‘My wife was here yesterday for belly pain. That doctor didn’t do nothing! Told me she just needed to get over it. I am not happy and something needs to be done about this!’
(Frequently spoken by spouse.)
Records are reviewed. Treatment: Included numerous doses of morphine and phenergan, as well as fluids and Zofran. Frequent warm blankets were applied. Labs included: CBC, Comprehensive Metabolic Panel, Lipase, Urinalysis, Pregnancy Test. All negative. Imaging: CT scan of abdomen and pelvis with contrast, followed by ultrasound of pelvis. All negative. Discharge medications: Hydrocodone, Naprosyn and Phenergan. Discharge follow-up: Despite lack of insurance, an appointment has been arranged with general surgery (or gynecology) who will see the patient in one week, whereas it would normally take eight.
When confronted with this fact, patient and family say: ‘Well yeah, they did all that. But nobody did anything!’
It’s a peculiarity, I suppose, of our society that even the most aggressive, compassionate and thorough care is considered ‘nothing.’ Perhaps it’s frustration, or perhaps it’s a need for more prescription medication. Maybe it’s all somatization. But on some level, I have to believe that we have transcended ‘science.’ People simply don’t believe in the wonders and effectiveness of the very system they count on every single day. And in a subset of the population, there are two other phenomena.
One, the striking disappointment that seems to emerge with negative CT scans or tests. As the husband of a cancer survivor, a negative CT scan is enough to bring me to my knees in songs of praise. To many, it’s simply a failure. Two? This is tricky. But when you don’t feel the cost of any procedure or test, whether because of outstanding private insurance through an employer (typically a public employer), or through Medicaid, the value of the testing, the treatment, the thought processes involved, can all seem as cheap as dirt.
Odd times indeed. The more we do, the less we are perceived to do.
This post is why we all love you — Zeitgeist in such a succint, poignant, compassionate, revelatory, and balanced manner.
Cultural “norms” are hard to fight against because of the scale and the insistence that “if I think/feel so, it is so”. Objectivity seems no match for a tsunami of sentiment, no matter how small or far away the rumblings that caused it.
Thanks for another fantastic peak-behind-the-curtain for some and a well received commiseration for the rest of us.
Don’t let anyone tell you “you don’t do nuthin'”!
Charlene Mason
8 years ago
As always you heat the nail on the head. Just another night in the ER of doing nothing. Miss you! Happy Thanksgiving!
Constance Belcher
8 years ago
Perhaps we should stop ordering all the tests and just give out the prescriptions for narcotics, which is the whole purpose for the visit. I’m tired of ordering expensive xrays and blood work for people I know aren’t as sick as they claim to be.
Leslie pope
8 years ago
As a former employee in the ER, nothing upsets me more than hearing people critize the care they “do not” receive when they come to the emergency room. I have watched countless times the sacrifices the doctors and nurses make to provide the best possible care for the patients they see wether they believe they are sick or not. I have watched many go without a break or more than a quick snack for an entire shift because of the huge volume of patients waiting to be treated or seen. As a patient of the ER, it infuriates me when… Read more »
Scott Carroll
8 years ago
I feel your pain brother!
L. Lamar Williams NREMT-P (23YRS)
8 years ago
EMERGENCY Departments are misunderstood by the general public as a place in which you go in with a belly ache and they assume that you should have caught their brain tumor. We work off of a “chief complaint” and “chief complaint” only. That is also a misunderstanding. Most people have a specific problem that they always complain about and become complacent with. My back hurts from working in EMS for over 20 years but let something as a minor as a stomach ache interrupt my back pain and its off to the doctor I go. I get treated, and return… Read more »
David M
8 years ago
It’s quite simple. If a patient leaves without a definitive diagnosis and solution, then we have done nothing.
Frances Collins
8 years ago
Go on a months vacation… then compare the comments
Margie Smallman
8 years ago
Anymore, I just shake my head (hopefully inwardly!) when the patients come in for their stress echo and are flat out disappointed, frustrated and sometimes even embarrassed, when they’re given the good news that their test is negative. I tell them I get it. The same thing happens when I take my rattling car in and the mechanic doesn’t hear anything!! I remind them that it’s far preferable to have a disappointing negative test than to have cardiac issues. Some actually disagree! *sigh*
God bless ER workers. They were my heroes during a long year of horrible illness!!
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Dr Leap –
This post is why we all love you — Zeitgeist in such a succint, poignant, compassionate, revelatory, and balanced manner.
Cultural “norms” are hard to fight against because of the scale and the insistence that “if I think/feel so, it is so”. Objectivity seems no match for a tsunami of sentiment, no matter how small or far away the rumblings that caused it.
Thanks for another fantastic peak-behind-the-curtain for some and a well received commiseration for the rest of us.
Don’t let anyone tell you “you don’t do nuthin'”!
As always you heat the nail on the head. Just another night in the ER of doing nothing. Miss you! Happy Thanksgiving!
Perhaps we should stop ordering all the tests and just give out the prescriptions for narcotics, which is the whole purpose for the visit. I’m tired of ordering expensive xrays and blood work for people I know aren’t as sick as they claim to be.
As a former employee in the ER, nothing upsets me more than hearing people critize the care they “do not” receive when they come to the emergency room. I have watched countless times the sacrifices the doctors and nurses make to provide the best possible care for the patients they see wether they believe they are sick or not. I have watched many go without a break or more than a quick snack for an entire shift because of the huge volume of patients waiting to be treated or seen. As a patient of the ER, it infuriates me when… Read more »
I feel your pain brother!
EMERGENCY Departments are misunderstood by the general public as a place in which you go in with a belly ache and they assume that you should have caught their brain tumor. We work off of a “chief complaint” and “chief complaint” only. That is also a misunderstanding. Most people have a specific problem that they always complain about and become complacent with. My back hurts from working in EMS for over 20 years but let something as a minor as a stomach ache interrupt my back pain and its off to the doctor I go. I get treated, and return… Read more »
It’s quite simple. If a patient leaves without a definitive diagnosis and solution, then we have done nothing.
Go on a months vacation… then compare the comments
Anymore, I just shake my head (hopefully inwardly!) when the patients come in for their stress echo and are flat out disappointed, frustrated and sometimes even embarrassed, when they’re given the good news that their test is negative. I tell them I get it. The same thing happens when I take my rattling car in and the mechanic doesn’t hear anything!! I remind them that it’s far preferable to have a disappointing negative test than to have cardiac issues. Some actually disagree! *sigh*
God bless ER workers. They were my heroes during a long year of horrible illness!!