Being an Emergency Department provider is hard for several reasons. We make hard decisions with limited (or no) information. You know when someone is pulled out of the burning wreckage and you see a twisted shell of a car and a body rushed in the Ambulance? Yeah, they’re coming to us.
That’s what we trained for; and that is what is expected. No one can control horrible accidents. No one tries to get pneumonia. No one tried to get cancer. No one wakes up, eats breakfast, and then thinks, hmm, today seems like a great day for appendicitis! None of these are choices.
Unfortunately, sometimes people simply make bad decisions.
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So… let’s play the BAD DECISION GAME!!!
*Contestant A*
ME: Hello there ladies and gents, boys and girls, welcome to the fun and excitement of the ER show! I’ll be your happy host, Dr. Slicy with all sorts of action-packed fun coming from all angles! Jonny, tell us a little about our first contestant!
Jonny-Well Dr. Slicy, our first contestant is actually a nice middle-aged gal you took care of only four days ago. You had admitted her to the hospital after she injected a substance into her veins and began having chest pain.
ME: Was it heroin she injected? Crack? Morphine??
Jonny- Hahaha! Oh you! Of course not, that might actually make horrible twisted sense. No, you see she injected bath salts (link#1)!
ME: Did you say bath salts? (link#2)
Jonny-yep
ME: Well, if he’s injecting aroma therapy directly into his veins, I’m sure he’s one mellow, relaxed guy. lets take a look
Jonny-Hmm, he doesn’t seem mellow
ME: Indeed. Two days ago she came in complaining of horrible chest pain, hallucinations, and feeling like she was going to die. She was admitted for four days, released from the hospital, and within two hours of being released, HERE SHE IS! With the exact same complaints she had when you admitted her four days ago.
Looks like you made a BAAAAAAD DECISION!
Contestant B (note, this conversation is sadly surprisingly accurate)
ME: Contestant B has been seen in pretty much every ER throughout the country. She says she is here to get her pee checked.
Jonny- What does that mean?
ME: Well, it says on her card that her home pregnancy test was positive. She states that that simply is not possible so she came here to get it checked.
Jonny- But don’t we use the same tests that they have at any local store?
ME: Yes, but if WE tell her she is pregnant, then, um, well, I guess then she’s still pregnant.
Contestant B: “But there ain’t no way I’m pregnant again!”
ME: Did you have sex?
B: Yeah!
ME: Did you use protection?
B: Uh, no, duh!
ME: And you’ve been pregnant before so I assume you know how this happened.
B: Well, you see, I ain’t the cheatin’ type. But I was at my cousins wedding, an’ I met this guy, I dunno what his name even is, and we hooked up.
ME: So then you actually are the cheatin’ type.
B: No! It was just sex, di’in’t mean nuthin. Gah, if i’m pregnant agin my boyfriend’ll kill me.
ME: Well you are pregnant.
B: Can you give me an abortion?
ME: Me?
B: Yeah
ME: You want an ER doctor to give you an abortion. Right now. Just reach in there an pull out your fetus quick a minute?
B: Why the F*** not? I can’t keep no baby. I ain’t no cheater, but I can’t be pregnant.
ME: Well, you are, as a result of a BAAAAAAAD DECISION!
Jonny- Sorry folks, that’s all the time we have left for today. Even though we have oodles and oodles more contestants.
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I try not to be judgmental.
I try to be respectful and kind.
Sometimes it scares me.
However, doesn’t it seem that as a society we are rewarding bad decisions (warning, some bad language)?
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