Celebrating Laura’s Law

Written by: Laura Beretsky

July 15th marks the six-month anniversary of Laura’s Law, which sets standards for signage, lighting, security monitoring and intercoms outside locked hospital doors.[1] That it took somebody dying outside the E.R. to require these obvious essentials is a sad statement about our medical system. The law was championed by journalist Peter DeMarco, whose 34-year-old wife Laura Levis died of an asthma attack outside a local Emergency Room. She had taken herself there at 4:00AM in September 2016 but called 911 when she couldn’t find the unapparent entrance. Sadly, the ten minutes between Ms. Levis’ call, and when she was found in cardiac arrest cost her life.

Mr. DeMarco published a Boston Globe article detailing her story in 2018[2]. Reading the details of her preventable death, I was horrified and spellbound, struck by the systemic patient powerlessness built into the medical emergency system. I’ve had my own challenging experience accessing hospital’s emergency services, and while it wasn’t fatal, it was similarly subpar.

On June 28, 2014, I was taken to the emergency room where the neurosurgeon on call performed a life-saving craniotomy to remove a subdural hematoma. I woke up the next day woozy and disappointed. I have a history of seizures, and the hematoma had developed following an elective brain surgery I’d had two months prior.

I was surprised when the hospital discharged me the following day – I’d just had my head cut open, after all. I felt vulnerable because I was: I was readmitted to the same hospital two more times that week following grand mal seizures. The second time was an hour after they’d released me. It was the Esplanade annual fireworks night, so my husband, Mark and I decided to avoid traffic and take the subway home. Two stops after boarding, I felt tingling neuropathy in my left hand -the same precursor for the seizures I’d recently had. I wished I were back at the hospital!

“I’m afraid I might have another seizure. We need to get off at the next stop,” I told Mark. Approaching Harvard Station, I anticipated the train’s brake, and tried not to freak out as the tingles in my hand traveled up my arm. The last two grand mals didn’t kick in right away. I will probably make it to the hospital, I thought. “Maybe we should call 911,” I said exiting the train.

“No, traffic is miserable because of the fireworks. It’s only three stops - let’s take the train,” Mark said. Based on the past week’s experience, if I were about to have a seizure, we’d make it on time. Financial calculations bolstered my timing estimates: Health insurance wouldn’t cover an ambulance bill. We took the train, arriving at the T stop in ten minutes. During that time, the tingles had traveled up my arm and onto my face. I was coherent, but terrified - my body was succumbing to a seizure’s bedlam. Mark escorted me through the hospital lobby to the reception desk.

“My wife’s having a seizure. She needs help,” he urged. The administrator looked at us like we were from Mars.

“What’s your name?” she asked me.

“Laura Beretsky.” I was lucid, but the prickly sensations had spread to the other side of my face. “I was discharged less than an hour ago.” I added.

“Address?”

“She was just discharged!” Mark snapped. “Can’t you find contact info in your computer?” The woman impassively typed.

“So, you’re still at 64 Hooker Ave?” Were they friggin’ serious? Did they really think my address had changed in the last hour??

“That’s right. All the information is the same.” Mark retorted, annoyance overtaking his typically calm demeanor. “She’s going to need a doctor any second. Can you please get somebody?”

The woman completed her electronic intake. I saw her call to another staff person before losing awareness. I know eventually staff took me to a hospital room, as I woke up there the next morning. After that seizure, they kept me five days, during which time I had my fourth grand mal seizure that week - I was grateful I was inpatient this time.

Just as Ms. Levis knew she had to be hospitalized in September 2016, I knew my brain was too fragile when I was discharged post-craniotomy. I wasn’t surprised that I needed to be immediately readmitted that day, but I was shocked by how hard it was to get back into the hospital.

When I read the circumstances of Ms. Levis’ death years later, I was appalled but not surprised. Had Mark and I opted for the ambulance, there would have been no questions asked by hospital administrators. Medics would have brought me in and relayed medical details to staff. Instead, we made the decision to take ourselves to the hospital. Like Ms. Levis, our choice to independently seek out emergency care led to glitches when we got there.

Ms. Levis’s home was near the local hospital. I suspect one reason she chose to walk there was that it seemed like the simplest way to get from point A to point B. I felt the same way when I compared taking the subway to waiting for an ambulance navigating holiday-driven congested streets. It’s very possible that the cost of calling an ambulance also played a role in Ms. Levis’ decision. That patients must calculate dollar amounts into the equation of making safe healthy choices, as hospitals focus on the bottom fiscal line is another derogatory statement about our healthcare system. Patients are damned if they call 911 -with a bill- and damned if they don’t - with hospitals that may be ill-equipped to assist them.

Thanks to Laura’s Law, the signage and lighting at the local ER Ms. Levis tried to access are clear, the clinic obvious to passersby, and patients can communicate with staff via intercom[3]. While Laura’s Law doesn’t address penny-pinching discharge protocols and unaffordable ambulance fees, it improves patients’ ability to independently access care, an important step toward patient empowerment. Clearly there is more work to do.

[1] Governor Baker Signs ‘Laura’s Law’ | Mass.gov

[2] Laura Levis was left to die outside an ER. Why were the doors locked? - The Boston Globe

[3] CHA Somerville Campus (challiance.org)

Author description: Laura Beretsky is a Somerville-based writer working on a memoir about the challenges facing those who live with perceptible health conditions.Please visit her website at https://lauraberetsky.com/   Her work has appeared in Cognoscenti, Sisyphus Magazine, Wire's Dream, and The National Library of Poetry, and Cognoscenti.