If your stomach is settled, picture this:
I'm driving with a cell phone shrugged into one ear, an open address book on my lap, and my wife in the passenger seat with her left leg sticking straight up to the car's roof.
She's holding a bloody rag around her left foot, pressing with her thumbs.
Only a yoga instructor, which she is, could achieve and maintain this position for what would be more than an hour.
It being a Sunday evening, I'm calling our doctor's answering service.
My wife slashed the top of her foot with broken glass, I tell the answering service. It's wide open. I'm driving toward Torrey Pines Mesa. Where should we go?
Scripps Clinic Urgent Care, the woman says.
Urgent.
It sounded right. Lord knows the situation was urgent.
When she had screamed my name – followed by Ice! Ice! – I knew it was going to be bad. Blood pooling on the kitchen floor. We stared at the jagged cut that had severed a major artery. We almost passed out in unison.
In pure panic, she hopped to the car, turned onto the seat and elevated her leg in a vertical hamstring stretch, reaching up and holding her foot together in a bloody death grip.
To ensure I'm going to the right place, the answering service connects me to the urgent-care center. I explain that my wife's foot has been sliced open in a freak accident.
Bring her here, the receptionist says. We can take care of her.
We pull in front of the center. I run inside, half-expecting to find a nurse or doctor ready to rush out and evaluate the cut. Instead, I walk into a deathly still waiting room packed with people reading magazines.
The receptionist behind a glass window tells me to fill out an insurance form. I'm welcome to borrow a wheelchair. I might as well have been bringing in someone with a case of hemorrhoids.
In the waiting room, my wife cuts quite a pathetic figure, her leg still straight up with the rag around her foot like a bloody flag.
I go to the receptionist and ask her to please – please – level with me: Should we be in an emergency room? She shrugs. You're here, she says.
“I've been waiting two hours,” a sympathetic woman informs us.
After minutes tick by and the tension mounts, a nurse comes out to call another patient. My wife asks her when she would be checked. The nurse shrugs and says it could be a couple of hours.
That's it. We drive to the emergency room at Scripps Memorial Hospital La Jolla.
As I'm running inside, a nurse comes out on his own, examines the cut and dresses it. He congratulates my wife on stopping the bleeding, thanks to her vise-like pressure and Gumby-like flexibility.
Within five or 10 minutes she is wheeled into an examination room. X-rays show a sliver of glass deep in her foot. Dr. Sean Deitch, an emergency doctor, digs out the glass and stitches inside her foot as well as outside.
As they're discussing antibiotic options, my wife asks him, “What would you tell someone you loved?”
“We're not there yet,” he says, smiling.
“We will be,” she says, smiling back.
Now get this.
The next day, Dr. Deitch called to see how my wife was handling the pain of the cauterization and the 14 stitches.
The moral of this bloody tale isn't that urgent-care centers are inhumane and Scripps Memorial's ER is a five-star godsend.
This is, after all, a scientific sample of one.
No, the point is that it might be a good idea to know what “urgent” means when the panic spikes and you can't think straight.
To this English major, “urgent” means gravely pressing: DO IT RIGHT NOW!
In the medical marketing world, however, “urgent” means practically the opposite: OH, IT CAN WAIT AWHILE.
Dr. Davis Cracroft, medical director at Scripps Mercy Hospital and a veteran ER physician, explained to me last week that so-called “urgent care” is designed for problems that are not 911 – sprains, minor lacerations, infections.
In the event of complex lacerations like my wife's, chest pains, sudden shortness of breath, the worst headache of one's life, the ER is where to go.
Cracroft acknowledges that there's lots of overlap between urgent-care and ER patients. Some end up in an urgent-care center when they should be in an ER – and vice versa. That's why timely “triage” – the prioritizing of patients according to the severity of their conditions – is crucial, both at urgent-care centers and ERs.
Cracroft said someone should have come out to look at my wife's wound within 10 or 15 minutes, tops. But to be fair, there may have been good reasons why the Scripps Clinic center kept us in suspense, he said.
OK, I'll grant that. I don't believe anyone goes into the health care business to make patients suffer physical and mental pain in waiting rooms.
Moreover, it could have been an unusually quiet night at Scripps Memorial. We could have just been lucky that everyone we encountered treated us as if they (almost) loved us.
No doubt, urgent-care centers – more than 8,000 of them operate in the United States – have a secure place in a world where doctor house calls have gone the way of buck-a-gallon gas.
But if your situation is truly urgent, my advice is not to hesitate. Call an ambulance or get yourself to an ER.
And in the meantime, it doesn't hurt to work on the yoga.
Logan Jenkins: (760) 737-7555; logan.jenkins@uniontrib.com.
