"You're Next"

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Birdstrike

Full Member
10+ Year Member
Joined
Dec 19, 2010
Messages
10,255
Reaction score
13,584
"You're Next"

I saw a story in the news about something that happened to an ER doctor. It reminded me of something that had happened to me before, so I started writing about it. Then my imagination got a little bit carried away. So, let’s just say parts of this story are absolutely true, and other parts are, well…just read along.

I walk in for my ER shift. There’s a letter in my department mailbox. It’s a hand written letter from a patient. I open it,


“Hey doc! I just wanted to thank you for taking care of me last week. It was one of the low points of my life and I really had hit rock bottom. You’re the first one to talk to me like a human being. You convinced me to get help. They finally let me out. Thanks, again. You saved my life. You’re a great doctor. We should hang out sometime.”

Sincerely,

Jerry —–

Cell: XXX-XXX-XXXX”



I remember the patient. I admitted him for severe alcohol intoxication, depression and suicidal thoughts about 2 weeks ago. It’s not that often that you get to start out a shift with a “thank you” letter, albeit with a bizarre request at the end to “hang out sometime.” In this ER game, you take every pat on the back you can get, because they don’t come every day.

I walk to the pit to see my first patient. First up is, “Broken wrist.” I walk into the room and it’s him, Jerry, the letter writer. “Hi, Jerry, what can I do for you today?”

“This,” he holds up his mangled right hand and wrist. “I got pissed off and punched a wall.”

“Wow, you sure did a number on yourself. What happened?” I ask.

“Did you get my letter?” he asks.

“Yes. Why do you ask?” I wonder aloud.

He stares at me silently, and uncomfortably long. “Oh, I don’t know,” he trails off, staring through me. “Just fix me up, and we’re good.”

I walk out of the room. That was weird, I think to myself. I put in an order for x-ray of the hand and wrist. I put that plate up in the air to spin, and move on to:



Chest pain,

Migraine,

“Can’t see,”

Sprained knee,

“Menstrual,”

“Sick still,”

Split lip,

“Vag drip.”



Jerry’s x-ray is done. Wow. He’s completely shattered his wrist and 4th and 5th metacarpals in his hand. I haven’t seen a one this bad in a long time. I walk into his room. “Jerry, you’ve badly fractured your hand and wrist. You’ll probably even need surgery. I’m going to call the orthopedic surgeon.”

“No. I want you to fix it. You owe me, big time,” Jerry says.

“No, you don’t understand. It’s badly fractured. You need a surgeon for this, a specialist,” I explain.

“Did you hear me? I said, ‘NO ’,” he says, gritting his teeth so hard they could shatter.

After years of seeing anything from little old ladies to psychopathic criminals, it takes a lot for a patient to truly bother me, but this guy is truly disturbing in a way that’s hard to describe. It’s time to get out of this room. “That’s the way it has to be for you to get the best care,” I say and walk out of the room.

As I get to the door, he yells, “This s—t is your fault mother f—-r! You should have called me back. I left my cell number on the letter for a reason. YOU shattered my hand and wrist. This is because of you. You save my life and then just TURN on me, like I’m nothin’?! You’re a PSYCHO!” I get out of the room, and call security to come stand by as he is splinted up and turned over to the ortho team, who I made fully aware of his psych history and behavior. A psych consult is obtained. He denies all suicidal or homicidal thoughts and is admitted. After a little while, he leaves the department and my shift ends, uneventfully.

I walk out to the car. It is 4:00am and deadly black in the parking lot. I look around. Are you sure they committed him, or did they splint him and sent him home? I ask myself. I look behind myself. There’s no one. I look ahead: no one. I move a little faster and get to my car and open the door and get in. I start the car and look in the rear view mirror. I pause. Could someone be hiding in the back of my car? I turn around to look. No, you’re just paranoid, I tell myself. You just had a bad shift. There’s nothing to worry about. That guy was harmless; all bark, no bite. I’ve dealt with much worse before, and regardless, he was committed. Or was he?

I get home and I’m exhausted. I get inside and go straight upstairs to check on my kids. They’re both angelically asleep. I go to my room and my wife is asleep. I get in bed and as soon as my head hits the pillow I’m out. Sweet restful darkness takes over as the light switch of my consciousness flicks off. Then, out of blackness blasts a crushingly loud,



WHOOP! WHOOP! WHOOP! WHOOP! WHOOP! WHOOP!



My wife shrieks, “Oh my god! The alarm! The ALARM! The kids, THE KIDS!” I jump out of bed. Adrenaline blasts through my chest. Holy s—t, I think as I run out of our room. I have no gun, no knife, no weapon, nothing. I run through our family room. I might take a bullet tonight, I think to myself, or maybe worse. I run upstairs to check on my kids and they’re asleep, despite the unbearable screech of the alarm. I look around at the windows: nothing. I run back downstairs. I check the back door and front door. Somewhere around the corner, someone’s going to be there. Just then, I remember: Jerry.

Oh. My. God.

The door to the guest room. Holy crap. STOP.

Quiet…

Silence…

I tip-toe to the final room…

I put my hand on the door knob…

In silent slow motion I turn the knob and…(read more)
.
.
.
.
.
.

Members don't see this ad.
 
  • Like
Reactions: 1 user
VERY well written. sounds like a typical shift at USC/LA County....
 
Members don't see this ad :)
This is a pretty weird story. Not especially compelling. Just weird in that you felt the need to write it.
 
Lighten up Francis, it's fiction...
 
Last edited by a moderator:


I understand there is a higher probability for violence in a county Er setting like at LAC and Cook... but it's not like it's a typical occurrence. Yes there have been fights and incidents where the police or security got involved. There have been gangs waiting in the Trauma waiting room wanting to get in.

But again - it's NOT the norm. You make it sound like day in and day out, people are threatening to kill you like in the story. Happens once a in a while. In my 4 years at Cook County, I experienced something like this maybe 10-20 times. It's NOT every shift... that's just hyperbole.

We don't work in a war zone.
 
Members don't see this ad :)
I don't think anyone was really claiming that every shift something like this happens.

However it happens enough that the EP should always be aware of potentially violent scenarios in order to involve security and chemical/physical restraints earlier rather than later.

In that way, it is part of our daily job.
 
IT WAS A LIGHTHEARTED COMMENT ABOUT A FICTIONAL STORY. YOU REALLY ARE BLOWING THIS OUT OF PROPORTION.
YES, IT HAPPENS EVERY NOW AND THEN, NOT EVERY SHIFT.
BETTER?(woops, sorry about caps-that's what happens when you have to look at the keyboard when you type....:) )
 
I understand there is a higher probability for violence in a county Er setting like at LAC and Cook... but it's not like it's a typical occurrence. Yes there have been fights and incidents where the police or security got involved. There have been gangs waiting in the Trauma waiting room wanting to get in.

But again - it's NOT the norm. You make it sound like day in and day out, people are threatening to kill you like in the story. Happens once a in a while. In my 4 years at Cook County, I experienced something like this maybe 10-20 times. It's NOT every shift... that's just hyperbole.

We don't work in a war zone.
OK, now I get where you were coming from. At first I thought you were saying that it's no big deal that EPs are not uncommonly exposed to explicit and implied threats to their lives. What you were bothered by was the perceived maligning of "county" EDs. In that, you're completely correct. I know a private practice office-based doc who got death threats over a workman's comp case (guy even showed up with a knife one day). This is not a privilege reserved for county staff.
 
Two words, Smith&Wesson or at least a shotgun for home protection.
 
I had a situation earlier this year that paralleled this. An ex-GF from college married a very unbalance, violent, and jealous guy. She and I had remained friends, but one day I received some threatening texts from him.

It got me to thinking about all of the mentally unstable and violent people we see every day in the ED. Their records, discharge instructions, prescriptions, etc. all have my full name on them. I googled my name and found that I'm the only MD in the family. I have a second cousin who is a police officer and one who plays volleyball in college. I have a rather unique last name. The websites that list MD info all had an address on them. Most of them listed the address of the hospital, but a few had the 'office address' that is actually the address I filed with the NPI and other state organizations to receive my mail. When I gave that address, I used my parents' address, as I was moving for and during 4th year and residency and didn't want any important mail to get lost.

I emailed them and had the addresses changed to the hospital address, but my parents' home address kept showing up on a few searches in cached pages. I still wonder what risk we, as ED docs, have with the unstable and sometimes resourceful patient regarding finding out where we live. I've never felt in fear of my life while at home. We're probably more likely to be the victim of a random break-in than a retaliation by a psych or drug seeking patient, but it does make you pause and think sometimes.

edit: bad connection was making me have to copy and re-paste the post to get it submitted, but somehow didn't copy the whole post.
 
Last edited:
I had a situation earlier this year that paralleled this. An ex-GF from college married a very unbalance, violent, and jealous guy. She and I had remained friends, but one day I received some threatening texts from him.

It got me to thinking about all of the mentally unstable and violent people we see every day in the ED. Their records, discharge instructions, prescriptions, etc. all have my full name on them. I googled my name and found that I'm the only MD in the family. I have a second cousin who is a police officer and one who plays volleyball in college. I have a rather unique last name. The websites that list MD info all had an address on them. Most of them listed the address of the hospital, but a few had the 'office address' that is actually the address I filed with the NPI and other state organizations to receive my mail. When I gave that address, I used my parents' address, as I was moving for and during 4th year and residency and didn't want any important mail to get lost.

I emailed them and had the addresses changed to the hospital address, but my parents' home address kept showing up on a few searches in cached pages. I still wonder what risk we, as ED docs, have with the unstable and sometimes resourceful patient regarding finding out where we live. I've never felt in fear of

didn't finish post?
 
I understand there is a higher probability for violence in a county Er setting like at LAC and Cook... but it's not like it's a typical occurrence. Yes there have been fights and incidents where the police or security got involved. There have been gangs waiting in the Trauma waiting room wanting to get in.

But again - it's NOT the norm. You make it sound like day in and day out, people are threatening to kill you like in the story. Happens once a in a while. In my 4 years at Cook County, I experienced something like this maybe 10-20 times. It's NOT every shift... that's just hyperbole.

We don't work in a war zone.

Exactly! The comment you initially responded to was hyperbole. Used for comedic effect! Glad we've got that settled.

Good post, Birdstrike. Always enjoy your stories. The extent to which this story was true is the extent to which I'm creeped the hell out. Yikes.
 
Good post, Birdstrike. Always enjoy your stories. The extent to which this story was true is the extent to which I'm creeped the hell out. Yikes.

Thanks man. 'Preciate it
 
I don't know if you knew that there was a horror movie called "You're Next" from 2011 (but only got wide release this summer, August 2013).

I had no clue. Are they going to sue me for royalties, on all of the millions of dollars I make on these posts? [/end sarcasm font]. Lol
 
I think the story was true until the part where you got home. Either way, that was a well spent 7 minutes to read.
 
I think the story was true until the part where you got home. Either way, that was a well spent 7 minutes to read.

Thank you, and good work. The blog stats show the average reader is spending 8 minutes. You're ahead of the curve by a full minute!
 
Top