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Of all the recent experiences I've had involving my dying brother, the time we spent in the emergency room was the worst

This is a story about hell in midtown Tucson.

Any place can become hell if the conditions are right, but the potential for despair and agony in an emergency waiting room is right there in the words: It's a place to sit and wait for help when you've already decided that you need it immediately. For nearly four hours on March 27, the emergency waiting room at a major Tucson hospital became an entirely adequate hell for my brother, my sister-in-law and me.

I won't name the hospital, because once my brother was finally admitted, he got fine care. But I do want to tell you what happened to a 46-year-old, middle-class, home-owning guy with good health insurance.

Charlie has had hepatitis C for 30 years, but was diagnosed only about a decade ago. (In the new, brutal, punitively righteous America, I guess that means he deserved everything that's happened.) He started a year-long course of interferon treatment when he first learned he was infected, but he quit after a few months, because it made him too sick to work.

Last fall, he began to feel awful, went through a lot of tests and was going to try treatment again as soon as everything got OK'd by his insurance company. He was approved for treatment only after it was too late.

In mid-February he got sick with fever and chills, night sweats, an ominous swelling in his belly and bad pain in his lower back and legs. His GP tried a couple antibiotics, ran no tests and gave him nothing for the pain. When he could not stand the pain any more, he called his wife, Beth, at work and asked her to take him to the emergency room. His hepatologist--who was ordering a series of tests that would take days--chose not to just admit him but sent him through the funnel at the ER. I do not know why.

I got to the hospital after she and Charlie had already been there an hour. I thought I'd have to catch up with them in an examining room, but, no, there they sat. Charlie was gray-faced and rigid, barely able to walk and only able to sit by shifting constantly in his chair.

He was kept sitting for nearly three more hours, as dozens of people were called back for treatment. To my eye, none of them looked nearly as sick as my brother. After an hour, I went up to the desk and complained, emphasizing that my brother was in great pain. The gatekeeper, a woman with puffy black hair whom I will hate forever, looked into her computer and simply agreed with me that Charlie had been waiting for two hours.

Another hour passed, and Charlie and I went up to complain again. It was hard for him to stand; his color was appalling and his eyes half-closed. He asked Puffy-Hair, "Is there any point in waiting if I keep being triaged to the bottom?"

She said that what was going on was not triage, but medical something-or-other (the second word got lost in my rage and frustration). And that what we didn't realize was that there were ambulances and helicopters bringing in very serious cases all the time. (We hadn't heard any helicopters. Besides, not even a suicide bomb at the mall would have explained why so many obviously minor cases were called back before Charlie was.)

About 40 minutes later, he was called back: At three hours and 40 minutes, he apparently hit some sort of time limit on being shuffled to the bottom. He was started on morphine almost immediately and spent the next 11 days in the hospital. Diagnosis: Stage IV liver cancer, metastasized to the marrow and bone. The pain in his back was caused by a tumor pressing on his spinal cord. It took nearly a week to get his pain under control.

My brother is dying as I write. Obviously, there have been many terrible days in the last three weeks. But the worst hours of all--for me at least--was that afternoon in the waiting room. Beth and I discovered that we have the same fantasy: To throw Charlie's chart in the receptionist's face and explain to her that she had made a man with cancer on his spine wait four hours for treatment.

Of course, those four hours in hell can't reasonably be pinned on Puffy-Hair: It's not her fault that every poor kid with an ear infection has to go to the same fantastically expensive, sophisticated facility as people who have real emergencies. It's not the insurance companies' fault or the government's or the hospitals'. It's the system.

The lesson to be learned here? Do not get hep-C. (Please.) In fact, don't get sick. Or, if you do, consider staying home, sending out for street drugs for the pain and just dying.

Because there is no way in but the ER.

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