My Night in The E.R.

[ChandutheMagici]

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I figured I'd share this story with my fellow non-trads. Warning, it's long.

I'm not going to lie. As of late I've been reading tons and tons of stuff related to medical training etc. Whether it be a blog, book, or magazine article I've noticed a lot of cynicism and distaste towards the training process in general. I admit that these things have influenced me a bit. That isn't to say I regret going through the application process, but more so that I find myself in a bit of self doubt at times.

That being said last night, I went to the E.R. Not shadowing, not to volunteer, but as a patient. Yesterday is one of five times in my life I've been to the E.R. as a patient. The first time was when I tried to fight a tree (I was on a bike) when I was about 13. The second was for a broken bone and lucky numbers 3 and 4 were both related to the eventual lap chole I had done. I like to think of the E.R. as an absolute last resort. I only go there if I feel really really bad.

Well, last night I felt really really bad. At about 8:30 I started breaking out in sweats, my heart started skipping beats, and I began to feel pains in my chest. I'm more of a tough through it sort of guy, so I went on with the night. These symptoms lasted for about an hour. I told my wife and she asked me what I wanted to do. I said I could wait and would go see a PCP or urgent care in the morning. As we were out with friends, I tried my best to relax and eventually my symptoms subsided somewhat. However, that would only be temporary as when I got home (about 1am) the real symptoms began. At about 1:30 I started sweating and couldn't lie down. Then I started to feel fairly deep stabbing pains in my chest (fairly painful) compounded with a massive building of pressure in my head (Very painful). So, I told my wife that I think I should go to the E.R.

That was it, we hopped in the car and off we were. I got there, told the triage nurse my symptoms and was immediately put in a room to get an ekg. My wife (who handled this all brilliantly) suggested I look at the ekg. So, I do and I start thinking out loud. Rate is fine, a pvc in a rhythm strip, axis is normal, no ST changes (whew), No significant Q waves, nothing really of notice. Essentially a stone cold normal ekg. As I'm doing this the nurse starts to look at me funny like..

Her: "So you know about ekg's eh?"
Me: "Yeah, it's a hobby." ← smiling.

I try to be the best possible patient I can in the E.R. because for one, it's the right thing to do. For two, people are generally more motivated to help you if you're polite. And lastly, I get that E.R. people have some of the rudest/meanest SOB's for patients.

So they wheel me off to a room, get me set up, draw blood and get a urine sample. So then a PA comes to see me and gives me one of the, "So I hear you like ekg's." He was really nice and even though the pressure was continuing to build in my head and my chest hurt like the fire of a thousand suns, I was cordial. We talked, I told him my symptoms and then I told him I was starting medical school in the fall. He told me I'd be his boss some day and we both laughed. We chit-chatted, I made a few jokes and he talked to me about how he hated to be pimped back in the day.

Meanwhile, I can hear a patient tell some of the staff to F*** off and that she's leaving. In another room I could hear a nurse calmy explaining to a man why Dilaudid isn't really necessary for his pain (that one made me laugh).

So, in a bit the attending comes in and we talk. He's a DO, I'm going to be a DO. We chit chat for a bit about specialties and OMM and then he tells me what's up. Normal ekg, normal enzymes, but he wants to run enzymes again in 4 hours. I tell him ok, but that the pressure in my head is really starting to get bad (It was). He says..

"Let's get a CT. And I'll get you some medicine to help you relax."

I say fine, we chit chat some more (his wife is an internist). Essentially, one of the coolest dudes I've ever met. I really felt like he cared.

Nurse (who was very cool) walks in with relaxing medicine (morphine), she gets about halfway down the syringe and I tell her to stop. This is the part in the story where I try to comprehend anyone wanting to be a drug addict. It felt like poison. I got sick, felt hot, thought I was going to throw up. Not relaxing at all. In fact, far from it. Eventually though I did calm down and the pressure in my head seem to subside.

Long story short, other than my BP (which was high all night >150/90), everything came back normal. I talked to the internist and he said the pressure in my head could be due to allergies (just having moved and not used to where I live now) and that the second set of enzymes were fine. The internist was a DO too. I could tell he hadn't slept in about 2 years, but again it was obvious that he cared. They were d/c'ing me and I'd follow up with an outpatient stress test.

For the most part, all my pain has gone away. I'm just sharing my story because the people (PA, Nurses, Docs) at this hospital really helped me. Yeah, they didn't give me a definitive diagnosis but they sure as hell pushed me through what was to me a pretty scary situation (I've NEVER felt that bad before). It was obvious that many of them were exhausted, but that they also honestly gave a crap for someone they hardly knew (which is more than I can say for most people in this world). Last night made me proud to say this is the field I'm going into. I just hope one day, I can be there for somebody too.

Thanks for letting me share. Now, I'm going back to bed 🙂

 

[ChairmanMao]

Well we're glad that you're OK now. Speaking of which, what part of the country do you live in? I find it unusual that you would run into two DO on the same night at the same hospital. At the hospital where I work, we're lucky if there is even one DO in any of the department.

 

[dragonfly99]

Whew!
I thought this was going to be one of those, "Doctors are evil and money-grubbing and don't care about people!" types of posts (sigh of relief, since I'm working in the ER tomorrow a.m.).

You should definitely follow up with your doctor (or get a primary doctor). I'm a little worried about your symptoms...can't give medical advice on here, but allergies by themselves don't seem like they'd be enough to cause all those symptoms you had.

 

[nontrdgsbuiucmd]

would agree that being a patient through a serious event like this really helps one to understand things in a different way.

a relative was admitted due to very sharp pains over extended time period, the recommended fix was to remove the gall bladder which seemed to be infected, tentatively first thing the morning after being admitted. I felt really uncomfortable with the speed at which everything was happenning -- into the ER around 8pm, tests until 2am or so, tentative surgery the next morning around 9am -- and how little knowledge it felt we were being given regarding alternatives. It seemed that we were on the conveyer belt; waiting to be rolled from one test room to another without a good feel for what the test results indicated or what possible plans of action were available.

Ultimately, the first of two surgeons who did that type of work for the hospital recommended immediate surgery, but the second surgeon, after a closer examination, decided that the gall bladder might not need to be removed, and the relative was released from the hospital after stabilizing a bit 2 days later -- 1 yr later, no problems with the gall bladder.

From my limited, as of yet outside perspective, having a patient advocate (as I was trying to be in this case) seems like it would offer lots of benefits. I felt very comfortable with the level of care, and the medical staff seemed extremely committed; only change in an ideal world (as a patient) would be more timely/complete information about what was happenning.

 

[ShyRem]

being a patient gives you an entirely different perspective of our health care system. And it gives you a reason to treat your patients like people rather than diseases.

 

[Thorpedo]

Well we're glad that you're OK now. Speaking of which, what part of the country do you live in? I find it unusual that you would run into two DO on the same night at the same hospital. At the hospital where I work, we're lucky if there is even one DO in any of the department.

In South Jersey, the hospitals have tons of DOs; at least, the ones around me do.

 

[ChandutheMagici]

Hey guys, tks for all the replies.

@ChairmanMao

Midwest = DO country.

@Dragonfly

I'm following up next wednesday with a stress test. I'm somewhat concerned about my symptoms as well as these things had never really happened to me before.

Anyway, it seems to me that all I ever hear about is money hungry doctors and how health care is ruined and blah blah blah. Well, my first real experience with civilian emergent care (under my own insurance) showed me the exact opposite - genuine people who honestly cared.

 

[NTF]

Midwest = DO country.

Too true. In Columbus, OH we have a bunch of hospitals founded by DO's and staffed by 70% DOs. What cracks me up is I still have to explain to RNs at my job what a DO is. It really is true, if they call you Doctor nobody checks or notices whether your coat says MD or DO.

 

[orbiter104]

Thanks for the share, glad you were able to report back some good stories about personal ER experiences. I've heard a lot of horrific stories but have witnessed a lot more positive ones. It is often that patients don't understand that emergency departments are acute care facilities and often come in for issues that need to be taken care of by their primary providers. They feel like they are not being treated for the causes of their symptoms but simply given some tests, perhaps even meds, and kicked out. Also, because of the influx of patients that don't have critical issues, like patients checking in because their kid caught a cold, the ER is often overcrowded and wait times can be up to several hours. Our lab techs are pretty good though as they get samples to the lab shortly after the pt checks into triage and sent back to the waiting room. Results are often in the system once the patient is assigned a bed and sees a physician but that can also take some time too.

 

[DrJosephKim]

In regions where healthcare disparities are highly prevalent, the ER becomes the PCP office for many (especially the uninsured).

 

[action3344]

Well we're glad that you're OK now. Speaking of which, what part of the country do you live in? I find it unusual that you would run into two DO on the same night at the same hospital. At the hospital where I work, we're lucky if there is even one DO in any of the department.

I live in Dayton Ohio and there are two hospitals in the area that are Osteopathic hospitals. We have Grandview and Southview Hospitals and they employ all D.O.s. This is for information only.

Ps. I am glad you are doing ok.