I have picked up Mr. Reynolds (not his real name). He is a frequent visitor to the ED for alcohol intoxication. He was found drunk on a street making a scene, and a good samaritan called him in.
Paramedics bring him in. He is not bashful about showing his discontent for his arrival to the ED. He promptly flips off the charge nurse and continues to verbally berate the paramedics. The paramedics and nurses laugh as this is nothing new for Mr. Reynolds. They put him in a room; he gets registered. I sign up for him and go to see him. He cusses me out. I let him finish his piece, and then I distract him by asking him a slew of random questions. His posture changes. He is relaxed. That’s right … I may not be a dog-whisperer but I sure as hell am the drunk-whisperer. I ask if I can examine him. He agrees. No head trauma. No evidence of intrathoracic or intra-abdominal injury. He admits that he just had “a tad too much to drink.” Overhead I hear the sweetest announcement. “The Cares van is here. Last call.”
Cares is a detox center where patients can go to sleep off their alcohol. As long as a person is not too drunk to walk to the bathroom, he/she can be medically cleared of injury and be sent there to sober up.
This place is a godsend. Usually, when a drunk person comes to the ED, he/she becomes the responsibility of the department. If a drunk person bolts from the ED and gets hit by an 18-wheeler, the ED remains medically legally responsible. As a result, we have to sit on drunk patients four to eight hours until they sober up completely. So, you can imagine what that means on especially festive nights.
For example, on New Year’s Eve and St. Patrick’s Day, the baseline chaotic environment of the ED can exponentially amp up by the overload of … let’s just say “animated” drunks. Gurneys start lining up in the hall where friendships can be made, and colorful debates can be had. Inevitably, all the beds fill up with drunkards, and sick patients get relegated to the waiting room. Wait times rise to 20 to 30 hours, and people get pissed that it is taking so long to be seen by a doctor. It is a vicious cycle, to say the least. So that is why Cares gets mad props for being such a magical place that provides such an amazing service.
Back to my story, I wrap up my visit with Mr. Reynolds and walk him to the ambulance bay. We pass by the charge nurse. I look at his sun-beaten face. His jeans are dirty. He is wearing multiple shirts and a long tanned leather jacket that is stained all over. Before he leaves the department, he turns to me and hugs me.
His 6’5” frame engulfs my puny body. “I love you, man,” he says.
And with that, he leaves the department.
Everyone in the department starts laughing. The charge nurse looks at me and says, “You may want to shower.”
Zahir Basrai is an emergency physician who blogs at the Physician Grind.
Image credit: Shutterstock.com
