The unfortunate reality is that I get a lot of bullshit trauma. A lot. A LOOOOOT. Out of 20 patients I may see in a 24-hour period, perhaps 3 or 4 will actually be critically injured, requiring some kind of life-saving treatment or manoeuvre. That leaves (if you're following along the arithmetic with me) about 79.9999% of patients who at least have some sort of injury that, while it won't kill them, at least needs some sort of attention by a medical professional.
"Wait just one damned second, Doc. What happened to that other 0.0001%? Sixteen divided by twenty is 0.8, not 0.79999! Did you fail maths? Lawl!"
Settle down there, math wizard. That 0.0001% belongs to the 1-in-1,000,000 patient like Howard (not his real name©).
Howard was playing basketball. Howard got poked in the eye. Howard was brought to me.
No seriously, that's it. That's the whole story. He didn't fall, didn't hit his head, didn't lose consciousness, didn't sprain his ankle, didn't have any other injuries. He just got poked in the eye. Hell, I injured myself worse than Howard that morning while I was shaving.
But that's the wile story - the medics brought him to my hospital . . . to my trauma bay . . . to me . . . because he got poked in the eye. His eye wasn't hanging out of his head, it wasn't bleeding, it wasn't swollen, there were no lacerations. Oh, and his vision was of course totally normal. How's that for glamorous?
I felt bad taking 5 seconds to look over him and send him home, but that's all I could do. I couldn't justify doing any blood work, X-rays, CT scans, or anything else for that matter. I should be happy to get such an uninjured patient, but it left me feeling annoyed and strangely empty.
I think the next time I nick myself shaving, I'll call an ambulance. It'll probably be a quicker way of getting to work than driving myself.
EDIT: My apologies for the arithmetic error. I made a mistake that a reader caught. I then corrected the mistake incorrectly, and the new mistake was caught by another reader. It should be fixed now.
In the future, if any readers catch any errors, kindly email me so I can correct it rather than posting a comment.
I gave myself half a black eye opening my car door. Yes, opening my car door into my face. I was talking to the dogs in the back of the vehicle, whipped open the front door, caught myself in the middle of my eyebrow with the edge of the door, and ended up with a nice shiner on the top half of my eye. I just stood there clutching my eyebrow and swearing, so it never occurred to me to call an ambulance. (Sigh... and you think your days are uninteresting?)ReplyDelete
You got off easy! I have a scar on my lip because my ex yanked the car door open and smacked my in the face. My lip busy open, I was spitting blood, and we wound up going to the ER at 2:00 am to stitch it up.Delete
What I want to know is who called the medics in the first place? Did Howard seriously feel that getting poked in the eye was reason enough to call 911, or was it the friend who poked him and felt horrible about it? Or maybe it was some socially awkward guy who was trying to help but is unfamiliar with the social customs around minor annoyances (I can't even bring myself to type "injuries", because it wasn't.) and so fell back on the type of knowledge ingrained into us as children?ReplyDelete
I have no idea who called them. I usually don't get the story.Delete
From a doctor's blog, link now broken.ReplyDelete
The man was wheeled in. He had injured himself while drunk. The resident immediately noticed that one of his eyes had a fixed and dilated pupil, which is a sign of severe brain injury. He questioned the man about his eye and what had happened.
The man sat up suddenly and popped his glass eye into his hand to show the resident.
hahahahaha!!!! That's something my grampa would have done! No seriously, he had a glass eye!Delete
heh heh heh....that's funnyDelete
Worked in a level one trauma center and many times saw patients flown in from smaller hospitals just to be discharged shortly after arriving. We have a healthcare crisis why??ReplyDelete
Think it through, doc. You call an ambulance to get to work. The medics start to hate you. Suddenly, someone tripped on the sidewalk and the mechanism of injury is a fucking planet so they're trauma. Someone twisted their ankle and called an ambulance because it might be broken, but they upgraded it to trauma as a precaution because the person is diabetic (what?). Keep the medics happy. =PReplyDelete
and here I was thinking you only see 2-3 patients a week...ReplyDelete
yeah, the cases where the person is most likely okay, but since there was a loss of consciousness, or the person is intoxicated, they are not considered able to assess their own condition annoy those of us on this end of the ambulance ride, too.
Kind of sounds like what happens around here whenever there are gunshots. EVERYTHING gets helicoptered out, from the serious shit to a grazed arm. Why? Because if county EMS doesn't "do everything possible" for our lovely little gang-bangers, families scream "Racist! You don't care what happens to my beloved thug-life embracing friend/relative/homie. Lawsuit coming!"ReplyDelete
And to think I'll take my COPD/atrial fib/hypertrophic cardiomyopathy mother to the hospital in my car with O2 sats in the high 80s/low 90s, because I feel that waiting the 10 to 20 minutes for an ambulance (that's probably actually parked close to a 'hood in order to respond to those poor-aiming gang-bangers) is a waste of time. LOL
just a question - but how long is the drive time from your home to the hospital?Delete
not that I don't understand your annoyance with the EMS services having to cater to people who think its okay to shoot other people as a means of interpersonal problem solving.
My mother's house is 7 minutes from the small community hospital (that I felt could handle an exacerbation of COPD with nebulizer treatments and 24 hours of IV Solu-Medrol) and we are 40 minutes from a larger, full-service hospital. The last time I took her to the hospital (going on 2 weekends ago) I chose the local hospital; I did not relish the idea of being in a car with her, audibly wheezing, her chest rattling, yet jonesing for a cigarette while refusing to wear a seat belt for 40 minutes, not to mention the minimum 8 to 18 hour wait for a telemetry bed to open up.
My mind boggles at how people just HAVE to have that cigarette even though they are dependent on wearing low-flow O2 (but of course she removes it to smoke!) and they can't do anything but lie in bed, wheezing and unable to breathe after the minor exertion of taking oneself to the toilet or shifting position in bed.
My parents' employee watched her mother die of lung cancer - while still determinedly smoking. when she told the doctor he had to make her quit, the doctor replied, "what can I threaten her with?"Delete
my wife is still an addicted smoker, despite the fact that her father also died of lung cancer - literally coughing his lungs up in her lap.
I quite literally have NO sympathy or use for the tobacco industry. it is a terribly insidious drug, and I wish it would go away - along with many other drugs.
There needs to be a brain-cell transplant procedure. I've seen and/or read about so many people that need one.ReplyDelete
I worked in a trauma ICU...we had many family members ask about brain transplants when their loved ones were declared brain dead. They saw it on TV. Must be real. ;-)ReplyDelete
Can you write any funny stories about encounters with psychiatrists?ReplyDelete
I agree that it was over the top to call an ambulance for being poked in the eye, and yes it was probably unnecessary to have a trauma surgeon evaluate the patient, but I've scratched my cornea from a similar injury, so I don't think it was that crazy to want to be checked out at the ER. You couldn't justify even doing an eye stain to check for scratches? Or did my doctor over-exaggerate the need to get that kind of injury checked out?ReplyDelete