A letter to my patient…

Dear Drunk Guy,

             You must have had a pretty rough night.  I am glad that I had the opportunity to meet and care for you this morning at 3:00 a.m. I just wish you had not made my time with you so difficult.  Take for instance the ten or so minutes that I tried to obtain a history from you.  You were so evasive and short with me.   I asked you, “What brought you in to the emergency department tonight?” Your response was, “Police department.”  In your defense my question was not very specific.  You do have a valid point, in that, it is true that a police officer brought you to the emergency room, although your response would indicate that the entire police department brought you, which I am fairly certain was not the case.  So then I asked you, “Well, why did the police bring you here?”  Remember you told me,”I didn’t quite make it to my hotel.”  You kind of got me on that question too.  I still was not very specific.  I assumed that you would realize that I was asking you these questions to try to figure out why I was about to perform a CT scan of your head.  In most cases if a patient’s only symptom is not quite making it to their hotel there is not a clinical indication to perform a head CT.  I did try to be more specific with you though.  Remember I asked you, “What specific problems brought you to the emergency room? Did you fall and hit your head? Were you in a motor vehicle accident”?  To which you responded, “No.”  That was pretty much your best answer, but I have to be honest–it was still not very helpful.

             Oh and remember after we were done with your CT, and I said you could get back onto your stretcher.  You instead decided to stay laying on my CT table and salute me.  It was even better when I asked you again to get up and this time you stayed laying flat but this time reached for the sky with both arms outstretched.  It reminded me of when I change my one year-old daughter’s diaper.  She always reaches her arms up for me to pick her up and give her a hug.  Wait! You weren’t expecting me to…

             Well at any rate I just wanted to tell you that all you had to do was tell me that you fell and hit your head.  You could have even said that you had been drinking a little too much and were not sure what happened.  I can appreciate that being brought to the emergency room as a result of having too many drinks can be embarrassing.  Out of respect if you had been a little more forthcoming I could have simply wrote down your history as: Patient presents with unknown injury to head.  Done.

             I want to be transparent with you, mostly because you were not transparent with me.  Because you chose to make things more difficult for me, your permanent medical record, courtesy of me, now includes the following:  Patient unable to provide accurate history.  + ETOH.  Per PD report, patient was found down outside of liquor store with pants around his ankles and abrasion to his left ear. 

             Now everybody knows.

Regards,

C. Langston R.T.(R)(CT)(MR)

 

Are you a student?

Amidst a recent Facebook post suggesting that “my wheels are falling off” as I approach 30, I have found my saving grace.  Despite any physical ailment that makes you feel old, a compliment, whether intentional or not, makes it all go away, if only for a little while. 

Background Info:

Yesterday on a Facebook post I mentioned that I felt like I was getting old, citing back pain, upcoming knee surgery, and the fact that I have been put on thyroid medication.

Picture retreived online from the Journal of the American Academy of Physician Assistants website.

At about 1:00 a.m. I am called to the ER for a patient with suspected appendicitis: a 22 year-old female with RLQ pain, fever, and loss of appetite today.  As I walk into her room to introduce myself, I find a relatively attractive brunette in pink sweats, slippers, and hospital gown lying on her stretcher, and her knight in shining armor boyfriend at her side.  She smiles.  He tenses up.  As I finish explaining who I am, and that I will be taking her down the hall for a CAT SCAN, I ask if there are any questions.  Only one:

Jealous boyfriend: “Can I come with?” 

(At this point I realize that this guy sees me as a threat, which is a compliment in itself I guess, because I am definitely not a threat.)

Me:  “Of course.  I can’t let you in the room during the scan, but you are welcome to come along.  There is a sitting area outside of the room.”

We walk down the hall to CT.  Boyfriend takes a seat in the waiting area and I roll the patient the rest of the way into the CT room and close the door.  As I get the patient positioned on my table, she asks, “So are you a student?”

I initially think to myself, “Crap.  Am I acting like I don’t know what I am doing or something?  Why would she think I am a student?”  I push the thought aside and say, “No, I have been doing this for like 7 or 8 years.”

Patient: “Wow!  You look so young.”

Me (smiling on the inside, and probably on the outside, too): “Thanks, I guess I’ll take that as a compliment.”

I suppose if an attractive 22 year-old female thinks I look young, the wheels aren’t falling off just yet.  Then again she had just been given morphine for her pain.   Crap!  I hadn’t thought of that until now.