Friendly advice from the emergency room


Years of working in an emergency room have given me a lot of ‘worldly wisdom’.  I was reviewing some of this in my mind just the other day, and it occurred to me that it would be wrong to hoard all of this myself.  Everyone needs access to these little pearls, these ‘Hippocratic Aphorisms’, if only to avoid future embarrassment.  So here are a few ‘Emergency Proverbs’, to make all of my readers wiser in the coming year.


1) Don’t drink and drive.  That’s a given.  But if you drink and ride in a car, always empty your bladder before leaving in a vehicle.  If your friend wrecks the car, you may lie on the backboard for a very long time while we take x-rays.  At that point, it’s often a choice of ‘catheter or hold it.’  This is not any fun at all.


2) Only a very few women should wear thong underwear.  There may be guidelines, possibly somewhere on the Internet.  If you suspect you may not qualify, do not do it; for everyone’s sake, but mostly for your own dignity.  This rule applies, incidentally, to all men, everywhere, ever.


3) When you come to the hospital after a fight or accident, please let us know who should be allowed to visit you, and specify whether the woman in attendance is your girlfriend or wife.  If both show up, unpleasant incidents have been known to occur.  Ditto for husbands/boyfriends.


4) We know you drank more than two beers, so don’t try that one.  At some point, most of us have had two beers, but even then we didn’t do anything as ridiculous as the thing that brought you to the emergency room.


5) If you friend suggests any combination of the following words on Saturday night, heck, on any night, slip away and stand by with your cell-phone in order to call 911.  (And find a video camera, because it’s going to get interesting):  Beaver dam, dynamite, chainsaw, beer, four-wheeler, waterfall, pistol, beer, someone else’s girlfriend/wife, wood-carving, beer, train-tracks, whisky, convenience-store/panty-hose, methamphetamine, beer, pit-bull, bon-fire, mushrooms, motorcycle race, bar-fight, LSD, gasoline, yellow-jacket nest, beer, nail-gun, beer, rattlesnake, cop-car.  Oh, and beer.


6) Remember that the drama of your life is much less interesting to everyone when you’re explaining it while handcuffed to a hospital bed.  Remember, also, that what may have seemed very important at 3 AM will probably seem stupid when you go over the details with the judge who sets your bail.  (Hint, he or she will think it was stupid too). 


7) Dogs, as a general rule, do not like to be kissed on the mouth by drunk people. 


8) Lewd or pornographic tattoos seem cute at the time.  But ultimately, everyone makes fun of them when you’re a) intoxicated and unconscious or b) old and demented.  Think before you ink.


9) Just because you found a mushroom, doesn’t mean you should eat it.  People have died, trust me.


10) If you don’t remember when you put it in the refrigerator, don’t eat it.  Really.  Here’s a confirmation test:  let the dog smell it.  If the dog looks up and says, ‘you’ve got to be kidding’, then don’t eat the food in question.


11) Police officers lose their sense of humor when they have to wrestle with you.  Extra tip:  the pistol has bullets in it.


12) Few people look good in their driver’s license photo.  No one looks good when their arrest photo shows up in the newspaper.


13) If your wife says ‘you need to go to the emergency room’, she’s probably right.  That crushing chest pain may be something to worry about after all.


14) When you drive a new truck, smoke 2 packs per day and have a camera-phone, no one in medicine is going to bend over backwards to get you drug samples because you ‘can’t afford to get a prescription’.


15) Men, it’s a t-shirt or an undershirt.  It is not a ‘wife-beater’.  Should you call it that, we will all believe that you are as well.


16) No one should wear shorts that say ‘Bootylicious’, ‘delicious’ or ‘hot mama’ across the back-side, but this is especially true if the shorts are size XXXXL.  No one should describe themselves as ‘Bootylicious’, even if they think they are.


17) If you let your child crawl on the floor of the emergency room, bath them as soon as possible. If you wear house slippers to the emergency room, consider burning them.


18) God gave you a life to live.  Try talking to him frequently.  Not just when you’re screaming in pain after the accident involving gasoline, a beaver dam and moonshine.


19) For heaven’s sake, not every bump on your skin is a spider bite.  Spiders have better sense than to bite most people.


20) Before you do it, whatever it is, consider the consequences.  You might get lucky. But probably not.


21) You don’t get to pick the way you die, unless you ignore my rules or flirt with the wrong woman.  So try not to worry about it too much.  As my partner says, ‘the death rate remains the same; one per customer’.


22) The surest way to die early seems to be to run every day, eat nothing but fruits and vegetables, take vitamins and have regular check-ups.  The surest way to live a very long life seems to be to be a jobless, drug-using, drug-selling drain on society with an extensive criminal record and bad teeth.  These people never die!


23)  Poisonous snakes are fascinating and beautiful creatures, best viewed in zoos and on the nature channel.  They do not like to be cuddled or kissed, especially by intoxicated rednecks.


24)  My parents, all parents were right.  Nothing good does happen after midnight.  An entire subculture of persons emerges from dark houses and creepy hotel rooms to walk the night like zombies, all in search of pain medicine and a work excuse.  Stay home after dark!


25)  The single greatest cause of chest pain and seizures is being read Miranda rights and arrested.  They all want to come to the ER to avoid jail for just a little longer.


26)  If I know your genealogy, you’ve been in the emergency room too often.


27) The emergency department waiting room, like any given bar on Saturday night, is a very bad place for matchmaking.  Sure, she might have a certain glow when she has a fever, and he might look especially manly in handcuffs.  But after the romance wears off, you’re both stuck with crazy people.


28) We worry way too much about privacy.  Everyone in the emergency room stops by the beds of strangers and discusses their problem anyway.  ‘Do you have a broken arm?  I have gonorrhea!  It sure is along wait tonight!’  Furthermore, in the era of the camera phone, anything you do with your friends that results in an ER visit, will be posted on the Internet within 8 hours of your discharge.


29) Every doctor believes that medicine is an art.  But what they are really saying is that the art is acting.  We all surround ourselves with what we think are the right props and scripts.  For some it’s a lab-coat, for others multiple pagers.  For me it’s my reading glasses and for my partners it’s the reflex hammer.  And for some it’s a catch phrase:  ‘These things require a delicate balance’, or ‘I don’t know what’s going on, but let’s call a specialist and get to the bottom of it’.  Medicine, dear friends, is performance art of the highest order.


30) Passwords may be the death of everyone in medicine.  I have three that I have to use constantly in the ER.  What I wish I could tell the government is this:  it’s medicine, not the Manhattan project or the hunt for Al Qaida!  I don’t need a password to protect the X-rays from prying eyes.  The average person doesn’t know his femur from his tonsils anyway.


31)  There are stupid questions.  They said in medical school that the only stupid question was the one you don’t ask.  Wrong!  That’s a dirty trick to make you ask stupid questions.  Case in point.  ‘I was in the ER on August 20 and they told me I was six weeks pregnant.  How far along am I now?’  Bless her heart, that was a stupid question.


32)  Crazy people are everywhere.  They look like you and me.  They may not have official diagnoses.  But when they say things like ‘all the teeth in my mouth moved around and then locked back into place’, you know that crazy is well entrenched in the seemingly normal folks of society.



33) As hard as everyone works, the hardest wisdom is this:  when we all die, the emergency room will just keep going on.  Our place in the schedule will be filled, our job replaced and the work will continue.  So, and this goes for everyone in every job, we might as well stop, rest and have fun. We’re all very important.  And none of us are all that important.  


34) The highest praise I ever received was when someone told me ‘you don’t act like a doctor’.  From my years of observing doctors from the emergency room, I can tell you that’s a high compliment.


35) I like to make fun.  I always wanted to be a comedian or a writer.  So I can tell you with confidence that seeing people in a medical setting is some of the best training a writer can have.   They will tell you all of their secrets, all of their pain and all of their comedy for the price of a little kindness.  I can’t imagine any better training in the human condition.  Medicine teaches me that people can be unimaginably noble.  That they can be miserable and cruel.  That they can love like angels and kill like devils.  That they endure everything from paralysis to cancer with a smile; and at the same time can give up and take disability for the slightest injury just to withdraw from the world.  Medicine teaches me the way people speak and the way they laugh, the way the sound when they’re frightened for their child, and the way they stumble when they’re drunk. And it teaches me that all of them, from the ones I admire to the ones I have to laugh at, are just children in search of a father.  



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