Rush

When I was growing up, the expression "emergency room", was always appended to the expression "rushed to", as in "he was rushed to the emergency room".

Of course you got rushed to the emergency room: There was some kind of emergency going on! Either you were having a seizure, or you fell off a ladder and broke several bones, or you were having crushing chest pain radiating down your left arm... And virtually always you were rushed to that emergency room in an ambulance.

Emergency rooms back in the day didn't look like they do today. There was very little regular staff, certainly no dedicated emergency room doctors.  An excellent picture of the 1960's emergency room is drawn by the film Parkland , which tells the story of the doctors of Dallas' Parkland Hospital on November 22, 1963, the day JFK was assassinated.  Every physician called to the emergency room that day (and by the looks of it, by the end, every physician in the house was in that room) had been elsewhere in the hospital prior to the President's arrival.   None were dressed in scrubs or operating room gear. Each was wearing white shirt, tie, and black pants. And each was fairly drenched in the President's blood by the end of the code (which is wrenching to watch).

A lot has changed in 52 years. The expressions "emergency room" and "rushed to" have been separated. Ambulances often bring people there, but more often than not people are driven there by family, or drive themselves (presumably not in mid-seizure).

The expression "emergency room" itself has evolved to "Emergency Department", to reflect the fact that these formerly empty, intermittently used spaces are now fully functional, fully staffed parts of a hospital.

Sometimes the word "emergency" is dropped entirely when one talks about a medical misadventure. The word "hospital" is substituted. "I went to the hospital". "We took her to the hospital".  Well of course, the individual went to the hospital, but not exactly.  They went to the emergency room of the hospital. This may be because of tacit acknowledgment that there was no true emergency, but I cannot be sure.

Why does all this matter?

As I hope to describe in future posts, the transformation of the emergency room into the Emergency Department is central to the story I am trying to tell in this blog. It is a multi-layered and nuanced story and by no means do I intend to distill the many issues down to One Big Thing.

For now, I will observe only that the disappearance of the expression "rushed to" is a symptom of our culture of over-treatment, about which I will have much to say later. There are two foci in the universe of over-treatment: one is the private doctor's office, and the other is the Emergency Department.  How the universe of over-treatment came into being is a long story with many parts.

Stay tuned.