No He DIDN’T!

Next time you visit your local ER, please remember your doctor is human and try not to be a jerk. The other day the jerk-to-reasonable person ratio in the ER was astronomically high. Everyone thought they were the only patient, and I was the only doctor for all 20 of them. I was getting slammed and the shit was flying.

The older docs I work with reminisce about the times when doctors were treated with some respect. I’ve never known those times and just have accepted that being an ER doc and getting bitched at go hand-in-hand. Usually it doesn’t phase me; partly because I do understand that whatever brought people to the ER is stressing them out, but more so because when you get bitched at everyday, you have to find a way to ignore it if you want to stay sane. But the other day this guy somehow managed to get under my skin so much that even the next morning in the shower I was still fuming about what an asshole he was.

His wife came into the ER by ambulance after a minor fender-bender and went straight to room 6, not even realizing she had bypassed the 4+ hour wait time for patients who did not come by ambulance. My first clue that she wasn’t too seriously hurt was that her biggest complaints were related to being immobilized in a cervical collar on the backboard. I understand those things are not particularly comfortable, so to the extent possible I try to get to such patients as soon as I can and get them off the backboard. Maybe I took a little longer with this lady because there were so many REALLY sick people who came in at the same time, but I explained and apologized as soon as I walked into her room.

As I examined her, she never jumped or winced but complained of tenderness EVERYWHERE (another clue she wasn’t too seriously hurt, because pain will usually localize at least to a general organ system if there’s a serious conditions). When I went to clear her out of the c-collar, she said her mid c-spine was tender right in the center, but unfortunately the one place she wasn't tender was on the sides of her spine where the paraspinal muscles run (which maybe would have allowed me to chalk it up to just a sprain / strain or spasm). I doubted the lady broke her neck , but I ordered x-rays to cover my OWN neck.

Then, not too worried about her, I left her in the room, ordered her some pain meds, ordered her x-rays and went about my business… which – I should mention – at that moment happened to include intubating and stabilizing a nice lady with lung cancer in acute respiratory failure. By then, it was around the time the cafeteria closes, and I was starving because of my new diet. So once I knew everyone was at least stabilized, I ran to the cafeteria and grabbed some food and brought it straight back to the nurse’s station, holding it in my hand as I checked a few things. Then I disappeared for 5 minutes to wolf down a bit.

When I emerged, the administrative head of the ER found me to ask what the delay was in bed 6. Generally she shows up only when people ask to speak to "whoever is in charge." The fender-bender woman hadn’t even physically been in the ER for 2 hours at this point! (I’ve had SCHEDULED non-emergent OB appointments longer than that!) I told the administrator that I hadn’t checked the x-ray yet because I was taking care of sicker patients, and she went off to her room to smooth things over.

Not too long afterwards I checked her x-ray, which, of course, was negative, and then I went to discharge her. I AGAIN apologized for the delay, and no sooner had the words come out of my mouth than a grumpy old man growled from the foot of the bed an extremely accusing and sarcastic, "How was DINNER?!"

My jaw hit the floor. The nerve of some people. I mustered a smile and made a joke out of it, trying to keep it light… "Don’t even give me grief for eating," I teased. "You don’t want a doctor taking care of her who doesn’t have any fuel in her brain!"

He became less growling and less accusing, but still continued, "I wish WE could eat."

"You can."

"The cafeteria’s CLOSED now," he snapped, like somehow I have control over the cafeteria hours, or the fact that he wasn’t resourceful enough to run down there when they were open and bring something back.

"Well, there’s a subway just across the parking lot and that’s probably better than our cafeteria food anyway."

"Well, WE’VE been hungry for hours." He gave me a how-dare-you-feed-yourself-when-my-wife-is-waiting glare.

I exercised a great deal of control and instead of going off (I won’t even put into writing all the things I wanted to say to him), I politely and pleasantly said, "Well, then, let’s get you discharged so all of you can get out of here and go get some food." I couldn’t get out yet another apology for the delay… even though I could tell they wanted one. (This asshole wouldn’t have been happy unless I knelt down and spit-shined his shoes while groveling.) As I fled room 6, they were right on my heels, chasing down the nurse for her portion of the discharge papers. Then they hovered around the nurse’s station, just glaring at everyone until her nurse succumbed and stopped in the middle of doing something for one of the other sicker patients to give them their papers so they could finally leave. I was so relieved to see them walk out of the ER.

Ever since then I’ve been eating in stealth, hiding out in the doctors’ lunge. I’ve learned my lesson – I don’t dare let my patients know that I actually stop to pee… and sometimes I even EAT!