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The opening sequence of the Channel 4 docuseries 24 Hours in A&E once showed a harried receptionist telling a phone caller that the department is open “24 hours a day, 7 days a week, 365 days a year”. “I love that question, ‘what are your opening hours?’”, she joked to a colleague. She was right. The very idea that a facility designed to treat unforeseen calamities might have a schedule is amusing ... unless you’re planning to go posh.
I had reason recently to attend the emergency department of one of Dublin’s private hospitals and was tickled to find that it keeps civilised hours. Opening and closing times within which to have one’s emergencies feels very illustrative of our two-tier health system. Only mannerly catastrophes occurring between the hours of 10am and 7pm and likely subsidised by private health insurance, please. Everything else to the 24-hour drop-in shop.
I spent 10 hours there, which immediately contradicts the idea that the IVs are shut off and the ECGs are packed away on the dot of seven, or that you might be in and out in a jiffy. Doctors were overworked, queues were long, the staff were blue in the face telling everyone the hospital had no beds, and everyone was at their nosiest, including me. Here’s who I saw:
The Phone Lady: Every emergency department has at least one Phone Lady. She’s ringing everyone she knows with minute-to-minute updates. She has a Bad Leg and they think it might be vascular and she hasn’t been able to walk further than the gate since Friday. It’s desperate altogether.
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The No-nonsense Triage Nurse: I could almost hear her eyes rolling in her head after she gave me a form to fill out and I remained luxuriating in the bay with my pen ready and my shoes off. “You can go back to the waiting area, we have more patients to see.” That was me put in my place. And yet, I would die for her.
The Concierge: I’m not sure “Concierge” was their actual title but there was a team of snazzy staff checking people in and warning them of the cost (between €200 and €695 regardless of insurance cover. I know. I was scandalised too). They brought a bit of glamour to an otherwise deeply unglamorous situation.
The Helpful Porter: When I was about 14 I had my tonsils out and a glorious hospital porter allayed my fears on the way to theatre with some daring swerves of the bed and jokes about what they might do with the tonsils once removed. I’ve been a porter fan ever since and was intercepted by one on this occasion on my way to a scan. “You look lost,” he suggested brightly. And he was right, I was.
The Frail Old Man: The emergency department was awash with posters and flyers warning about the dangers of having A Fall. I was right beside an older gentleman when he tried having a fall, but staff and patients alike were able to intercept his glacial stagger before he hit the ground. He later admitted that he was on his way to the tea trolley.
The same doctor I had seen at 11am apologised for the wait when discharging me at 8pm
The Minor Irish Celebrity: After about five hours of waiting came a brief stir of excitement when a sports-adjacent celebrity arrived into the emergency department. I was sure they’d be whisked away to some sort of suite but they were duly informed of a minimum six-hour wait and thus began eyeballing the one available socket from which to charge your phone, just like the rest of us.
The Overworked Doctor: The same doctor I had seen at 11am apologised for the wait when discharging me at 8pm. Having once spent 15 hours on a metal chair in Tallaght Hospital emergency department with kidney stones, her apology was unnecessary. She was kind and thorough and gave me one of her precious MRI slots. An angel.
The Immigrant: Almost everyone I met seemed to have come to work in Ireland from a different country of origin, as is the case with so much of the healthcare system here. We owe so much to these people. There was potentially a cultural barrier when I received my paperwork to go to the MRI scanner and pointed out with juvenile delight that it was called a “ticket to ride”. I deserved the blank stare. The nurse had more important things to do.