no free lunch, this is america...

So, I recognize that, although I am by no means wealthy, I live a pretty comfortable--and therefore privileged--life. Both S. (husband--) and I work, we live in an area with low cost of living, we have excellent health care benefits, we have retirement savings, we're white middle-class Americans so we don't really deal with discrimination issues, and so on. I really can't say that I know what it is like to be disadvantaged. However, last weekend I had an experience that gave me just a taste--a tiny, tiny taste--of how things might be.

As you read in the intro, I have 1.9 kids--in other words, I'm just about 35 weeks pregnant. Last weekend, I had been experiencing some pretty severe headaches. Headaches in the third trimester can be a sign of preeclampsia, which is pretty serious. At first, I wasn't too worried, because I had my blood pressure taken on Wednesday, and it was perfect. But, my doctor had told me to call if I ever experienced anything strange, so I called. Turned out my primary care OB was the doctor on call, so I got to talk to her directly--this was nice, because she knows me, knows my mindset, and my medical history.

She said that it was probably not related to my blood pressure, since I had no problems previously, and no other symptoms of preeclampsia, but that I should get it checked out anyway. Since I didn't have any other warning signs, she strongly suggested that I not get admitted, but that I go to the emergency room at my hospital, because they had a 24 hour free blood pressure clinic. These were her words, and you see that I am emphasizing them, right? She repeated herself--do not have them check you into Labor and Delivery, but tell them right away at the desk that you are there for the free blood pressure clinic. If there was a problem, she said, then they could admit me.

Okay! I can do that! So, because my head really hurt, S. said he'd go with me. The three of us went over to the hospital. We walked into the emergency room, and it was completely empty in the waiting room. I went up to the desk, and remembering the doctor's instructions, entered into the following conversation:

Admitting clerk: "Hello, dear! Can I help you?"
Me: "Hi...I am here to get my blood pressure checked in the free blood pressure clinic?"
Admitting clerk: (voice frosty, short laugh, roll of the eyes>: "This is not a free clinic. This is the emergency room."
Me: Oh.....because I've been having these problems (relays conversation I had with my doctor).
Admitting clerk: Weeeeellll....yes. We can have people come up and check your blood pressure for you, but they're really busy back there, and I'm not sure anyone would want to come up right now.
Me: ..... (not sure what to say)
Admitting clerk: Have you taken your blood pressure recently?
Me: No, my doctor just told me to come here...
Admitting clerk: Did you want to go up to labor and delivery? Do you have insurance for that? Or are you just looking for the free check?
Me: I'm just telling you what my doctor told me. She said specifically not to be admitted unless there was a reason.
Admitting clerk: What is your doctor's name? (I tell her, she calls L&D to see if the doctor had called in with any instructions. She had not). Well, I suppose you can sit over there (points to triage) and someone will come up.

And she gets me seated, and leaves with yet another eyeroll. Someone did come in and take my blood pressure, which was fine, so the story ends there. Oh yeah, and the card they gave me with my BP info advertised their 24 hour free blood pressure check service on it.

Now this was just a minor issue--I was not refused medical care in any way, and I certainly wasn't treated as poorly as some have been. At the same time, I felt awful--like I had no right to be there, even though I was acting on advice of my doctor. I wish I could tie this coherently into a discussion of the failings of the health care system, what needs to be fixed, and how to fix it...but I'm not skilled enough to write about that effectively. I do know that in a system where more and more are going without insurance, more and more are going to feel marginalized unless something does change.