State of Emergency

What happens when 130,000 kids lose their taxpayer- funded health insurance? To find out, visit the ER at Children's Medical Center Dallas, where the waiting room is always full and chances are you're footing the bill.

THERE’S A THEORY MAKING THE ROUNDS in the emergency department at Children’s Medical Center Dallas: “I’m not sure why it is,” Dr. Thomas Abramo told me one morning last April as he headed toward one of the ER’s cramped treatment rooms, “but it just seems like the cutest kids with the nicest parents always turn out to be the sickest.”

Inside, Valeria Galarza, a seven-year-old girl with cinnamon-colored skin and giant eyes lay quietly on a gurney. Abramo gently probed her abdomen, while her father, Luis, described how she’d been complaining of pain in that region for a few months. They hadn’t sought help, he explained, because the family had no health insurance, but the pain had become more acute the night before. Abramo nodded, then asked Valeria if she’d been coughing a lot, and she shook her head. “I was thinking it might be pneumonia with referred pain to the lower abdomen,” he said, turning to the resident taking care of Valeria. “But we need blood tests to see what else it could be. It could be worse than that.”

Abramo left the examining room and headed out to an L-shaped counter that is the hub of this sprawling trauma center just northwest of downtown Dallas. The six corridors that extend out from the hub were filled with doctors and nurses striding briskly to and from the ER’s eighteen

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