One of our nurses was checking a patient in a few days ago, and had the following interaction while taking his information.  Let me preface with the fact that the patient was in his mid 40’s.
Nurse:  ‘Do you work or go to school?’

Patient:  ‘I don’t work.  I’m thinking about getting disability.’

Nurse:  ‘For what?’

Patient:  ‘Oh, I don’t know.  Maybe my nerves.  I’m under a lot of stress.’

Nurse:  ‘Really?  What sort of stress?’

Patient:  ‘Those people I ride the bus with are driving me crazy!’

In a classic example of sheer, American know-how, in a brilliant perversion of the entrepreneurial spirit that makes us great, this individual figured that disability was tantamount to a career choice.  Like ‘I might become a pilot,’ ‘I might learn to be a plumber,’ ‘maybe I’ll go to law school,’ or even ‘I’ll go to New York City and walk dogs!’
In light of that, I began to wonder just what sort of disability I could get; then I started wondering what kinds of injuries or illnesses were unique to the practice of medicine in general, and to the practice of emergency medicine in particular.

For instance, could I get repetitive stress injury from typing too many orders onto the computer, born of our treatment algorithms, ‘pay for performance,’ and general spirit of defensive medicine?

Perhaps I could get ‘suture wrist,’ similar to tennis elbow.  Or maybe, ‘bimanual hand,’ from doing too many stressful pelvic exams.

Certainly, walking on concrete for the past 18 years hasn’t made my knees feel very good.  Maybe I’d be able to wrangle some sort of arthritis determination.

Of course, the weight I have gained as a result of stress eating can probably be tied to hours spent in the emergency department.  At home, I’ll walk, play, ride bikes, jump on the trampoline, swim or wrestle the children.  At work, since wrestling, swimming, bike-riding and trampolines are out, I just stand around between patients eating tortilla chips and salsa, chocolate, Chinese food, cups of peanut-butter designated for patients, bland saltine crackers or most anything else that sits unattended in the break room.  ‘Omnivorus medicus chronicum.’

My senses have also started to slip; so there’s a possibility. My right eye cataract is driving me nuts, and my left has troubles too, despite Lasik.  It may have to do with looking at computer screens.  Or it may be some sort of cortical blindness that my brain has developed as a defense mechanism against very disturbing patients and family members; or from the strain of looking for imaginary redness, swelling and foreign bodies, and searching for unimaginably obscure insect bites.

My arms gets tired from writing vague information, and from performing the exams we have to document now in order to be paid.  Is that a kind of repetitive stress injury?

And my poor nose.  Assaulted for years by everything from draining wounds to feet that qualify as biological weapons, I may soon have a hysterical loss of smell, purely as a defense mechanism.

Of course, let’s not forget selective deafness. My auditory cortex simply has an ‘off switch’ that engages when any story passes 10 minutes, or begins with the words, ‘let’s see, it was back in ’63 when I fell and all this started.’  I also experience this loss of hearing when I hear any news report that says I’m doing a bad job, or not doing enough to help the country in the course of my daily practice.

Furthermore, I think we all get a little bit of PTSD.  More on that later.  But what sort of disability rating can I get from telling people, over and over, that someone is dead?  That the news is bad?  That I have no idea how to help them?  Or that I simply won’t give them the same pain medications that their own doctor shovels into their Halloween pumpkins every month. Does that qualify?  The combination of terrible things and ridiculous things must cause some kind of ‘pseudo-stroke’ syndrome, or ‘near psychosis,’ or ‘patient tangential story disorder.’  I mean, there are pseudo-seizures, right?

I should do some research.  We may be sitting on billions in class action suits for doing what we do year after year, without anyone in positions of authority taking the time to recognize our unique risks and specially concocted work-related illnesses and injuries.  Considering the enormous fear of cell-signals and wireless networks, despite any evidence of injury, I think my above-listed ailments should cause some very real alarm, or at least some very significant snickering and forwarding behavior!

Fortunately, I don’t in the least bit want disability.  A best seller?  I’ll take it.  Strike gold on my property?  No guilt at all.  But simply to sandbag and decide work is too much, or too annoying, or to darn hard?  It flies in the face of my upbringing.  It insults my ancestors in their labors to survive.  It would shame my great grandfather who refused his Army pension, saying ‘I don’t want or need their money!’  It throws back into the face of God the very gifts and health he gave me and continues to pour out into my life.

I may not always like working, but I’m sure as shootin’ proud I keep going back.  And I’m equally proud that the idea of fishing for a disability diagnosis never crosses my mind.

Except during very busy shifts!

God bless you and keep you laughing…and working proudly!

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