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Why the ER is a mixed blessing for society

Edwin Leap, MD
Physician
July 15, 2014
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We live in an incredible age. Life expectancies continue to rise. The environment in the U.S. is cleaner than it has ever been. The sum of the world’s knowledge is at the fingertips of any and every smartphone user, waiting to be accessed when they finish playing Candy Crush. The face of poverty in America is still terrible to behold; but it bears little resemblance to poverty down the long march of human history. We fight wars, but they are (so far) distant from our endlessly entertained shores. All in all, it’s a pretty good time to be alive in America.

But what I continue to see in my work is a world of people separate from fundamental realities of existence. For instance, I don’t know how many times I have seen patients who fell and injured an extremity, who had normal x-rays, who then said angrily, ‘Well if it isn’t broken, tell me why it hurts!’ Because it’s bruised? Because pain exists without fractures?

Others, with even the slightest red bump from an insect bite, all but fly to the ER for evaluation. “When I saw that bump, I figured better safe than sorry!” And God bless the spiders. They catch the blame for everything.

“I’m pretty sure I have a spider bite.”

“Did you see a spider?”

“Nope, but that’s what it is!”

Understandably, it’s worse with parents of small children. Fever, in 2014, remains a thing of ancient mystery and terror despite untold numbers of commercials extolling the virtues of ibuprofen and acetaminophen. And even the youngest child or adolescent with a pulled chest muscle is dragged to the hospital because, “His grandpa had a heart attack, you know.” Smokers are surprised that they cough and the drunk amazed that they fell.

I’m not trying to ridicule anyone. In fact, I frequently say that one of the most important things I do is reassure people than nothing is seriously wrong. I love that part of my job. It’s easier 21 years into my career. (Reading glasses and some gray in my beard are excellent aids to reassurance.)

What I am saying is that it’s ironic that in an age of such knowledge, such access, such health care advances and so much money spent on education, we have citizens completely disconnected from the realities of their physical existence.

But I think it gets worse. All too many Americans are completely disconnected from their hearts and minds as well. It makes me so sad to see them confused about their emotions following the death of a loved one. It’s not mental illness. It’s called grief. Crying is normal; so is screaming, sometimes.

Young and old engage in sexual liaisons with many partners and then seem surprised that they are sad, or lonely; or that they feel unloved, rejected or angry. Children are neglected or abused by boyfriends or girlfriends of their parents who have no interest in those children. And the parents are surprised that their edgy partner, fresh from prison for drug trafficking, might be untrustworthy.

Families of divorce can’t understand the sorrow of their children; or of their own hearts. Furthermore, many are told that the guilt they feel over life choices is old-fashioned. Rather than dealing with the past, by facing it or making amends (or repenting, heaven forbid), our culture medicates and justifies every negative act and it’s associated toxic emotion. So much so that I see young and old alike medicated into near comatose states, still describing every pain as a 10/10 and still asking for ever greater doses of various medications to anesthetize their inner sorrow.

I think the physical disconnect has many causes. Ironically, the ER may be a cause. There’s no need to think or learn when every illness or injury can be seen by a doctor immediately. A mixed blessing for society, I admit. Part may also be the lack of the extended family, in which many families lose touch with the collected wisdom and knowledge of grandmothers and other loved ones. And part may be the lack of good, general health education in school.

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As for the non-physical? Social sciences continue to confirm what priests and preachers and rabbis said for ages. Families matter. Our thoughts, beliefs and actions (surprisingly) have far-reaching consequences. Neglect of body, mind or soul harms all the rest.

But in an age quite literally hell-bent on expunging faith, morality and tradition and common knowledge, I fear we’ll be needing a lot more pills, and ERs, for quite a while.

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of The Practice Test. This article originally appeared in the Greenville News.

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