I’m working nights tonight.  So since it’s flu season, and since I pulled up to our 20 bed emergency department at 11 pm with 5 ambulances outside the ambulance entrance, I’ve decided to rant.  I’ll write all night long when I have breaks, and give you some insights and rants into my evening as I go from ‘crisis to crisis.’

First of all, you can’t have a 24 hour drive through at Jack-in-the-Box and close it at 11 PM!  It’s not fair!  I need my large half-Coke/half-Diet and my large sweet tea with no ice.  You don’t just close Starbucks before it’s time, do you?  Well that just sets the tone for the night, doesn’t it?

That and the fact that I couldn’t sleep this evening.  I lay in bed dozing, listening to the Vox music channel with American Spirituals, then waking up to watch snippets of Fantastic Four, Weaponology, Scrubs and The Matrix. 

(I just realized!  I’m not in the ER.  I’m plugged into a machine contributing electricity to an alien race while I’m suspended in a fluid.  Pretty close to reality except that I’m actually contributing money, time and effort to the health-care system in order to care for a race of aliens who want Lortab and disability.) 

23:10  MVA with possible loss of consciousness.  Jeans pulled down to mid thigh, boxers visible.  Not due to accident; clearly fashion statement.  Now let me propose this:  if you can actively check your cell-phone and text message while on the backboard, your likelihood of significant in jury may be lower.

23:15  Chest pain, 50’s year old woman.  Radiation to left arm, shoprtness of breath, nausea, history of hypertension.  Of course, it all began ‘after an argument.’  You say the right things, you get admitted.  Sigh.  The Drama Center strikes again.

01:00  University student with laceration to arm.  Punched or fell through glass window at drinking establishment and needs stitches.   Easy money! 

01:30  Surprise!  No serious injury in MVA boy.  Text messaging magically saves another life.  Leap’s Law:  The severity of injury or illness is inversely proportional to the time and attention spent on the cell phone talking or ‘texting.’  I have seen people die.  Do you know what they don’t do?  Ask for a cell-phone to text someone!

02:20  Back pain and disorientation.  ‘I don’t know what’s been going on for 2 or 3 days doc!’  ‘Have you been taking your Oxycontin?’  ‘Well, I don’t know.  Them dogs might have gotten into it.  You know how they are…’

(Let me pause for a minute here…dogs are probably the most consistently accused drug thieves in America.  The dogs ate the pills, the dogs stole the prescription.  What are these dogs doing with it?  Are we experiencing a silent epidemic of tragically addicted Chihuahuas?  Of Beagles looking for a fix, abandoning rabbits for Lortab?  Do I need to send EMS to his house to resuscitate the dog, who is now unconscious with the television on Animal Planet?)

Here’s a reality show for you:  Let’s all seek disability!  15 men and women compete for the title of most pathetic (or most annoying) and the winner gets lifetime disability. 

OK, I’m so tired.  MacDonalds tea is OK, but it’s not Jack-in-the-Box!  Thankfully, it’s slowing down and a pretty reasonable night.  More rants to come. 

Remarkably little flu!  However, more fun…

04:30  University police bring student who is incarcerated and ‘thinks he might have a seizure.’  When did this become an option?  ‘I think I might have a heart attack.’  ‘I think I might fall down.’  Pre-emptive ER visit?  So I says, says I, ‘let’s give you some Ativan.’  ‘Really?  I mean, I don’t want to take something that will make me say crazy stuff again!’  He and his mother stopped his Depakote about a year ago.  Having seizures?  That worked out pretty well.  His mother, he says, makes him afraid of medication.  I said he might actually need some.  ‘Well you need to tell her that,’ he suggests to me.  ‘No, you need to tell her that.   You’re 26.’ 

Side note:  I taught my kids how to fake a seizure.  My wife asked ‘why did you do that?’  ‘It’s a skill,’ I replied calmly.  You need some dark, sub-culture skills now and then.  ‘You know, nunchuk skills,’ as Napolean Dynamite would say.  Case in point.  Mere threat of seizure results in vacation from jail.      

TA DA! 

Oh, his t-shirt:  ‘My other ride is your mother.’  Classy.  Really classy.   Police roll their eyes.  I just keep checking my watch. 

Mumbling, incoherent hip fracture from nursing home, bless her little heart.

Chest pain, palpitations, kidney stone, dehydration, abdominal pain.  All still here at…

04:58.  Will the sun never rise?  Has eternal darkness enveloped the earth?  Will dogs continue to steal oxycontin and sell it to innocent cats?  Have I had too much caffeine?  Entirely possible.  Must have more…

05:30  More chest pain.  A weight on my chest…and bipolar.  Also, she looks angry about her chest pain.  Take a step back.  I asked her to squeeze my fingers.  My ring is imprinted into my fingers. 

06:00  Patient’s sister:  ‘Doctor, doctor, can I talk to you?  My sister has chest pain, but she’s not right and our brother committed suicide and can you just commit her for a few weeks to the mental hospital?  She hears voices.’

patient:  You can talk to me in front of my face.  I’m NOT crazy and you can tell Connie I said so.  And I ain’t GOING to no mental hospital. 

sister:  Doctor, you see?  No one listens to us.  She’s not right.  I’ll go get her husband.  (Complex exchange of phone calls on cell phone thrown back at each other)

niece, on phone:  no, I haven’t seen her hallucinate!

patient:  I got bipolar, not the kixophrenia!  You don’t hear voices!  I’m just going through the change!  I’ll sue this hospital. 

To nurse:  And what are you looking at?

me:  clicking heals together:  ‘There’s no place like home, there’s no place like home.’

Eating peanut-butter and cheese crackers can be such a little slice of heaven. I like cheese.  And peanut butter.  The sun isn’t up, but my partner is getting in his car.

Wow, I can’t wait to get in bed.  And see my family, whose only subtext is something simple like ‘Papa, will you make me some toast?’ 

Sweet dreams all.  And may your patients solve their months old crises before coming to the department at 3 am.

Edwin, zzzzzzzzzz