Ways to Annoy your ER Doctor

This post is inspired by my not-so-wonderful shift two evenings ago.

Ways to Annoy your ER Doctor:

1) Ask her "When is the doctor coming to see me?" immediately after she finishes doing a history and physical and explaining a work-up and treatment plan for your complaint.

I cannot tell you how many times I have to answer "I am the doctor," or the nurses have to explain to the patient, "You know that little blonde girl that was in here before? She is the doctor." You'd think people might clue in when the first thing I say upon walking into their room is "I'm Dr. So-and-so. Nice to meet you." All my scrubs are monogrammed to say "MD" and I always wear my hospital badge which clearly states my title, but what I really must need is a big bright button that says "I am the doctor!!!"

Apparently my undoctorliness became an issue two evenings ago. I returned to work yesterday evening and the nurse asked "Do you remember the little boy in Room 16 last night?"
"Yes," I answer.
"Did you examine him?"
"What?" I ask incredulously. "Of course I examined him. He was my patient."
Turns out that after I signed out his care to the overnight doc and went home, the patient's mother threw a fit and insisted that no doctor examined her child. Ironically, not only had I done a full head-to-toe exam on him and explained in depth my plan for evaluating his fever, I had then been cornered by the mother in our staff lounge while I was trying to quickly wolf down some dinner and had answered all sorts of questions about his eczema, his eczema creams, his allergies, and his allergy creams. I had even left the prescription on the chart for the new eczema cream that she wanted, even though it had nothing to do with the fever that brought him to the ER. Nonetheless, when his fever work-up came back negative and it was time to discharge him home, she was irate because no doctor had laid a hand on him. Guess I needed my button.

2) Be Agist
Another patient two evenings ago was downright hostile about how young I look. Patients love to comment on how young I look, but most of them manage to do it in a complimentary manner.. unlike this gentleman. He was an elderly gentleman with a laundry list of medicines and an utter inability to articulate his medical history or what brought him to the ER. I was probing by asking questions such as, "Have you been admitted to the hospital here before?" and "For What?"
All he could say was "I been coming here for years." Finally he looked me up and down and asked, "And how long you been here?"
"A year," I responded.
"I been comin' here since before you was born," he scorned.

I wonder, is this more insulting to me or to him?

3) Be Sexist
It turned out this same gentleman needed a rectal exam, because, from what I could ascertain from his vague history, GI bleed was on his differential diagnosis. "I ain't takin' my pants down for no damn woman," he scorned again.
"Well, I'm your doctor and you need this test, so let's get it over with."
"I HATE takin' my pants down for a woman," he complained while begrudgingly assuming the position.
Lo and Behold - he did have a GI bleed. "I told you that you needed this test," I said victoriously.

4) Never be satisfied by anything... ever!
I don't know what was in the air two nights ago. Another patient with pelvic pain was signed out to me at the beginning of my shift. She was waiting on an ultrasound to rule-out ovarian torsion. The other doc thought it was going to be normal, because he suspected she might be drug-seeking. Sure enough, it was.
I went to talk to the patient and her husband and tell them the good news. It's amazing how saying "You don't have an emergent medical condition and are okay to go home and follow-up with your obstetrician" can evoke such rage. "We want a CT scan. We want an MRI. You and the other doctor haven't done enough. I just saw him leaving in his golf clothes," complained the husband, "and my wife is in pain." I reassured him that I'd give her pain medicines for a day or two to cover her until she good follow-up with OB and explained again that there was no indication for an emergent CT. I left the room to do her discharge papers. They were unhappy, to say the least, and while I was writing I succumbed to the fear of lawsuits that plagues all emergency physicians and blurs the line between what we should do and what we actually do. I ordered the CT, rationalizing that she'd be back anyway for the same complaint, and I was doing a favor for the next ER doc who would see her. Hell, it might even be me... this way I could just pull up the CT report next time.
I went back to the room and told them that we'd to the CT so they could rest easy. I then told them explicitly that they'd be in the ER for multiple more hours to get this test. "We don't care how long it takes. We just want the test done."
Multiple hours later, I was in the middle of an acute stroke, a chest pain, a possible central cord syndrome (spinal cord injury), and (my personal favorite) a traumatic ejection from a golf-cart with altered mental status -- all of which had come in within the past hour. I look over my shoulder and guess whose husband is lurking at the nurse's station, just staring me down? Guess who is now pissed that they were in the ER for multiple hours? And guess who, even with a normal CT scan, still won't go home happily? And guess what lucky doctor is still being told "You haven't done enough"?
I had gone out of my way and they still weren't satisfied. Sometimes you just can't win.

Yes, two evening ago I went home very annoyed. Then last night, thankfully, I returned to have a great shift and today am back to loving my job. It all balances out in the end.

P.S. STILL no poop from Graham.