Adventures in a Puerto Rican Emergency Room  

Posted by Brock Booher

I watched the waves of the Pacific Ocean lap up onto the beach. Too bad I was in the window seat of a Southwest Airlines B-737 headed to Nashville, instead of Hawaii. It was fall break, and my wife and my two youngest children had just spent a day attempting to fly standby from Los Angeles to Hawaii without any success. Every flight had filled up last minute. (Who buys last-minute tickets to Hawaii?) So, we rallied the troops and decided for Plan B.

“It will be an adventure,” I promised.

Now we were on a flight to Nashville to visit my parents and then head down to Puerto Rico for a few days in the sun. Unfortunately, my bag of snorkeling gear was on its way to Maui. The misdirected bag was just one of many signs that this vacation would be more of an adventure than we bargained for.

After a short night at my parent’s house, we headed back to the airport in an attempt to make it to a beach somewhere. We caught the flight to Baltimore, and killed a couple of hours window shopping in the Baltimore/Washington Airport before we hopped on the half empty flight to San Juan and landed a little before midnight.

Since we weren’t sure that we were going to make it San Juan, and the lady from the Gran Meliá resort had told me they were empty, I decided not to make a firm reservation and risk losing all of my money. When we landed in San Juan, I called them. Now the resort was full. I called the hotel used by the airline crews – booked. So, there I was with my wife and two kids in the baggage claim of San Juan International Airport at midnight without a hotel room. I panicked, a little, and then reminded myself that this was an adventure.

I left Britt and the kids to get the luggage while I grabbed a brochure from the taxi stand and started calling local hotels. By the time we got to the rental car place, we still didn’t have a hotel. The van driver from the rental car recommended a place nearby. He said it was close to the beach and clean. My wife found a pretty good price at the Hampton Inn, but in the end we opted for the driver’s recommendation because we could get two rooms. When we passed the bright lights of the Hampton Inn and turned down the dark street to the Coral Springs hotel, I knew we were in trouble. We pressed on in spite of the warning signs, and when we got to our rooms at almost one in the morning, we found two dingy rooms with window AC units rattling in the night. By then we were too tired to change. Britt warned the kids not to open the door for anyone and we all crashed.

“It’s all part of the adventure,” I said, as I kissed my wife goodnight.

After a fitful night’s sleep, I awoke early the next morning to the hum of the AC unit. I lay awake in bed worrying about getting a room in the Gran Meliá, like we planned. When Britt woke up I started calling. After four attempts, I still hadn’t talked to anyone that could make a reservation for me. I handed the phone to Britt. She tried three times before someone came on the phone. At last, we got a reservation, and the adventure continued!

After a big breakfast at Denny’s discussing our plans, we went back to the airport to see if my snorkeling bag had caught up to us. As we were driving to the airport, Britt started complaining about pain and dizziness. At first, I thought I might be a heart attack, but the symptoms didn’t seem right. We figured it might just be something she ate. She sat in the car with the kids while ran in to look for my bag.

The flight with my bag was delayed, of course. I went back to the car. Britt was gone, and her phone didn’t work. The kids didn’t know where she went. There I was, wife sick and MIA, kids bored, bag missing, still hadn’t checked into the resort. I was tempted to get on a plane and head home. I sent the kids to find their mother, and I circled the airport. It’s all part of the adventure, I kept reminding myself as I tried to stay calm.

When I came back around, Britt was standing against a light pole looking a little Nacho Libre with in his fancy white pants, and a kid on each side. She had lost her breakfast, but was starting to feel better. I got her into the front seat of the car to wait, and I went to collect my errant bag. The luggage carousel went round and round, but my bag was nowhere in sight. I spoke with the Delta employees and after a few minutes they located my bag – about to get on a plane back to Maui. (I thought for a moment that we should join it.) Finally, I got the bag and we headed for the Gran Meliá Resort. Now the fun part of the adventure could begin.

Iguana the size of a small dog
During the drive, Britt began to feel better. We finally began to feel like we were on vacation, especially when we pulled into the main entrance. The street was lined with palm trees and golf courses inhabited by iguanas the size of dogs. When we pulled up to the main entrance, everyone greeted us and made us feel welcome. We all started to loosen up and relax. We checked in and headed out to walk the beach and ended up at the pool playing water volleyball. We sucked down some expensive fruity drinks, and relaxed as the sun went down. That night we ordered pizza in the room, while I did some research on the Internet and found several exciting activities. The adventure was shaping up.
The Gran Meliá

The next morning I went for a nice run. I saw a lounge of lizards on the first tee I passed. The weather was beautiful. We had some great activities planned. It felt like things were finally going to fall into place for a few days of fun. We chowed down at the breakfast buffet and put on our swimsuits. Today was going to be an adventure.

Before we could leave the room, Britt felt sick again. I sent the kids out to explore the tennis courts and workout room while searched medical websites for an explanation of her symptoms. She called a doctor friend of ours in Arizona – gallbladder. According to the websites and the doctor, if the pain and discomfort subsided, the vacation could continue, minus fatty breakfast buffets. She began to feel better and we loaded up the car in search of our beach adventure.

We decided to stop the drugstore on the way to the beach for some recommended home remedies. We had just passed the front gate of the resort and turned on to the main road when my wife got really quiet. When we pulled up to the drugstore, Britt jumped out of the car and starting tossing her breakfast. Powdered eggs have a very unique look when you throw them back up – like yellow cottage cheese.

“Oh crap!” I said as I realized that vacation was over. The real adventure was just beginning.

After emptying her stomach, she had nothing left but bile, and she was in so much pain that she could barely breathe. She was crying and upset. I was nervous and frustrated. I took a moment to vent and rage about how frustrating this entire vacation had been. It was nobody’s fault, but I needed to vent. After a couple of minutes, I shut up, buckled up, manned up, and rushed back to the resort.

When we pulled up to the elegant drop-off area at the resort, my wife jumped out again and started dry heaving on the lawn. Carson and Rylee hurried to the room to get her a change of clothes while I ran over to the front desk and asked for help getting to the nearest ER or Urgent Care. A passing guest was a nurse and calmed my wife by explaining that she was most likely passing a gallstone. The staff kicked into action. A few moments later I was following the van to the nearest urgent care facility, talking on the cell phone to my insurance company, and trying to keep my wife from screaming every time we went over a speed bump. (I swear they have a million of them in Puerto Rico!) It was quite the adventure in driving.

When we got inside the ladies behind the counter jumped into action. (Maybe it was my wife’s screaming.) They got her right back and the nurse took her vitals.
“Está lista.
Out walked a female doctor wearing four-inch, bright turquoise platform shoes with her toenails painted to match. She looked a lot like Jennifer Lopez with her hair pulled back tight away from her face. She looked to be about the same age as my oldest son, and if she took off her white medical smock I’ll bet she would have fit right in at a frat party, or the local salsa club.

After a short review of her patient, she declared, “You have gastritis.”

Now, Britt was not only in pain, but also pissed off. (It was a good thing the doctor wasn’t in reach.) My wife explained that she was not some sort of wimpy drama queen. She had delivered four babies, and this pain was 100 times worse! I’m not sure if the dancer-cum-doctor really understood, but I convinced her to put my wife on an IV for pain, inflammation, and stomach acid. Within a few minutes the painkiller brought her some relief, but the only way to know for sure about her condition was through an ultrasound, and of course, that facility didn’t have one.

I got on the phone with my insurance company, and they found a hospital in network about thirty minutes away. I stood next to the doctor’s office so I could get Wi-Fi and pulled up the map on my iPad. With a little help from the ambulance driver whose Spanish sounded more like machine gun fire, I thought I could find my way there. Back into the car and off we went into afternoon traffic in San Juan trying (unsuccessfully) to avoid speed bumps.

I knew we were in trouble the moment I walked into the emergency room. It was packed with wall-to-wall sickness. Almost every seat was taken. One guy was doubled over in pain. A young mother rocked her coughing baby. A guy walked in with an IV stint and what looked like x-ray films. Everyone stared us with hollow eyes as they waited anxiously to pass through the squeaky steel door to see the doctor.

Every good bureaucracy has to have a gatekeeper to keep it functioning. The gatekeeper of that Puerto Rican emergency room was a young bald security guard with a blank stare and a gun on his hip. “I’ll be witchu in a minute,” he said as he swiped his key card. (At least he spoke English – of sorts.) His official demeanor wasn’t exactly warm and friendly. At last, he took our name, asked about the problem, and put us on the list.

Now the waiting adventure began. We found an empty seat for Britt. I stood.

For about an hour I watched the guard perform his impossible task as the gatekeeper. He guarded the door, signed people in, and occasionally made the rounds. I began to see that his stern look was a façade. I could tell that in spite of the blank stare, he actually cared for people. He approached me and told me that he was working on getting us in sooner since we had already been to the other urgent care. An hour later we saw the triage nurse. Two hours later he swiped the key card for us, and we pushed open the squeaky steel door to the ER. The emergency room adventure had begun.

We walked down the short hallway into a sea of human misery still in our swimsuits. Every open spot in the L-shaped room had a gurney with a patient. Despair and pain were written on every face. The beeping of medical equipment mixed with groans of pain and despair. We stood in the middle of the hallway for a few minutes until someone noticed that we were new and took us in to see the Doctor. He spoke English, and after a short diagnosis, he pronounced that it was most likely the gallbladder. He ordered a nurse to hook Britt up to an IV with the same medications as before. He ordered an ultrasound, and the nurse led us to an empty gurney in the corner of the emergency room.

Britt's "room"
Butterfly above her gurney
Her bed was really a paper-thin mattress on a gurney without a sheet, blanket, or pillow. She was in the corner next swinging doors that constantly slammed open and shut as staff hurried through. The thin curtain that separated us from the next bed was so close that I often bumped into the bed next door when I stood to attend to Britt. The whole scene was a barrage on the senses – antiseptic smell, banging doors, beeping machines, the hum of foreign conversations, the loudspeaker, the dimly lit room, the thin mattress, and the sense of hopelessness and misery that permeated everything in the room like dark sunshine. In the midst of it all they had painted a butterfly on the ceiling tile above her head.

We waited for the ultrasound as the IV drugs began to take effect. I read a book and tried to tune everything out. The ultrasound got done. We waited. The doctor came and told us what we suspected – gallstones – but in addition a stone blocking the duct had caused pancreatitis. (Oh joy!) He explained that they were going to admit her and possibly operate. We waited. The cacophony of misery and chaos continued. We waited. The guard came and checked on us. We waited more. Finally I sought out the Doctor.

It was amazing how I invisible I became when I stood in front of the nurses station. It was like I was a ghost and they refused to believe in my existence, or I had to scare them before they would speak to me. I scared the Doctor and he spoke with me.

“When can we get her into a room?” I asked.
“We can’t,” replied the Doctor. “ We don’t have any rooms available.”
“What do you mean? You said you wanted to admit her.”
“I do, but look around. All these people are waiting on a room as well. It will be sometime tomorrow before we can get her into a room.”

I traipsed back through the sea of misery to face my wife and tell her that she would be spending the night in the corner of the emergency room on a gurney without a blanket or pillow. In hindsight, I should have made the doctor do it. It’s an adventure, right?

“What do you mean they don’t have any rooms?” asked Britt.
“He said all the rooms are full and all these people are waiting as well. What do you want me to do?”
“I want you to advocate for me!”
“I am! But I don’t have control of this situation. Everyone is waiting for a room. What do want me to do? Tell them that you’re more important than everyone else?”

It was her turn to lose it for minute. The stress was too much. She said a few things she didn’t mean (at least I hope not), and stormed off to find the Doctor with her IV in tow. I sat there feeling helpless. I don’t like feeling out of control, but I certainly didn’t have any control of this situation. A few minutes later she came back angry and full of despair. She cried for a few minutes, and I held her while the butterfly watched. Now it was her turn to woman up and face the difficult situation. We accepted the bleak outlook and faced it together, like good adventurers.

I tried to find someone from my church nearby that could come and help me give her a priesthood blessing. (It is customary to have two brethren to administer.) After several hours of trying, I gave up and did it solo. The blessing brought her some comfort. It certainly made me feel better. I couldn’t get her a bed. My smart phone was now dumb without 3G or Wi-Fi. I was a long way from home. Like Peter at the gates of the temple, all I had to offer was the power of the priesthood of God. I was thankful I had that to offer. I went to a nearby Walgreens and bought her a pillow, blanket, and earplugs. I made her as comfortable as humanly possible, and I sat with her until about one in the morning. Then I kissed her and went back to the resort with a prayer in my heart, and faith in the power of the blessing.

While all this was happening, the kids had lounged in the resort playing tennis, swimming, and ordering room service (steak to be exact), but at least they were safe. I slept on the pull-out sofa bed. I woke up before my alarm went off and shaved and showered before heading back to the hospital. I wanted to look more like a guy in charge of his world, instead of a guy in a bathing suit with a three-day beard. I was back in the emergency room by six o’clock. Nothing had changed. She was still tucked away in the corner of the emergency room next to the slamming door waiting for someone to ease her pain. The butterfly hadn’t helped.

The surgeon arrived around eight. He seemed like a competent and caring individual. He felt like it might be best to get Britt home before doing surgery, but he wanted to make sure that none of the gallstones were still trapped in the canal. He told us that she would be moved to a room, monitored, and given an MRI. If all went well, we could get on an airplane the next day with some medications and have the surgery as soon as we got off the plane. We waited. We waited some more. Finally I went to the nurses’ station again – still invisible – and scared a nurse. They sent me down to admissions. Admissions talked a good game and told me that they were cleaning a room for my wife. I signed the paperwork and went back to wait with my wife, and the butterfly.

Around eleven o’clock, it appeared that things were happening. They told me they were moving her to a room. The MRI was ordered. Things looked like they were beginning to move. Britt insisted that I go check on the kids and do something fun with them so the whole vacation wasn’t a bust. Once again, I kissed her on the forehead and drove back to the resort.

When I walked into the hotel room, I told them, “Fate has won every inning so far. We are going to win this inning. We are headed to that secluded beach and going snorkeling.” Thirty minutes later, we were walking through a mosquito-infested rainforest trying to find a secluded beach on the northeast shore of Puerto Rico. 
We beat fate for one inning
Headless Iguana
We passed a headless iguana that stunk so bad we had to run past, but we didn’t stop. Swarms of mosquito attacked us, but we pressed on. At last, the jungle parted and we found ourselves on a pristine beach with only two other people. We donned our snorkeling gear and explored the beautiful reef just off shore. It was an adventure, and we beat fate that inning.
Rylee Snorkeling

When we got back to the car we sent a text to check on Britt – still no room. We texted her back – We are coming to bust you out! After showering and changing, the three of us headed for the hospital on a prison break mission. It was an adventure we looked forward to.

“You are about to experience a room of human misery,” I told the kids as I parked the car. The guard from the night before was back at his post and ushered us through the squeaky steel door. We were bombarded with the same cacophony of sights, smells, and sounds. I made a beeline for the corner through the maze of gurneys with the kids right behind me. Britt’s face lit up when she saw the kids, but I could tell that we needed to bust her out NOW! The surgeon had stopped by and apologized for her suffering, had already signed the release papers and given her various prescriptions to get her home. I went to the nurses’ station and scared them into talking to me. I stood there and refused to leave until the doctors and nurses signed all the necessary papers. Then I grabbed my wife and got her out of that black hole of sickness and misery. It might be an adventure getting her home, but we didn’t need any more excitement in the ER.

That night back at the resort I tucked her into a bed by herself and slept on the sofa bed again. She slept better than in the hospital and the drugs were keeping the pain at bay. The next morning, we loaded up the suitcases and headed for the airport. Everything was going well until I missed the poorly marked exit for the airport. I had enough adventure for a while. I was so mad at myself for missing the turn that I took it out on the steering wheel for a few seconds. (It’s a rental.) I got off the freeway and found my way through the maze of side streets and speed bumps back to the airport. I sped over the bumps in the rental car and pulled up to the front door of the airport two hours early. I got her a wheelchair and left her and the kids to check in while I dropped off the rental car, off property. That turned out to be an adventure.

It was nighttime when we picked up the car, and nothing looked familiar in the daytime. I felt like a rat in a maze as I followed side streets through the local barrio. I stopped to got gas and ask for directions. The attendant was so helpful. “A la izquierda,” was all he said. After a few dead ends and wrong turns, I found it.

Once I got back to airport property, I was in my element. I could feel my sense of control return like Superman after he gets away from an extended stay with Kryptonite. We preboarded, with Britt in a wheelchair, and about ten hours and two flights later, we landed in Phoenix. The adventure was almost over.

My in-laws picked Britt up at the curb and took her straight to the hospital for surgery. The kids and I grabbed the luggage and the car. On the way home, I complimented them for their outstanding behavior during the trip from hell. They put up with all the difficulties with little complaining. They took the setbacks in stride. They helped in stressful situations. All of my children are good travelers. Maybe that’s why we all like traveling so much. They said, “It was an adventure, right Dad?”

When I got to the hospital, they were already prepping Britt for surgery. The hospital environment looked like the Ritz compared to what we had experienced in Puerto Rico. Everything was clean and spacious. For the most part it was quiet. (No butterflies on the ceiling) We waited in relative comfort for her turn in surgery. After a couple of setbacks because of other emergencies, it was her turn for the OR. I kissed her before they wheeled her away and then went to the surgery waiting room. It was already 1:30 in the morning. Around 2:30 Devin, my surgeon friend, came out and told me that everything went well. I anxiously waited for them to let me back into the recovery room, knowing that she would want to see me as soon as she opened her eyes. Around 3 am, they let me in. She was groggy and lethargic, but everything had gone well. After a few minutes I kissed her on the forehead one more time, and trudged to the parking lot like the walking dead. By the time I crawled into bed, I had been up over 24 hours, but at least I knew that the vacation from hell was over.

It certainly had been an adventure.