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Dr. Kenneth Mattox, Harris County Hospital District’s chief of staff, in the emergeny waiting room at Ben Taub. The grandmother, who speaks no English, fusses ceaselessly over the baby, fluffing her small pigtails, or pulling the blanket tighter around her feet. Rebecca’s mother, Irene, is calmer. “You can feel she’s really hot,” she says. “I’m worried, because it’s Friday and I don’t want her to be sick all weekend. But my mother is the most worried. In Mexico, you know, she knew women who had babies die. This is her only grandbaby. So she worries.” Rebecca has made the trip to Ben Taub twice before, once for a fever and ear infection, once for a crying fit that wouldn’t stop. Rebecca is covered by the Children’s Health Insurance Program, and has a regular physician she sees for check-ups a few times a year. But the trip to the pediatrician’s office from the Ramirez home requires three bus changes, and the office closes at 5:30 p.m. Since everyone in the family works, it’s hard to take Rebecca to see him. “I know his name, but I talk more to his answering machine,” Irene says. The bus pulls into the circle drive at Ben Taub, and the Ramirezes climb out. In Ben Taub’s emergency waiting room, they sign a list and sit downto wait. The room is beginning to fill with the usual Friday afternoon rush, compounded by the long weekend ahead. There are many families with children, several pregnant women, and scores of others whose slumps and twisted faces testify to their pain. One old woman passes her hand across her face repeatedly, without pause. A man at the nurses’ desk pleads to have his prescription filled. The nurse’s face glistens from exhaustion. “You can sign the list and sit down,” she tells him. “But this is Friday night. This is a trauma night. The wait for you will be many, many, many hours.” In fact, for “non-emergent” cases at Ben Taub, the average wait to see a doctor is around 12 hours. For those sick or injured enough to warrant a bed in the surgical or medical bays, it is closer to six hours. The most severe cases are seen as soon as possiblea sliding measure that depends on how many beds are open, how many doctors and nurses are on call, how fast the beds are cleaned once they are cleared, and how many even worse cases are already waiting. Trauma experts talk about the “golden hour”the 60-minute window during which, if treated, a trauma patient has the best chances of survival and recovery. After that hour, those chances go down. At Ben Taub, hospital policy dictates a physician see the most serious cases within 30 minutes. But like most emergency rooms in Harris Countyand a growing number across the stateBen Taub is sometimes precariously close to letting the golden hour pass. “We are on the verge of not being able to provide safe care because of the sheer volume of people coming in,” says George Masi, Ben Taub’s assistant director of emergency services. “Because emergency rooms have become in many ways the sole source of care for so many people, they’re just overwhelmed. Every day is a crisis, all day long:’ Toward midnight, a small man with an Astros cap pulled low wheels his wife into Ben Taub’s emergency waiting room on a gurney borrowed from the hospital. She is moaning under her white sheet, a continuous, high-pitched sound like a baby crying. Her husband explains to a nurse at the triage station that she has an abscess on her leg “this size”he shows his fistand that her painkillers aren’t working. She woke herself up with her own screaming nearly two hours ago and hasn’t stopped since. Their 10-year-old daughter stands at her mother’s head, nodding solemnly. The nurse tells the family to sign the list and sit down until their number is called. But there’s nowhere to put the gurney. The father and daughter won’t leave the woman by herself, and so the three stay by the nurses’ station, waiting for something to happen. Ten minutes later a nurse’s aide moves the woman’s gurney around a corner, but you can still hear her. The daughter paces back and forth to the nurses’ station; every few minutes she asks again when her mother will be seen. The nurses try to explainthere are lots of sick people, people who need help right away. Mom has to wait. Fifty minutes later the woman is still waiting, and still moaning. Finally, the family gives up. Her husband curses, wheels the gurney around and heads back down the hall to the front entrance, and out into the parking lot. The girl trails 11/5/04 THE TEXAS OBSERVER 5