Fall takes columnist beyond UMC headlines

The perspective from above always seems to bring a greater understanding of the magnitude of what's happening below. Whether it's a helicopter traffic report or a satellite image of the Earth, a bird's eye view can be king.

But it only took 7 1/2 feet for University Medical Center's crisis to hit home for me last week. That's how high I was when a misplaced foot on an aluminum ladder let me see firsthand why the county's only public hospital is more than just a debt-ridden albatross and the focus of screeds against both real corruption and a more subtle bilking by illegal immigrants.

One slip and I got the kind of perspective to which few taxpayers are privy.

As my boss put it, my tryout for Cirque du Soleil didn't go too well. Or, as the story got mangled back East by my mother's co-workers, the fall was from a pole -- doesn't every Las Vegas woman work as a stripper?

But the truth is so mundane it is almost embarrassing. I was just trying to save some money by trimming palm fronds myself. One minute I was the savior of our family's budget. The next? Unconscious from the pain while my husband and neighbor both called 911.

In an instant, my attempt to save money turned into the need to save the part of me that earns it.

My brain could handle looking at my wrist once. The fingers were perpendicular to my arm and as limp as an unworn rubber glove. Las Vegas Fire & Rescue and American Medical Response workers soon arrived and worked to collar my neck, splint my arm and tie down a knee that couldn't bear weight.

I asked where they were taking me. I heard "trauma center," and my mind quickly conjured an image of fired UMC chief executive Lacy Thomas.

The pain was intense.

A short and bumpy ride later, I was in the belly of fiscal mismanagement, and I couldn't have been more grateful.

Care was fast. Not because I was in any danger, but because my sorry wrist, bruised ribs and sprained knee were no match for the trauma on its way.

After some X-rays, Dr. Thomas Matz said my wrist would have to be "repositioned." He explained the potential risks of sedation. The public address system called "ortho techs to trauma."

The morphine had kicked in, the sedative had begun working and my last thought was as good as any: Mel Gibson's shoulder dislocation in "Lethal Weapon 2."

When I awoke, suddenly the entire trauma unit came into a clearer picture. I was wheeled to a bay to recover and prepare for discharge. Several nurses asked whether the accident happened at home.

My reply came as a relief, erasing the need for some dreaded workman's compensation paperwork. Across the aisle sat a Supercross racer, knocked from the last race of the season by a spill that cracked his ankle.

To my left was one Spanish speaker who was injured in a car wreck. His pal across from him, who suffered an air bag injury, sheepishly fingered his friend across the way when a Las Vegas police officer asked who'd been driving.

Then a paramedic in training told the extreme racer he'd have to sit tight. The trauma system had been activated. Medics in Mercy Air jumpsuits arrived. Someone mentioned the town of Beatty.

Later there were long faces on staffers unable to pin down the outcome for a 3-year-old involved. That was just one accident.

The doctor authorized my discharge as a nurse struggled to keep another Spanish-speaking woman lying flat until a doctor could determine that her neck and spine had not been injured.

Trauma staff went about working miracles in some cases. They consoled an uninsured woman whose only method of transportation home were her newly acquired crutches.

Two staffers were chatting casually in the closed curtain bay to my right about the second trauma activation of the afternoon. "I just heard from a student that tomorrow's Cinco de Mayo," one said. "And fight night, too."

"Oh, Lord," came the reply.

For the frontline staff, a busy weekend can be a crisis. Few have time to think about the tens of millions of dollars of debt their institution will ring up next year. Yet few can work in isolation from the mismanagement or the public's perception of the public hospital.

One nurse summed it up while tying my sneakers. "We're working hard here. We can't control the management."

Nor can they control who comes through the door.

To reduce the debt, new managers have suggested closing the hospital's burn unit or some Quick Care clinics. Sometimes our best-laid plans to save money end up costing so much more.

Next time, I can hire a landscaper. But there's nowhere else for most of UMC's patients to turn.

Erin Neff's column runs Sunday, Tuesday and Thursday. She can be reached at (702) 387-2906 or by e-mail at eneff@reviewjournal.com.