Thursday, October 29, 2009

Viva America

Everyone, welcome a new guest blogger...NiceDoc. He really is one of the nicest people I know. As far out as his story might sound, I have experienced the same thing 2 different times in the last year. Enjoy, ER Doc
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It was thirty minutes before the end of my shift. I had almost tied everything up and was planning on leaving on time for once. Out of nowhere, paramedics burst through the doors of the ER with a very sick patient. The patient was a 400-plus pound intubated Mexican man. No one in the ER knew he was coming in. We always get an alert when an ambulance or helicopter are on their way to us. With this case there was no report, no one called ahead, NOTHING! As the paramedics came closer, I noticed something out of the norm. All of the paramedics were Hispanic, and the writing on their uniforms were in Spanish. "This can't be what I think it is," I thought.

So as we got him into our critical care room, we learned that he was in a Mexican hospital for the past week and his family was disgruntled with the care he was receiving there. The doctors tried to transfer him to us a couple of days prior, but our hospital refused (It's not a law that we have to accept transfers from other countries). So after being rejected, his family paid a large some of pesos to rent a jet to fly him to the states, and had a helicopter waiting once they landed to transfer him to our hospital. That explained why we didn't receive any advanced notice of the patient. It was an illegal transfer, and the chopper just landed on our roof!

Not only was the patient critically ill and on the ventilator, he was unstable. The only history we had was a patient summary from his hospital stay in Mexico...and it was hand written in Spanish. His oxygen saturation was low despite being on the vent, his blood pressure was low, and his heart rate was through the roof. He had medications hanging through an IV, but the IV wasn't working! It was a mess. Eventually we stabilized him, and he made it to the ICU.

What's going to happen to the Mexican hospital? Nothing. They don't abide by our country's hospital ethics laws. What's going to happen to the patient? I don't know, but I do know that we just inherited all the substantial medical costs to take care of this unfortunate gentleman... and I left my shift and hour and a half late :)

-NiceDoc

23 comments:

"Red" Merriweather Coast said...

"The paramedics were all Spanish"

You mean Mexican, don't you? Or was it the Spanish Inquisition?

xx said...

I'm pretty sure it says 'all of the paramedics were Hispanic' and then says that the writing on their uniforms was in Spanish...

Marco said...

I hope the hospital bills the family for everything! If they can afford a plane and a helicopter, they should be able to afford the care.

Anonymous said...

ITA with Marco..and it is too bad that someone couldn't have stopped the chopper on the roof. I am so tired of iillegal immigrants that are already HERE when they get hurt and run up millions in never-to-be paid bills, but to import one already critical??? GRRRRRRR!

Pattie, RN
(no longer working in FL for this reason)

Anonymous said...

Isn't there any law about foreign aircraft landing in our country. That Helicopter should have been impounded then maybe, sold to pay for the care of this patient.

Anonymous said...

It sounds like the family could afford the care. I wonder why the hospital wouldn't just take him as a patient in the first place but just require a substantial upfront deposit to pay for his care. If they wanted it bad enough to do what they did, they probably would've gone for this option.

j said...

Too bad you guys couldn't keep the helicopter as payment.

Doctor D said...

"You mean Mexican, don't you? Or was it the Spanish Inquisition?"

NO ONE EXPECTS THE SPANISH INQUISITION!!!!

Anonymous said...

This pisses me off.

Anonymous said...

Illegal mexicans suck. The mexican women are the worst patients. They come in "ah, ya, ya" and need extra attention to run up a 4 grand ER bill for reflux. It's pathetic.

Milk Chocolate Midwife said...

It's pretty unsettling to read some of these comments that either border on racism or are downright hateful. And from medical professionals who should treat the PERSON regardless of race, nationality, ethnic origin, etc., it's a shame.
As the child of immigrants (legal and citizens of the US since the 1980's), I understand why people come to this country. I do understand that illegal immigration puts a burden on our systems be they medical, educational, or whatnot. I also understand that if it weren't for immigrants (legal or not), many jobs and services that we value but rather not do wouldn't get done. And if it weren't for our own capitalist greed/American foreign policies, many impoverished countries could pull themselves out of the crapper eventually. But hey, somebody's gotta be poor so that we can be rich, right?

It's sad when people who are educated and should know better make comments disparaging immigrants. How many of us are decendants of the original inhabitants of this land? If it weren't for immigration, legal or not, many of us wouldn't be here to complain about others who just want the same opportunities that we take for granted.

Anonymous said...

Yes but most cultures don't promote dramatic women and tolerate it. Asians and polish don't call 911 for gerd nor do they come in screaming bloody murder. I have yet to see another culture as bad as Mexican females. Other immigrants are tough. Oh, by the way, Mexican men are nothing like their ah ya ya counterparts. Hispanicus hystericus!

Anonymous said...

Can someone get that MidWife gal a Xanax or something?? News flash, honey---America is sick and tired of illegal aliens and even sicker of having to press "1" for English. Yep, my great grandparents were immigrants--legal ones with jobs who came through Ellis Island. And our family speaks neither German nor Gaelic....Hablemos INGLES!!

Anonymous said...

I have no problem with immigrant legal or illegals. My problem is with illegals who demands service and demand us to change our laws to accomodate their illegal status.

BTW, why are hispanics so proud of speaking the Spanish Language, isn't this the country that bastardized your country, raped your women and destroyed your culture? When are you going to be totally independent of Spain, really.. have some pride in your own language and have some respect for the language of your chosen country.

Doctor D said...

Well now that everyone is using this post to spout off about Hispanic immigrants I figure I would throw my 2 cents in:

In my experience as both a primary care and ER doctor I have generally found Hispanic immigrants (regardless of their legal status) to be far more reasonable, more stoic, and less demanding than other patients. As any healthcare worker can tell you a lot of people we see are whiny, demanding, and rude. I have never seen such uncouth behavior from the Hispanics in our area. I have rarely had a Hispanic come in without a serious problem. Hispanic patients I have seen tend to be hard-working family-oriented people who I would am happy to have as part of our community. I think native-born Americans in our area could learn something from the work ethic and stoicism of my Hispanic patients.

It may be different in other areas, but my observation is that here the immigrants are excellent citizens and not misusing the system at all. (I work in an agricultural area with a lot of illegal workers)

Anonymous said...

You must not be treating hispanic females then. Hispanic males are very stoic and hard working. Hispanic females make horrible patients b/c they have every positive review of system- chest pain, shortness of breath, fingers always numb, cough, fever, stomach pain, and always a headache. I cringe when I have to see a dramatic hispanic female b/c there's nothing stoic about them. What angers me is that most of the patients have been in the USA for at least 5 years and come in, without an English speaking person, and demand services in their native language. If I lived in Mexico for longer than 6 months to a year, I would learn Spanish! "Spanish only" patients take twice as long to treat b/c you have to wait for a translator.

Anonymous said...

I've even have Hispanics come into the ED asking for glasses? Tell me how this isn't abuse of the system? I've also had Mexicans drive hours straight from another mexican hospital to get a "free" cath for their heart disease. They think its "free" but US tax payers are funding their "free" health care. I think we should be able to write on the discharge- discharge to INS and then we should be able to call INS for deportation.

Trust us....we're doctors said...

I have to agree with the hispanic panic thing. I am a hispanic doctor so this is without bias. they usually have "pan positive" review of systems. Very dramatic. My family is the same way. I dont know why. Like last night had a mexican lady with a good chest pain story...but then in the middle of it she went into her toes tingling and something moving around in her ear and the pain in her knee. It unfortunately automatically decreases your suspicion for them having something serious. if you ask them do you feel "X", they will say yes. For more fun on this matter, check out our previous post about "stereotypes" from febuary 09.
http://serenitynowhospital.blogspot.com/2009/03/stereotypes.html

-ER Doc

Book em danno said...

On the positive side, they were able to take the 4 kilos of "pure horse" he was smuggling in his gigantic ass and sell for a huge street value and pay off all the debts. Ahh I do love a happy ending.

EMT Cracker said...

"I also understand that if it weren't for immigrants (legal or not), many jobs and services that we value but rather not do wouldn't get done."

That's a BS argument. Illegals drive down wages, if not for illegals, then companies and farms would be forced to pay a wage that people would work for. Supply and demand.

"And if it weren't for our own capitalist greed/American foreign policies, many impoverished countries could pull themselves out of the crapper eventually."

Except for the fact that almost all 3rd world, most 2nd world, and even some 1st world countries are ruled by greedy, corrupt, dictators that line their own pockets. We give more food and financial aid to the world than the next five countries combined.

Trust us....we're doctors said...

Here is one of the things that I need to point out in this situation.

If an ER in the USA transferred a patient in this scenario, it would be an EMTALA violation. The transferring hospital would probably lose all Medicaid/Medicare funding.

Since it was a transferring hospital from another country, we have to be compassionate and accept whatever comes our way.

This is the real reason, and only reason, that this is any kind of cultural/racial issue.

Otherwise, any of us would be pleased to treat this patient. That is what we all signed up for.

It is when other countries are held to different standards that upsets me.

- Psych doc

Eileen said...

Bit late I guess - but your Polish immigrants don't call 911 for nothing, eh? Would you like to swap for a few of ours please? The London Ambulance Service is struggling partly because of the number of that particular nationality who are found asleep on a bus (almost always drunk) or absolutely legless on a sidewalk by innocent MOPs who think they've had a stroke or fit or call 999 themselves because they would like a nice warm bed in the local ED whilst helping themselves to alcoholic handrub as a snack drink (I kid you not). Not to mention the large number of couples who came to Britain to have their babies free on the NHS when the pound to euro exchange rate was quite healthy but who have now gone home now it is nearer 1 to 1. Lots of them don't waste their time learning English either.

Anonymous said...

No, thanks anyway Eileen. We have plenty of our own who operate with that modus operandi! We call it "3 hots & a cot" Are you sure you are in England?

What disturbs me about this situation is the attitude that they can just waltz into our country, to do & get whatever they want. This is not Mexico!
When we go to another country we must abide by the entry rules. That's the way it should be for foreign nationals coming here.

Roozter