Tuesday, November 17, 2009


It isn’t often that I publicly change my opinion. And really? Most often, it is because I deliberately think through my words, my thoughts, my actions before making them public. But I’m finding that more days than not, my opinion of life, of people, of faith, of stuff is just changing. The changes are largely out of my control... fed by my experiences, resurrected by my stories.

And tonight? You deserve to hear more of the story. Instead of changing my opinion, however, I’m going to make an addendum.

To this post.

You see, when I wrote this story about this giggling girl’s mommy, I was writing mostly out of frustration. Because it IS frustrating to see patients that don’t have emergent (or even urgent!) problems, that are not sick, not in pain, not needing immediate medical attention in what is supposed to be the emergency room. In my ideal world, we’d see emergencies in the ER. And if you talk to “old-time” physicians, you might find that Emergency medicine has mercilessly changed. In most community (read: smaller hospitals without advanced trauma units) medical centers, the ER is filled with a myriad of patients on any given night. And what used to be a population of patients with what, in my opinion, were true emergencies or urgencies have now become patients with minor medical problems that very-well could have waited for tomorrow…or 2 days from now…or next week when they could have gotten an appointment with their primary care doctor.

I fully (FULLY!) realize that other issues are present in many of these cases. Patients may not have insurance. They may truly be worried…& in many cases, the patient truly does know best & their concerns are fully warranted. They may have an underlying condition or problem that would not have been discovered had they not come into the ER. But for the most part, the patients I was referring to in my post were those who did need medical attention…eventually.

Such was the case with giggling girl & her mommy. It wasn’t the fact that the little girl had a reddened throat that bothered me so. In fact, literature (& Grey’s Anatomy, for the record) cites cases where red throats turned into something much, much more serious. But such cases are, largely, outside the norm. And giggling girl had nothing more than a red throat. No fever. No cough. No signs of infection. But her impatient mother decided to forego waiting for her pediatric appointment just a few days following & rush her to the ER because it might be something serious. That "common sense" doesn't seem to be common anymore...

The patients I was speaking of were those who coming in for toenail trims. Or for hangnail removal. Or who want to “be fixed” in less than an hour after 19 years of pain.

And, more likely than not, the patients I was speaking of…ARE NOT YOU.

So PLEASE….go to the Emergency Room if there is an ioda of concern, of anxiety about your situation that arises in the midst of whatever medical chaos you might be experiencing. Use your best judgement. Think through the situation. Ask yourself if it really is EMERGENT…or even URGENT. I certainly can’t go through each diagnosis here (we’d all be dead by the time I was halfway done)…& that is not my intent. I write to vent, to share my now-feelings with my 40-year-old-self in a couple of decades, & to remind myself that there is PURPOSE, greater purpose, behind the sometimes frustrating-monotony of my days with patients.

I cannot be the judge of your medical decisions. And I cannot be the decisive voice in your care. That responsibility belongs to you. What I can do, however, is share: my opinions, my experiences, my HOPE.

Common sense.

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