sat with my kids while I had a brain scan. After my scan, I returned to my room, and I sat and waited for results with three children who were tired and cranky. After hours of waiting, I was eventually sent home without results.

The ER doctor and discharge nurse told me that I would be getting a call with my results, and that someone would also help me to schedule follow-up appointments. After a week of not hearing anything, I called to get my own results, and no one had any information about whom I needed to follow up with. I ended up coordinating my own care, eventually finding a PCP who accepted our insurance, and then got on a wait-list to see the only neurologist in the area who had any expertise with Multiple Sclerosis.

The civilian experience of finding out what was wrong with me took weeks, vs. the military experience, which took just a few mere hours.

There is nothing wrong with either kind of emergency room; in fact, the medical staff at every Emergency Room I have ever been treated at has been wonderful. The biggest differences for me have been the consistent experience at civilian hospitals of having to “hurry up and wait” for results, the lack of coordination of care, and, of course, the extraordinarily large, uncovered bills. Military hospitals universally accept military insurance. Civilian hospitals—not so much.