Agraphia Medical Tragicomedy

19Jul/09Off

I Do It For The Unwashed Masses

Friday and Saturday nights in the Emergency Department can be difficult for the nurses and docs working them. People come in for all sorts of frivolous complaints - because really, what better to do on your Saturday night than take a trip to the ED?

In the midst of a particularly hellish half-hour a very well-kempt lady kept motioning me over, clearly upset that she wasn't being seen. This was while my patient with a subarachnoid hemorrhage was trying to die before neurosurgery could help, my 3 drug-seeking back pain patients were diligently refusing my attempts to give them vicodin (Doesn't touch the pain! Need something stronger!), and my attending was trying desperately to staunch the flow of blood literally hemorrhaging from a girl's foot.

Young MAN, I have been waiting for 45 minutes to be seen! I demand you come see me RIGHT NOW!

I told her I'd be in as soon as possible, more because I wanted her to GTFO of my Department than because she was tired of waiting.

10 minutes later I was interviewing her. Her story was meandering and long. Since she had been waiting all of an hour at this point, she was going to take up as much of my time as she could. Her answers to my questions were sarcastic and rude ("Ma'am, any weakness or fatigue lately?" Not until you made me WAIT an hour!)

Suddenly I realized I was looking at shingles. Right sided C3 nerve root distribution with 4 clusters of vesicles. It was in all honesty an excellent diagnosis, and one that I easily could have overlooked. Beaming, I told her what she had.

You know, I just don't think you know what you're talking about.

She refused to take the antivirals I prescribed, because she thought I was wrong. She started loudly proclaiming how incompetent my nursing staff was. Her time from triage to discharge was an hour and 30 minutes - faster than most patients ever leave. She kept telling me how valuable her time was, and how I was wasting it.

It left a horrible taste in my mouth for the rest of the night.

Later that shift, I got around to sewing up a cut on a homeless man who had taken a bat to the face. He had been waiting for 7 hours, as the resident caring for him had been seeing trauma after trauma and couldn't find the time to sew him up.

As I started sewing, he and I started chatting.

You know, doc, I really appreciate you doing this for me. It looks like y'all have been really busy around here... I've seen ambulances just pouring in all night long. I certainly respect what you do for people and I just want you to know I'm grateful. I may not know you, but you strike me as a good man.

I suppose your faith gets restored by the people you least expect sometimes. Thanks, homeless guy. You made my night worth it.

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  1. I’ve always deeply admired ER docs for what they don’t do as well, such as NOT stabbing a patient in the foot with the knitting needle said patient was just clacking away on while downing jelly beans and loudly insisting her pain is at least a 12 out of 10. Even if the primary motivation for restraint is sometimes just the paperwork involved 😉

  2. Nice. What a great story!


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