"I thought I might be having a heart attack or a stroke; so I took some turmeric and ginger."

[RustedFox]

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A patient just said that to me.
I'm on-shift right now.

55 year old female, fat and smokey.
She's here for nonspecific myalgias.
BP = 244/110.
EKG is fine.

I can't. With these people. Anymore.

 

[thegenius]

Hey internet friend.
I want to see my fellow brethren stay happy and fulfilled, as best as possible.

It's easy to get down about these patients. They do nothing to take care of themselves and they want you to fix them so they can continue to not take care of themselves.

Somedays this stuff frustrates me, but I'm learning to just let go.

It's not a big deal to give her some clonidine 0.2 mg PO q1hr x2 doses
run some labs
maybe some toradol or even a norco for her myalgias
spend a little bit of tax payers money and rule out the flu.
make her feel a little bit better.

Another way I look at this is there is nothing in this world that We can do to change her ultimate outcome. Which is she will get a stroke, dissection, or MI in the next 5 years. Nothing. You can admit her, run every single test, put her on drips, educate her...it won't matter.

So if there is nothing I can do to help them, I'll try to make them feel a little bit better.

Bring their pressure down to 160/90 and call it a day.

You are more important to this board and this group than that patient is to our society. Take care of yourself. I would hate to see you lose it and leave EM over something like this.

 

[Birdstrike]

A patient just said that to me.
I'm on-shift right now.

55 year old female, fat and smokey.
She's here for nonspecific myalgias.
BP = 244/110.
EKG is fine.

I can't. With these people. Anymore.

Response: "Hey, didn't you know that belly button lint-cheese works 5% better? GEEZ."

 

[namethatsmell]

Did you explain that your department is fresh out of herbs but you have a number of evil big-pharma meds (and vaccines!) to offer her?

 

[RustedFox]

Hey internet friend.
I want to see my fellow brethren stay happy and fulfilled, as best as possible.

It's easy to get down about these patients. They do nothing to take care of themselves and they want you to fix them so they can continue to not take care of themselves.

Somedays this stuff frustrates me, but I'm learning to just let go.

It's not a big deal to give her some clonidine 0.2 mg PO q1hr x2 doses
run some labs
maybe some toradol or even a norco for her myalgias
spend a little bit of tax payers money and rule out the flu.
make her feel a little bit better.

Another way I look at this is there is nothing in this world that I can do to change her ultimate outcome. Which is she will get a stroke, dissection, or MI in the next 5 years. Nothing. You can admit her, run every single test, put her on drips, educate her...it won't matter.

So if there is nothing I can do to help them, I'll try to make them feel a little bit better.

Bring their pressure down to 160/90 and call it a day.

You are more important to this board and this group than that patient is to our society. Take care of yourself. I would hate to see you lose it and leave EM over something like this.

Oh wow.

I didn't expect this, but it's super nice of you. Thanks.

I'm really just super-blown-away by how much people want "all-natural magic potions" to fix things like "heart attack/stroke".

But yeah; I can't get bent out of shape over these people.
It just sad, and telling about 'Merica.

 

[deleted859535]

Big fan of picking my battles. In this case, polite ignoring of stupid bull**** comments, due diligence labs, gentle BP control, done. Dispo.

Better for my own blood pressure and happiness. Or "happiness" depending on the day.

Next case.

 

[Brigade4Radiant]

Well it’s good to be upset because ultimately when they do stroke out they will blame us. Not their primary care doctor but the ED physician who is working dealing with the chaos of the ED

 

[deleted859535]

Well it’s good to be upset because ultimately when they do stroke out they will blame us. Not their primary care doctor but the ED physician who is working dealing with the chaos of the ED

No, it isn't good to be upset. In this situation, it accomplishes precisely nothing. Do the medically appropriate thing with what you have, briefly explain why, document, and be done.

Getting worked up over things beyond your control is rarely a good idea.

 

[e30ftw]

Bro you gotta lower your expectations.

Channel your inner vulcan and the way will be clear lol.

 

[GeneralVeers]

No, it isn't good to be upset. In this situation, it accomplishes precisely nothing. Do the medically appropriate thing with what you have, briefly explain why, document, and be done.

Getting worked up over things beyond your control is rarely a good idea.

My approach exactly. They can kick and scream all they want, but I certainly don't go back in the room for: "Doctor the patient has more questions".

 

[RustedFox]

My approach exactly. They can kick and scream all they want, but I certainly don't go back in the room for: "Doctor the patient has more questions".

This has been my approach in the past several months.
The less "face time" I spend with a patient, the happier I am.