PHILADELPHIA -- Kevin McKenzie, 27, a graduate of Cherry Hill West High School, plays bass guitar in an up-and-coming Philadelphia indie pop band, Liam and Me.
Three years ago, because he did not have health insurance, McKenzie did something he still feels bad about.
At the time, he was working days for $10 an hour as a trucking company dispatcher and playing gigs or practicing most nights in pursuit of his dream.
One August night, McKenzie and his best friend, Greg Gaul, a high school classmate and Princeton University graduate, had just picked up a 12-pack of beer at 10 p.m. in Center City and were walking to the home of another friend to hang out.
Suddenly, McKenzie's heartbeat went berserk.
"One step I'm fine, the next my heart is just pounding," McKenzie said.
"I felt his chest," Gaul said. "His heart was pounding and it was really, really rapid. I got freaked out. 'We should call an ambulance or something.' "
"I don't know," McKenzie replied. "I don't have health insurance. I can't afford an ambulance or hospital or anything like that."
"You can't afford to die, either," Gaul argued.
They debated for several minutes, waiting for the heartbeat to return to normal. When it didn't, Gaul insisted they dial 911.
When the ambulance arrived, the paramedics checked McKenzie's pulse. "It was at 190," he said. "They're talking to me. 'Have I done anything tonight? Am I on drugs?' No. I had one beer earlier."
Paramedics told him he had to go to the hospital, McKenzie said.
"I said, 'I don't have insurance. I can't afford that,' " McKenzie recalled. "They made the decision for me. 'Listen, you're going in. Take your cell phone, give all your other identification to your friend. You're going in under a fake name.' "
In the ambulance, paramedics put an IV in McKenzie's arm and said they were giving him something like Adrenalin. (Matthew O'Brien, a physician at the Hospital of the University of Pennsylvania, said the drug typically used is Adenosine.)
McKenzie said the paramedic explained that after the injection McKenzie's heart should stop for a split second and restart at a normal rhythm.
Once the medicine entered, McKenzie said he felt like somebody was "sitting on my chest." But his heart rate didn't slow. "Now it's 250 a minute. I really start worrying."
Then, McKenzie said, the paramedics "gave me two doses at once. Fortunately, that was all it took. I felt even more pressure on my chest, and my heart rate broke immediately, and I was down to 90 beats a second."
The ambulance took him to an emergency room, according to McKenzie and girlfriend Jodi Epstein, a University of the Arts graduate who rushed there after he called her.
The ambulance crew, McKenzie said, wheeled him in on a gurney.
"They had me in a room," McKenzie said. "I was fine from that point on, just a little shaky. This lady came in to get all my info . . . "
"So you don't have any identification on you?" the woman asked.
"No. I don't," he replied.
"It was weird," McKenzie said, "because they all knew I didn't have insurance, and I was giving them fake information."
"The only accurate info I gave was my girlfriend's phone number," he said. "Just in case something happened, they did have that."
He spent six hours at the hospital and underwent tests. He said the only thing doctors pointed to was supraventricular tachycardia, a type of heart-rhythm disorder.
O'Brien, a Penn physician, said that when that happens, an electrical short-circuit in the atrium is sent to the ventricles, causing the extremely fast heart rate. The IV dose of Adenosine, O'Brien said, "allows the heart to reset."
McKenzie attributed the episode of tachycardia to exhaustion. "I'd been working full time, and going out at night, and drinking five or six cups of coffee a day."
O'Brien said "coffee can certainly do it."
After a few hours, McKenzie could leave, but first he had to sign forms. On each he had to write his fake last name, which began with the letter F.
"I couldn't even remember how to write a capital F in cursive," he recalled. "I'm trying to remember penmanship from elementary school. It was just so obvious I was making it up."
He said the medical staff was helpful and cared only about his condition, not his insurance.
As McKenzie left that morning, he looked for the ambulance crew that had brought him in, to thank them and buy them breakfast, but they were long gone.
When told this story and asked how often patients use fake names, Ken Braithwaite, executive director of the Delaware Valley Health Care Council, said, "I would say it is not prevalent, but it does happen on a routine basis."
He added that "it's a very sad reflection on our society that people feel that they would have to make up a name to go into the hospital." And he emphasized that the law requires emergency rooms to stabilize all comers in emergencies, regardless of their ability to pay.
Braithwaite, who is also senior vice president of the Hospital Association of Pennsylvania, said hospitals were willing to help uninsured patients get financial aid or work out payment arrangements.
Uncompensated care has skyrocketed in recent years, he said, climbing 15 percent in Southeastern Pennsylvania hospitals, from $224 million in 2006 to $258 million last year.
Asked about McKenzie's account, Daniel Williams, executive chief of the Philadelphia Fire Department, said he had never heard such a story and found it unlikely that Fire Department personnel would encourage fraud, even to save a life.
"We don't promote offering some type of deceit in order to get care," he said. "It's not a concern of ours whether you have insurance or not."
Three years later, McKenzie, who lives in Cherry Hill, is awaiting the release of his band's debut album. And he still feels uncomfortable with what happened.
"Whenever I do have a full-time job or I'm making money from this band," he said, "I'm going to pay back my debt somehow. It still bothers me."
But he said he couldn't afford insurance then and he can't afford it now. A hospital bill for a few thousand dollars would bury him.
"I still do not have coverage," he said. "I try to make sure I get adequate rest, and I lay off the turbo iced coffee at Dunkin' Donuts."
"We've been asked many times to play benefit shows for someone who didn't have insurance," he added. "It happens all the time. It's a real mess."
What Went Wrong
Kevin McKenzie, 27, plays guitar in an up-and-coming rock band and says he couldn't afford health insurance. When his heartbeat soared to more than 200 beats a minute one night, he refused to go to a hospital, because he couldn't afford the bill. The ambulance crew, he says, advised him to go undera fake name. He got care, but still feels bad about it.
Iyasu Habtemicael is an uninsured diabetic who had to miss his city clinic appointment due to work. He couldn't get through to reschedule, and then gave up trying, which he admits is partly his fault. Two months later, he spent several days in the ICU and nearly died when his blood sugar soared. It could have been avoided with easier access to care.
Contact staff writer Michael Vitez at 215-854-5639 or firstname.lastname@example.org.