In the last several months, we as a collective community have experienced the COVID-19 virus, civil unrest, widespread unemployment, wildfires, and political uncertainty. Over 200K Americans have lost their lives to Covid-19. Countless others have been affected by the aftermath of this disease. Healthcare in the United States is at a breaking point. Hospitals and medical centers have become overwhelmed and all normalcy has been replaced by uncertainty. Places that we use to frequent look and appear different. Faces that were once familiar are harder to see behind masks. Things are not as they use to be and may never look or feel the same again. However, when we look through this looking glass closely, we see things that we might not have noticed before. We are a nation in crisis and a nation at a crossroads.
The current estimate is that there are 27 million uninsured in America today. I am not one of them. As of August 2020, there are more than 35 million unemployed in the US. I am not one of them. Disparities in healthcare are widely known. The majority of those seriously affected by Covid-19 are minorities. I am one of them. In the midst of the aftermath of the death of George Floyd, we saw unprecedented acts of unity. However, there is one area in which we still need work and that is systematic and systemic racism in healthcare.
Your blood pressure can be 190/85 and you can explain that you are in extreme pain as I was and you will sit for 13+ hours with no assistance in the Johns Hopkins Hospital Emergency Room (JHH). You will be overly scrutinized, insulted, and blamed for your illness by the head ER nurse who is white. You will be questioned multiple times as to why you are even there and you will be asked where you work, what you do for a living, and if you have insurance.
As a black woman with insurance and a professional job, I had to prove that I was not indigent, had the ability to pay, and even had to state and affirm multiple times that I had a job and plead more than once in order to finally get seen after 13 hours of waiting in the ER lobby. White individuals came and went and even if their wait was long it was not as long as mine. I watched their vitals being checked and all had a BP less than 190 and were treated/admitted or otherwise prioritized over me. After waiting 13+ hours I asked the triage nurse how much longer I would be waiting. She told me that as soon as a bed was available, I would be seen. She then asked me if I had a job. Within 15 minutes of responding yes to her question, I was taken to a room. All of a sudden a bed was available. However, I saw several empty rooms on the floor once I was taken to a room for treatment.
I was seen by an unsympathetic PA and nurses who I don’t doubt were respectful and professional to me at times. However I still believe my level of care would have been better if I had been white. I would not have been treated like I was a drug seeker and just given extra strength Tylenol initially for my pain. I am grateful that I was somewhat believed by one of the PAs that examined me and I did receive pain medication at discharge. However, I have never been required to receive narcotic pain medication through an intramuscular injection (this was at discharge and not during the hours I was in the room while being treated). I believe I was not provided a prescription for the drug at discharge due to systematic racism and would have received one, if I were white. At discharge, I was provided a prescription for a muscle relaxer (not a narcotic).
My question to JH Hospital Management. Why is where I work so important to multiple nurses at JH hospital? Shouldn’t care be the focus? I believe I was labeled as a habitual drug addict or drug seeking black female though I never asked for any specific drug. I only stated that I was in severe pain which was evidenced by my stroke level BP of more than 190. I was even told by the ER doctor that my blood test showed nothing abnormal but at that point my blood had not been drawn. When I requested a referral at discharge, the ER doctor said it might be to far for me to come to travel to obtain follow-up care with Primary Care Physicians at Johns Hopkins. Again, why is this the focus and why is my care not the focus?
I was even questioned at discharge by a nurse as to where I had parked my car? Why was I even asked this? Why is this information important? Should not care be the focus?
I was treated at UM Baltimore Wash Medical Center the next day. I presented with the same exact pain symptoms and even higher BP 192/96. The medical staff there provided me with a narcotic pain killer within minutes of being seen (under 2 hours) and ran the same tests as Johns Hopkins (blood analysis, EKG, and X-ray). I was not required to have a physical exam performed and nor was I subjected to a urine test as part of my treatment. I was treated with an oral narcotic pain killer and then provided a prescription to take at home. I was never once asked about my job, occupation, or ability to pay for services by the medical staff providing treatment. The Doctor did not argue with me about my care and said she planned to rule out things as a part of my treatment. I was treated as a human being and not discounted or dismissed due to the color of my skin or gender. I was treated, paid my co-pay and was discharged without being made to feel as if I had done something wrong in seeking care. Yes, our medical professionals and essential workers are heroes in these unprecedented times when care is the focus.
JHH basically was refusing to treat me every step of the way. I was humiliated, traumatized, chastised by their medical staff and constantly made to prove why I was there in the first place. I was there for pain relief which was evident by my abnormally high BP (over 190 in both cases). I had no other underlying health issues present at the time.
What else could I do to prove that I was not a habitual drug seeker or drug addict to receive fair and equitable treatment at Johns Hopkins Hospital?
The answer is, NOTHING.
