'Waiting Room': Hundreds a Day Seek Hospital of 'Last Resort'

Oakland's Highland Hospital ER is overwhelmed with 241 patients a day.

September 24, 2012, 5:21 PM

Sept. 25, 2012— -- Eric Morgan, in his 20s and planning to get married, arrives at Highland Hospital's emergency room, shaken that he has been diagnosed with a testicular tumor that is likely cancer.

Surgeons at a private hospital have turned him away for lack of insurance but tell him it's "urgent" he get care.

Demia Bruce -- out of work for a year -- anxiously waits in the same ER with his 5-year-old daughter, her face swollen and burning with fever.

Carl Connelly has overdosed on drugs and alcohol, and Davelo Lujuan can't bear the pain of his spinal bone spurs. They, too, wait.

A provocative new documentary, "The Waiting Room," is a snapshot of Highland Hospital in Oakland, Calif., one of the nation's busiest safety-net hospitals, which is stretched to the limit with 241 patients a day, mostly uninsured, who need medical care they can't afford.

The film, directed by Peter Nicks and getting Oscar buzz, opens at the IFC Center in New York City on Wednesday, Sept. 26 and in the greater Los Angeles area at Laemmle Theaters in Santa Monica, Pasadena and Claremont on Friday, Sept. 28, before showing around the country. "The Waiting Room" will also be aired by PBS in 2013.

Nicks follows 24 hours in the lives of artists, small business owners, factory workers and unemployed parents who have been hit hard by the economy -- and hit harder still by a healthcare system that has left them out.

"Bring your breakfast, lunch and dinner -- everything honey," an African-American patient who has been waiting for days to see a doctor, tells a new arrival.

They take a number and they wait, sometimes coming back two or three days in a row. It might be months before they can get a doctor's appointment. With only one operating room, the most urgent cases go first and the rest wait. A man with a survivable gunshot wound has waited two days to be seen.

"It is the place of last resort," said Nicks, 44, whose wife is a speech therapist at Highland Hospital and came home with stories of patients' troubled lives.

"Historically, these hospitals serve the indigent, the homeless and the mentally ill -- the population on the fringe of the system," said Nicks.

But today, patients who are down on their luck also come in to have their prescriptions refilled or to be hospitalized when a disease like diabetes has escalated.

"These people are using the waiting room as their doctor because they have no continuity of care," he said. "More and more people are losing their jobs and are showing up at the public hospitals."

One Asian immigrant stopped taking his blood pressure medicine because of the cost and had a stroke.

Lujuan, a carpet layer who took a pay cut, bemoans his life as an unemployed daughter moves back home. He returns to Highland for his back pain: "I can't sleep at night -- the muscle relaxers don't work… My checking account is down. I don't know what to do."

Some of the best-trained doctors in the country, from schools like Harvard Medical, do their residencies in trauma at Highland, according to Nicks. Though the care is exemplary, these safety-net institutions are at risk for survival.

Florida's Gov. Rick Scott has waged a campaign to cut safety-net hospitals to close budget deficits. Just last March, he closed A.G. Holley hospital, a 100-bed institution in Palm Beach County specializing in tuberculosis. In April, a TB outbreak among the homeless caused 13 deaths.

Those who wait and those who work long hours to care for them cope with sickness, bureaucracy, frustration and difficult choices, but Nicks finds hope in the system. The nurse assistant who is the patient's first point of contact, Cynthia Johnson, has both compassion and humor in this overwhelming environment -- and the patience of Job.

Johnson, a cheerful African-American with pink glasses, takes pride in being able to "spell every name, no matter what country."

Some patiently wait in line and others jump the queue, losing tempers and swearing at the overburdened staff.

"Get a grip," Johnson firmly tells one aggravated man, without losing her temper. He waits.

To director Nicks, she is the "symbol of the system and what we all want in our care -- an empathetic, caring individual, who sits down next to you and says, 'How are you doing?'"

Highland Hospital Staff Have 'War Mentality'

In such a high-stress environment, it would seem logical that doctors and nurses would also burn out. But Nicks said, "We didn't see a ton of that."

"What's more revealing is that these doctors at public hospitals are a very unique group of people, a self-selecting group. They could choose to go elsewhere and make a lot more money, but they don't. It's akin to M*A*S*H*, like they are in a war -- they have that mentality."

"They love it, thrive on it," said Nicks. "You have to be wired a certain way to treat someone with empathy that smells and curses at you."

Nicks didn't want his film to be a typical "disaster documentary" like "Waiting for Superman" or "Sicko," but storytelling.

"At this moment the health care debate voices are dominated by journalists and politicians and pundits," he said. "This is the voice of the people on the front lines."

"The waiting room was a metaphor for me," he said. "What are you waiting for? It really struck me that people wanted to talk about who they were."

Nicks dispels the myth that safety-net hospitals are free. The carpet layer with bone spurs who finally sees a specialist, but earns just a little too much to qualify for Charity Care, takes home a large bill for Highland's services.

Nicks shot 175 hours of raw footage over months, but captures just a day in the life of several characters in the hospital waiting room.

He previously worked as a staff producer for ABC News, as well as for the PBS series, "Life 360."

"Some of the best scenes were not in the film," said Nicks. "In the end we wanted to make sure the patient population was represented in a diverse and accurate way."

Now he is creating an interactive digital project to continue the work of the film so people in waiting rooms across the country can share their own stories. "We want to collect cultural data that is valuable for the hospital," said Nicks.

Most of all, he said he hopes that the film will bring attention to the nation's ailing healthcare system just as the United States begins to roll out the contentious Affordable Care Act.

"I am not a policy expert and not even remotely a healthcare journalist," he said. "But what we do know from talking to people is that there is a lot going on behind the scenes … It's important to understand how the health care law affects the community and those served by the public hospitals."

As for Demia Bruce, his daughter was luckier than the son he lost at the age of 2 from a seizure. She was diagnosed with strep throat, given antibiotics and sent home.

Carl Connelly, whose drug addiction had sent him to Highland on repeated occasions, could not be released because the pastor who has given him shelter would not take him back. Connelly took up precious space in a bed that might have been given to another waiting patient.

The story of Eric Morgan, who is last seen standing alone and bewildered in the hospital parking lot, ends well, according to Nicks. Morgan was able to wade through the system and qualify for Charity Care and a $30,000 surgery revealed his tumor was not cancerous.

Morgan, who had banked sperm just in case, has since married the woman who accompanied him in such distress to Highland and they now live and work in Hawaii.

"We are all connected," said Nicks. "And we can't forget that. Insured or not, we must share the same values."

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