December 7, 2013.

10 Things Emergency Rooms Won't Tell You

She flung herself into his arms, kissed him almost violently, and a moment later pushed her way through the saplings and disappeared into the wood with very little noise. Even now he had not found out her surname or her address. However, it made no difference, for it was inconceivable that they could ever meet indoors or exchange any kind of written communication.

1. “Patience will get you nowhere.”

Nobody likes a visit to the emergency room. Babies are crying. People are wheezing or moaning in pain. And there’s little relief in watching the worst cases being rushed to an operating room. Nonetheless, more people step into ERs every year, with visits hitting 130 million in 2010, up 34% from 97 million in 1995, according to the Centers for Disease Control. Meanwhile, the number of emergency departments is down about 11% over that same time period.

As it happened, they never went back to the clearing in the wood. During the month of May there was only one further occasion on which they actually succeeded in making love. That was in another hiding place known to Julia, the belfry of a ruinous church in an almost-deserted stretch of country where an atomic bomb had fallen thirty years earlier. It was a good hiding place when once you got there, but the getting there was very dangerous. For the rest they could meet only in the streets, in a different place every evening and never for more than half an hour at a time. In the street it was usually possible to talk, after a fashion. As they drifted down the crowded pavements, not quite abreast and never looking at one another, they carried on a curious, intermittent conversation which flicked on and off like the beams of a lighthouse, suddenly nipped into silence by the approach of a Party uniform or the proximity of a telescreen, then taken up again minutes later in the middle of a sentence, then abruptly cut short as they parted at the agreed spot, then continued almost without introduction on the following day. Julia appeared to be quite used to this kind of conversation, which she called "talking by instalments." She was also surprisingly adept at speaking without moving her lips. Just once in almost a month of nightly meetings they managed to exchange a kiss. They were passing in silence down a sidestreet (Julia would never speak when they were away from the main streets) when there was a deafening roar, the earth heaved, and the air darkened, and Winston found himself lying on his side, bruised and terrified. A rocket bomb must have dropped quite near at hand. Suddenly he became aware of Julia's face a few centimetres from his own, deathly white, as white as chalk. Even her lips were white. She was dead! He clasped her against him and found that he was kissing a live warm face. But there was some powdery stuff that got in the way of his lips. Both of their faces were thickly coated with plaster.

As a result, people are waiting longer to see a doctor: A 2009 report from the Government Accountability Office found that patients whose condition indicated they should have been seen in 1 to 14 minutes, according to Emergency Nurses Association guidelines, waited 37 minutes on average to see a physician. Even worse, those who were supposed to be seen in less than 1 minute were left waiting for about 28 minutes. Crowding can be worse during the holidays, when some hospitals see an uptick in visits from patients suffering from heart disease or from excess alcohol consumption.

There were evenings when they reached their rendezvous and then had to walk past one another without a sign, because a patrol had just come round the corner or a helicopter was hovering overhead. Even if it had been less dangerous, it would still have been difficult to find time to meet. Winston's working week was sixty hours, Julia's was even longer, and their free days varied according to the pressure of work and did not often coincide. Julia, in any case, seldom had an evening completely free. She spent an astonishing amount of time in attending lectures and demonstrations, distributing literature for the junior Anti-Sex League, preparing banners for Hate Week, making collections for the savings campaign, and such-like activities. It paid, she said, it was camouflage. If you kept the small rules, you could break the big ones. She even induced Winston to mortgage yet another of his evenings by enrolling himself for the part-time munition work which was done voluntarily by zealous Party members. So, one evening every week, Winston spent four hours of paralyzing boredom, screwing together small bits of metal which were probably parts of bomb fuses, in a draughty, ill lit workshop where the knocking of hammers mingled drearily with the music of the telescreens.

Hospitals are addressing the crowding by assigning more responsibilities to physician assistants and nurse practitioners and treating some patients without assigning them to a bed. Some hospitals are treating patients more quickly by using a team approach where patients are attended to by a doctor, nurse and registration worker at once who can immediately order needed tests and procedures as well as quickly treat patients with simple cases, says Alex Rosenau, president of the American College of Emergency Physicians, or ACEP, a trade group for emergency physicians.