Saturday, June 6, 2009
AT A SNAIL'S PACE
Ah, the ER in off-season. It is a joy to be there. Empty rooms, quiet hallways. The occasional stir of a drunk or drug seeker. Sunburns as medical emergencies. Quietly punctuated by the patient who comes in for "cold symptoms" and is in full florid CHF.
I tell you, they just walk in and say "I have a cold. I can't sleep at night because I can't breathe." Never mind that they smoke 2 packs a day, or that they haven't seen a doctor in YEARS or that they're coughing up black goop from their lungs. But the fun starts when you start a nebulizer treatment and their heart rate shoots up into the 180's, put them on the monitor and it's A-FIB, and suddenly they're huffing and puffing. Start the Cardizem, etc, etc. No cardiologist on call? It's time to FLY!!
Or when they sign in and say "I've got a terrible headache." Ok, let's give you some drugs, check out the CT. An hour later, the headache is still there, but now you're complaining of chest pain, midsternal, radiating to the left arm, suddenly relieved by 2 Nitro sublingual. Where the hell did THAT come from? Oh, and he forgets to mention the old meningioma on that side of the head that was gamma-knifed several years back. Yeah, we kind of picked up that one on the MRI. Whoops! forgot to tell us about it, huh?
So one patient flies to Miami. One patient gets admitted. And the sunburn with the horrible itching goes home and is warned, under penalty of DEATH, not to go out in the sun again for the rest of his vacation stay here. Surrrre.......
I wonder if I could get the nail technician to do a house-call (work-call?). Maybe I could get a manicure/pedicure between patients. Or pick up my dry-cleaning, or do grocery shopping. Twelve hours of this laid-back pace could kill.
I miss the juicy traumas. I need to wrestle a drunk or something. One shift in Key West should resolve the old ennui.
Scratch that, I might break a nail.