There are two key scenarios when doctors fail to tell “the whole truth and nothing but the truth so help me God.”
Sometimes doctors give a diagnosis we’re not 100 percent sure of and other times we don’t diagnose something we’re almost 100 percent sure of. The truth is complicated and often more gray than black and white.
Scenario #1: “You have [insert diagnosis …
I have been an emergency physician for 12 years. I have had the opportunity to learn from and try to emulate an impressive number of amazing clinical physicians. These doctors seemed god-like at first, but as my training and career progressed, I realized that they were mostly teaching me through their own experiences.
One of my favorite teachers had a humbling saying: “Good …
1. Wait times in most emergency departments are ridiculous. But, if you have a real emergency, you won’t have to wait. If you have abnormal vital signs, a worrisome ECG, or concerning chief complaint, you will be seen long before the person who checked in with a sore throat to get a work excuse.
Patients with chief complaints like “GSW abdomen” and “found down/unresponsive” don’t wait to …
Natalie Fuelner created a well-written article in the Bangor Daily News describing some of the tribulations many new parents go through with young children. One weekend, her toddler fell face first onto a metal patio table. Immediately, the toddler’s face is full of blood. The dad panicked. Natalie was a “trembling mess” on the inside.
Their physician neighbor wasn’t available to look at the child. …
Do you remember Mad Libs from when you were a child? A story is filled with blanks, and as you fill them in with inappropriate and ridiculous words, you laugh until you can’t see straight. You laugh until you can’t breathe, and your parents beg you to stop! Let’s be children again. Share these with the nurses, and give the shift a little levity.
Pain medication. You see, doctor, my pain specialist …
Idioms are expressions everyone understands as something other than what the literal words say. For example, when I talk about “putting all of my eggs in one basket,” everyone knows I’m not really talking about eggs.
We say things like:
It’s raining cats and dogs.
It was a piece of cake!
I heard it straight from the horse’s mouth.
We have a few idioms in medicine, too. If I talk about “hanging crepe” in a …
In the last several shifts I’ve worked in the ED I’ve had more people stop and compliment me on my care. I’ve heard the usual, “Do you have a private practice?” compliment and, “I’ve been here a lot and you really took the time to hear what I was saying, I appreciate that.”
Kudos are nice. They are what makes a tough …
Recently I’ve been asked to write about rural surgery, what it’s like, what’s good about it. Everything has its ups and downs.
First of all let me say that whatever your job is, the money you get paid to do that job is for the crappy part, and every job has a crappy part. The trick is to find a job that …
Note: This case is meant to illustrate the potential negative effects of inappropriate imaging. It is not intended as a diatribe towards any member of the health care team. Really the only “mistake” made here was the ordering of the CT scan in the first place.
A 37-year-old woman presents to her local emergency department (ED) with a 4-hour history of heartburn …
Emergency medicine physicians: Could these be your cases?
For my entire life as a physician, from medical school, through residency and now until this 22nd year in practice, I have subscribed to the idea that I should have a chaperone when performing breast, pelvic or rectal exams on women. I was taught to do this from the beginning, and I still do it.
Why is this? On some level, the …
A couple of weeks ago I was on-call and had to go down to the emergency room to see a patient. Before I entered the room, I was told that the patient was accompanied by her long-time physician who was a bit “crazy and old school.”
“Hmm … that’s strange … why would her physician be in the room with her?” I …
While working at small rural hospital I was once again faced with the emergency physician’s dilemma. Admitting a patient and being told to write holding orders. In the midst of a very busy department, I sat with a nurse who guided me through the ridiculously complex and counterintuitive electronic orders system. All this so that the admitting doctor wouldn’t have to log onto the computer, from home mind you, and trouble …
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Although I pride myself on catching the obscure snapshots of typical life moments that occur daily while dealing with patients and their families in the emergency department, occasionally there are times when I am so focused on the task at hand that I completely fail to see a glaring moment of obvious humor, sadness, or tenderness. At times like this, then, I am glad to have our hard-working nurses and …
The following article is satire.
In the first application of a new “reverse AMA” system put into place to improve patient satisfaction, a patient was admitted to the hospital for the first time against the wishes of her treating ED physician. Constance Dolor, a 37-year-old morbidly obese patient with chronic unexplained pain and a frequent visitor to the emergency department, became the first person in known history to be admitted the …
I have been doing emergency medicine for almost ten years — thirteen if residency counts, and I sure think it does. I face the same issues that cause my work colleagues, physicians and nurses alike, to burnout. I struggle with burnout myself, but I keep coming back. Many days (and nights), I ask myself why I continue to do what I …
A local hospital is trying a new, controversial but more efficient approach to medical care. “We have changed our guidelines, if you want Dilaudid you get Dilaudid, if you want Valium, you get Valium. No questions asked,” CEO Michael Shoemaker told reporters Wednesday.
In what experts are calling pure genius, emergency …
One of the things that I love about my job as a hospitalist is the ease with which we can develop friendships with colleagues from other disciplines. Since I am an inpatient physician, it’s not surprising that some of my good friends are cardiologists, nurses, endocrinologists, physical therapists and, of course, other hospitalists. In fact, I met my neurosurgeon husband while co-managing his patients at the hospital. While thinking about …
Every ER has its call roster, that sacred list of oracles, laying out who we can call when our patients need some service that we cannot provide. If I need a cardiologist, or a neurosurgeon or even a dermatologist for some acute emergency condition, all I need to do is ring up the operator and tell them, “This is the ER …
“My wife died uncomfortable and alone. She died thirsty!”
The man who spoke those words came in to the emergency room recently where I was working a shift. He was accompanied by his wife, a 70-year-old with high sugar, weakness, and nausea. The team worked to get her seen under the presumption that her diabetes needed control. Once she was brought back to …
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