Thu Jun 14th, 2007 at 04:53:28 PM EST
They refused to treat the woman and ignored her, even when she was in agony and couldn't walk. They ignored her husband's pleas, even while she was collapsed on the floor from the pain. When she vomited up her own blood, the janitor came out and mopped around her as though she were a piece of furniture.
Edith Isabel Rodriguez was a 43-year-old mother and grandmother. She died May 9 of a perforated bowel at the emergency room of King-Harbor Hospital in Los Angeles. But let's face it -- people die all the time, and her medical condition, while serious, is not uncommon. What's more unusual in this case is the seeming callous disregard with which the hospital treated her. Or didn't treat her.
Desperate, her boyfriend called 911 from the pay phone outside the ER. Eight minutes later, another patient called 911 begging for someone, anyone, to help Edith Rodriguez. Finally her boyfriend found someone interested in Edith -- the police. They arrested the dying woman on a warrant, assuring her boyfriend they'd give her medical treatment.
There's no doubt Edith Rodriguez died of her condition as she was being wheeled from the ER to the police car, but she did not have to die. Edith Rodriguez was killed by something else.
It would be normal to suspect our broken health care system, but the fact is that this woman did have access to medical care. She didn't die because she couldn't get care. She didn't die because she waited too long. She went to the hospital three times in the days leading up to her death.
It could be argued that racism, classism and poverty played a part in killing Edith Rodriquez. King-Harbor Hospital serves the Watts area. It was in fact built as a response to a study showing lack of healthcare in the community was a contributing factor to the Watts Riots. The hospital treats 49,000 emergency patients a year. In 2003, it handled over 2,300 gunshot wounds.
As with inner-city schools, it is underfunded while a fortune has been spent studying it. In the wake of this and other incidents, there is mounting pressure to close the hospital, leaving the communities it serves without medical care.
Listen to the tapes of the 911 calls and you'll hear the boyfriend speaking Spanish through an interpreter. "My wife is dying and the nurses don't want to help her out,"
Listen to the second call. You'll hear what sounds like an older African-American woman speaking with a white male dispatcher. You'll hear the voice of prejudice, bigotry, a closed mind -- the refusal to believe, listen, or reason -- this is the brick wall that minorities and the poor try to tell people about and that's so hard to explain.
Dispatcher No. 2: What's your emergency?
Caller: There's a lady on the ground here in the emergency room at Martin Luther King and they are overlooking her, claiming that she's been discharged, and she's definitely sick and there's a guy that's ignoring her.
Dispatcher: Well, what do you want me to do for you, ma'am?
Caller: Send an ambulance out here to take her somewhere where she can get medical help.
Dispatcher: OK, you're at the hospital, ma'am. You have to contact them.
Caller: They have a problem, they won't help her.
Dispatcher: Well, you know, they're the medical professionals, OK? You're already at a hospital.
Caller: But you can still send an ambulance if that's my request.
Dispatcher: Well, if you're not pleased with the result you're getting from them, you know, we can't....
Caller: It's another patient. I'm not pleased with the result that I'm getting from 'em but it's another patient that's sicker, and did you know she's down, all down on the ground....
Dispatcher: If you have a problem with the quality of the hospital, OK, you have to contact the hospital supervisors, OK, and let them know. The police have nothing to do with that, ma'am. This line, 911, is used for emergency purposes only.
Caller: This is an emergency.
Dispatcher: Life-threatening emergencies. It is not! OK? If you want to call us back on our business line, I'll give you the number.
The dispatcher informed the woman it wasn't a criminal matter, to which she replied that it would be if the patient died. The LA Times says the call ended on this hostile note:
"May God strike you too for acting the way you just acted," the frustrated caller told the dispatcher, just before 2 a.m. on May 9.
"No. Negative ma'am, you're the one," the dispatcher responded before disconnecting.
As bad as that is, as difficult as it is to hear or comprehend, the 911 dispatchers are not the ones who killed Edith Rodriquez. In essence, they were correct -- Rodriquez was at a hospital and professionals were right there. Neither did underfunding or overwork have anything to do with the death. Rodriguez did not die unnoticed or because of a mistake or a long wait. It's clear she had been seen and treatment was not delayed, but refused.
So what did kill Edith Rodriguez? What can account for the seemingly inexplicable actions of the emergency room nurses and workers? What would make people show such indifference to the sufferings of a fellow human being?
I suspect Edith Rodriguez is yet another casualty of the Drug War. Collateral damage, to the DEA's way of thinking. The clues are all right there in the articles.
The Drug Enforcement Agency has been very busy these past few years, expanding the Drug War front into the medical community. Churning out propaganda and arresting doctors. The DEA advises, practically orders, medical personnel to act just like those involved in the Rodriguez case acted.
The DEA gives out pamphlets detailing signs of abuse and instructs doctors and nurses that "You have a legal and ethical responsibility to uphold the law and to help protect society from drug abuse." That may sound innocuous, but what they are telling our medical professionals it to withhold treatment for people they suspect of fulfilling the DEA's criteria.
You'd think that this criteria would be pretty strict. Instead, the DEA is creating a new Bogeyman -- the "drug-seeking" patient. Out of the 10 common drug-seeking behaviors listed, 9 are open to interpretation and could have explanations either entirely innocent or due to the patient being in pain.
Unusual behavior in the waiting room;
Assertive personality, often demanding immediate action;
May show unusual knowledge of controlled substances and/or gives medical history with textbook symptoms OR gives evasive or vague answers to questions regarding medical history;
Reluctant or unwilling to provide reference information. Usually has no regular doctor and often no health insurance;
Will often request a specific controlled drug and is reluctant to try a different drug;
Generally has no interest in diagnosis - fails to keep appointments for further diagnostic tests or refuses to see another practitioner for consultation;
May exaggerate medical problems and/or simulate symptoms;
May exhibit mood disturbances, suicidal thoughts, lack of impulse control, thought disorders, and/or sexual dysfunction;
Only the last item on the list -- "cutaneous signs of drug abuse, skin tracks and related scars" -- is unequivocal.
The DEA further describes these patients' MOs, all 12 of which could have alternate innocent explanations. They include wanting to be seen right away, coming in after hours, asking for an early prescription refill, exhibiting symptoms that may make your doctor feel sympathy, exhibiting anxiety, stating that things like aspirin are not helping you, and not having a primary care giver.
Suspicious conditions include uterine pain, toothache, back pain, abdominal pain, or headache. Any of which can and should be treated as a red flag, according to the DEA. Combined with more than one or two things on the lists, these things trigger the legal obligation to "uphold the law" and keep drugs out of the community.
This propaganda by the DEA has been successful in scaring the bejesus out of medical professionals to the point that study after study shows that US hospitals widely under-treat pain. The DEA's "Red Flags" of "Drug Seeking Behaviors" are widely known and discussed by doctors and nurses. Tagging charts with code words is commonplace. Rarely do the charts contain the accusation "DSB" outright, but rather patients have notations of "difficult" and the word "complains" is used frequently. In one survey, 67.6% of emergency nurses admitted using the term "DSB" in conversation with other caregivers, but 93.2% denied using it in charting.
Was Edith Rodriguez a victim of this kind of profiling? I believe she was. She had abdominal pain, flag; she visited the emergency room multiple times, flag; she was assertive (one of the nurses described her as "demanding"), flag; she asked for immediate action, flag; she arrived after business hours, flag.
We don't know how many other categories she inadvertently fell into -- did she have a primary care giver? lack insurance? did she tell them aspirin wasn't working or ask for an early refill? did she seem sufficiently interested in the diagnosis, or was she only expressing interest in getting relief? was she vague and confused? or too specific? was her behavior unusual?
Clearly, the ER workers didn't believe she was sick -- they thought something else was going on. A nurse described her as a "complainer." When the police arrested Rodriguez, a nurse said "Thanks a lot, officers. This is her third time here." Perhaps they suspected her of "feigning" or "exaggerating" symptoms as they coldly watched this mother of three writhe in pain.
Perhaps they'd written Edith off as just a drug addict, undeserving of humanity or respect, as she lay dying on their floor.
Crossposted from Unbossed.