When the Safety Net Is Stretched Too Thin: ‘The Waiting Room’

Editor’s note: The Waiting Room screened this weekend at the Camden International Film Festival, and is now open at New York’s IFC Center and Laemmle Theaters in LA. It opens in the Landmark E Street Theater in Washington DC 30 November, with a PBS broadcast to follow.

Well, we do provide care for people who don’t have insurance, people — we — if someone has a heart attack, they don’t sit in their apartment and — and die. We — we pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care.

—Mitt Romney

“I’ve had that pain for years, and I’ve just worked with it, I’ve just lived with it,” says Davelo Lujuan. “But the last six weeks it started growing.” Now that x-rays have revealed he has bone spurs, he goes on, “They said they were gonna have a doctor see me, but it’s been a week.” CNA Cynthia Johnson (CJ) shakes her head. “They won’t call you within a week, it may be a month before…” her voice trails off and Davelo looks surprised. “Even though I’m hurting and in extreme pain?” “Well, sometimes,” she begins, then stops. “Yes,” she say, not so simply.

It’s a familiar scene in the emergency room at Highland, the Oakland, California hospital where Peter Nicks shot his documentary, The Waiting Room. Every day and night, patients wait: they wait to be seen, they wait to be treated, they wait to learn diagnoses. They’re expectant and frustrated, earnest and afraid, a complex jumble of feelings the film makes almost painfully accessible.

This sense of waiting shapes the film, filmed over many months and shaped to look like one day. It’s punctuated by close-ups of tense faces and tapping feet, forms to be filled out and blinking computer screens are set alongside long shots of halls lined with gurneys, people waiting for beds, doors opening and closing, rows of chairs, filled. People talk on their phones, share stories (“So, like, that just kind of like puts things in perspective, you know, like maybe how long you guys could be waiting: even with a referral we’ve been waiting like three days, four days”), and pray (“He needs to be healed and clean in the name of Jesus,” says one woman, before she tells the nurse, “He got a bullet in him that they left when he was shot two days ago. He’s numb”).

Waiting is a combination of delay and expectation, an eerie sense of time slowed even as stakes are raised. A little girl comes in, her face swollen and her breathing labored. Her parents stand nearby as a doctor asks questions. Is she taking medications? Does she have medical problems? Her father wears a Comcast jacket, and in voiceover, he frets. “It’s the first time I’ve gone almost a year without a job,” he says, “It just seems like a letdown when you have to depend on someone else, without the means to do it yourself, you know, the right way. It’s okay, I’m glad there’s a way to provide, to help out, but I wish there was another way.”

For now, no other way seems imaginable. Hearing that his daughter’s heart is racing and her temperature is 105, his voice rises, as you see a close-up of little Deja, his hand on her shoulder. “She’s gonna be okay, big papa,” CJ’s voice interrupts. The camera cuts to her fingers flying over a keyboard as she talks: “Why you gonna stand there and talk about her like that, over her little head?” Cut to a shot from over CJ’s shoulder, as she jots down notes and advises, “You be cool with it. You’re supposed to be the shield.” In a tight frame, Demia smiles at his daughter, agrees with CJ, then takes a very deep breath.

While patients wait, doctors and nurses rush. Each day, they’re making judgments on cases that might need more attention and longer term attention than they can offer. As Dr. Douglas White puts it, the appeal of working ER might have once derived from media images, where it appeared a n intense, high-adrenalin, nonstop-action world.” Though the staff at Highland does see gunshot wounds and car wrecks, they also deal daily — and for hours on end — with patients who have nowhere else to go. This is a function of the state of US health care, from insurance to funding to numbers and types of doctors coming out of medical schools. “Unfortunately, we see a lot of patients coming in with very treatable conditions who don’t have access to regular doctors,” he says. “I know that I can make someone better in the short term, but the ER is not the place to manage someone’s overall health. It’s gonna require a heck of a lot more follow up than I can provide.”

As Doug makes deals and extracts favors from other doctors he knows, other staff members have to figure out how to get people looked at in the first place. Eric Morgan comes in with a testicular tumor, which a doctor at Kaiser has told him needs surgery “as soon as possible.” But after performing the tests, Kaiser can’t provide the treatment they prescribe, he’s been told, because he’s not a member of the HMO. And so now he’s arrived at the ER, with an urgent condition, and no way to pay for it. He and his girlfriend repeat their story and watch carefully as a social worker does her best to make something happen, as close to now as possible.

The film showcases other patients on other verges who embody this upside down world, where insurance policy — or more accurately, lack of coverage — ensures that emergency care must replace long term health care. Little Deja begins to cry when a nurse approaches her with an IV Needle. Her mother explains to her the purpose of the needle, holds her hand, tells her to pinch her when she feels the pinch. When Deja’s breathing turns fast and shallow, both her mother and the nurse ask why, ask what she’s feeling. “I’m trying to take the pain,” she explains, her eyes wide, wise, and extraordinarily calm.

A 44-year-old man (his high blood pressure, among other things, makes him look older) comes in, having had a stroke two days before. He looks wan and frail on his hospital bed (and you realize he’s lucky to be in one), as he tells Doug, “I’ve been falling. I fall about 10 times. Sometimes it makes me laugh.” It’s his first time in a hospital, and for that, Doug congratulates him; afterwards, he scrambles to make sure he receives treatment, a month from now, but, he says, “We have to take what we can get.”

Doug’s pragmatic approach seems a function of just such situations, conjuring stopgap, “Sometimes,” he says, “I have to admit them as much for their social conditions as their medical ones. It’s not ideal, but we’re a public hospital, we’re the safety net in society. We’re an institution of last resort for so many people.”

The Waiting Room makes this much plain, in images pulsing with pain and compassion, framed to show constraints and also courage. Their stories are endless, many of the subjects here don’t even speak, only sit and wait. As impossible as each day must seem, for doctors, nurses, and patients, the waiting room is an ongoing process.