Health Care 911
The call comes in and, for the 10th, 12th, or 20th time, paramedics take a middle-aged man from the streets to the ER. Such frequent users cost the emergency medical system millions, yet don't get the help they need. This five-part series examines the problem of frequent users of emergency services. The frequent 911 users in this series are the most chronic users of the emergency room and can defy institutional, government-based, solutions. They will remain a challenge no matter what becomes of the health reform law currently under U.S. Supreme Court review.
John Gonzales
CHCF Center for Health Reporting
With an ambulance gurney cradling his defeated body, Raohl Hursh sought peace with his past inside the frenzied emergency room of the UC San Diego Medical Center in Hillcrest. It was his 29th visit in four years, his 12th in a month, his second in four hours.
"I've already tried to kill myself," the former serviceman with a history of mental illness said, vodka-addled and occupying a room where a beehive of doctors and nurses would soon hover over a heart attack patient. "I’ve killed others. ... So I’m being punished for all this. It hurts. It hurts."
CHCF Center for Health Reporting | April 3, 2012
The engine of Fire-Rescue Co. 7 heaved out of the station on a recent night — wailing past couples bound for the Gaslamp Quarter straight to a man who was sprawled, legs akimbo, on a dirty third-floor walkway.
The address was familiar: a Father Joe's Villages complex. The victim was recognizable: an epileptic man with a history of substance abuse whom firefighter/paramedic Dave Stepp treated blocks away just days before.
CHCF Center for Health Reporting | April 4, 2012
Behind the curtain of an exam room at the UC San Diego Hillcrest emergency department, Dr. James Dunford attempts to coax the truth from a woman who is a stereotype of drug-seeking behavior.
While she fidgets and shivers in a paper-thin exam smock, tears roll down the gentle slope of her cheeks. But there is every reason to believe the patient is feigning stomach pains to receive an intravenous dose of the semi-synthetic morphine Dilaudid — so powerful when injected it is sometimes compared with heroin.
CHCF Center for Health Reporting | April 5, 2012
The pitchman for San Diego’s effort to reverse the cycle of 911 calls from the city’s homeless enclaves makes no apologies for his fiscal-first approach.
Brian Maienschein, commissioner for United Way’s plan to end chronic homelessness, and prospective state assembly candidate, explains: “I’m the only guy in America working on homelessness with a picture of Ronald Reagan on my office wall.”
CHCF Center for Health Reporting | April 6, 2012
The needle kisses Joan Kloh’s skin, and she is about to inject the meth it offers into her weather-beaten, twisted rope of an arm.
She is with street “friends,” who have joined her in feeding various addictions through each doorway of a derelict house. She thumbs down on the plunger in shameful anticipation. But it does not break through. Her hide is too thick, though she jabs again and again at the craving vein.
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