Top Ten Reasons to Not Get Sick

31 Dec

Dr. MD

From “Dr. MD”, our New York Medical Correspondent, here are the Top Ten Chief Complaints of 2009…

Chief complaints are, as the name implies, the number one reason why you are seeing a physician. They’re the first thing we document on a chart, and are supposed to be the main reason that brought you to the Emergency Room (in my specialty’s case). Sometimes a chief complaint is the first thing a patient says to me, sometimes it takes several minutes of prodding and the eventual “yes but why did you come to the ER today?” question. Regardless, if I’m in the right mood – and not totally overwhelmed by the masses trying to keep me company at my place of work – I have a few moments to reflect on how interesting this piece of information is and what it tells me about humanity in general. Below are some of this year’s “best” chief complaints. Information has been altered in all cases so as to protect patient’s confidentiality as well as myself from any lawsuit for HIPAA violations.

10. “My son needs to see an ophthalmologist”

Right so here is a prime example of what is wrong with the healthcare system. How could anyone think that an Emergency Department could provide you with the specialty care that you have been given an appointment for in SIX MONTHS from now. This is an example of an uneducated public, or just someone who has given up on trying to figure out how to get the medical care that his son needs. Ding! 5 minutes of counseling and a brief eye exam screening for potential emergencies and you are walking out of the ER with the same appointment scheduled. Good work… you spent 4 hours in the waiting room for that? You should be mad… AT YOURSELF!

9. “I was fencing in a warehouse and fell backwards 15 feet to the ground”

So I have a lot of questions after hearing this one. This was a young teenage gentleman. First off, fencing? Really? Secondly, what the hell were you doing in a empty warehouse on a Friday evening at 11pm? After ruining a perfectly good pair of trauma shears cutting through the mesh protective fencing gear, we learned that he broke his hip, spine and had internal bleeding. Hope the swashbuckling was worth the admission to the trauma service.

8. “My 8-year-old son has chest pain”

I walk up to this patient and his parents to find him and his dad both drinking XL cups with the Dunkin Donuts logo on the outside. They start to tell me the whole story and being my abrasive self I demand to know what is in the cups. Dad says, “Don’t worry, its not coffee, its Chai… he loves it!” Loved it so much that he drinks two large cups a day and that combined with the other forms of caffeine he was addicted to and abusing led him to his multiple panic attacks and “chest pain.” Child services didn’t have a case but you better believe they were called.


7. “I jumped off a moving tractor”

wow

This is one of those patients that I think exist merely for the enjoyment of the medical staff taking care of them. Dude was racing a tractor down a hill and got it up to 40 mph before he lost control and then jumped to save himself from going down with the tractor. His ankle ended up next to his shin on the foot he landed on. Got put back together nicely by the Orthopedic Surgeons but then developed a whopping infection and needed weeks of antibiotics and, likely, months of rehabilitation before he even tried to walk again.

6. “We need to be home by Shabbos/Mass/Prayer-time”
One of my good finance friends has a plaque that says “Under-Promise, Over-Deliver,” and that applies nicely here. These patients and their family members get a nice reminder that even in their culture the health of their loved one supersedes having to walk home and asking a non-hasidic neighbor to open their door for them. Or missing something you’ve done every week. Or every day. You came to the hospital to get help so let me do that first, please.

5. “He passed us doing 120 mph ten minutes before we heard the call of the motorcycle accident”
This was the police describing the patient who was in a coma from profuse bleeding in his brain. My question to them was, “how do you know for sure it was this guy that passed you… I mean he was going 120 wasn’t it a blur?” Their response was to pick up the mangled helmet that lay on the ground next to his stretcher and point out that not everyone glues a neon green mohawk on the outside of their helmets. Touche.

4. “I’m allergic to morphine”
Translation… “I’m addicted to narcotics and I’m going to be a pain in your ass if you don’t give me Dilaudid (or whatever the drug is that the patient is seeking).” I’m not the first person to write about this. My personal opinion… I’d rather give narcotics to nine drug addicts than miss the one person who really needs it.

3. “He was perfectly healthy before his heart attack”

Right… no. Unless your loved one was smoking crack he probably had a little bit of underlying disease that no one was coming to terms with. Not seeing a doctor for 10 years also doesn’t mean that there’s nothing wrong with you. Your husband was in his late 40s, smoked two packs a day since he was 18, had high blood pressure diagnosed a while ago but doesn’t take the medicine he was told to take… oh, and his dad died at 45 from a heart attack… denial sucks. If you know someone like this try to have this conversation with them or their family before I do in the ER, after their heart attack.

2. “Too much fever”
Call me culturally insensitive with this one but I’m less making fun of this and more just in awe at the phenomenon of which cultures are unable to understand disease. In this case, worried mommies with little grasp of the English language show up without someone to translate and expect me to cure the fever their child has for less than 24 hours. And sometimes these fevers are 99.9 degrees farenhiet. It is “mind bottling” how many kids I see over two years old with low grade fever and constitutional symptoms who just need chicken soup and tylenol… yet they get dragged to a pediatric ER by parents who seem hell bent on making sure they put their already sick kid around other sick kids. Guess what, if your child didn’t already have the flu… they do now!

1. “F@#$ YOU!

This was by far my favorite of 2009. I walked into a room with four NYPD officers, two of my hospital’s security guards and a mean-looking nurse with a syringe of “happy juice,” with all the commotion coming from a 5’2″ man bound to the stretcher with handcuffs. I wasn’t delusionally thinking I was going to make the situation better by asking but its kind of my job… and I was met with the same answer to: “What happened,” “Why are you in the Emergency Room,” and “If you just calm down we can try to get you out of those handcuffs.” In trauma hospitals (which mine is not) there is a 3-F-U rule. Dropping the F-bomb three times gets you paralyzed, coma-tized and put on a respirator until whatever it is that was making you so abrasive wears off. This guy just got enough Haldol and Ativan to keep him asleep for 12 hours. I went home after my shift, went to bed, came back the next day and got to send him off the the precinct. End of story… he only admitted to drinking alcohol… now that’s one angry drunk!

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5 Responses to “Top Ten Reasons to Not Get Sick”

  1. Claire December 31, 2009 at 4:52 pm #

    #7 – AAGGGGGHHHHHH

    #1 – This man is my hero

  2. Cara December 31, 2009 at 5:26 pm #

    Haldol and Ativan? I work with kids, so maybe it’s different with adults, but we usually try to start with an atypical, like Seroquel, rather than jump in with something like Haldol…

    I can’t believe I’m leaving a serious comment on this blog. What is wrong with me?

  3. molly January 2, 2010 at 9:52 pm #

    I fenced in college

  4. Kelly January 3, 2010 at 4:15 pm #

    How did Alex incidents not make this list? Also, I think we should institute the 3 F-U rule in life.

  5. Drewpreme January 14, 2010 at 2:25 am #

    Easily one of the best drops on this blog in a while. I apologize that I haven’t read nor commented on this sooner. Sounds like your job is as nutty as any high school teacher, only drugs and bodily fluids are involved…

    Nuff respect due there Doc…

    PS – I can relate to this mayhem. My alma mater’s hospital/med school was smack dab in economically depressed N. Philly. So people treated the emergency room like a clinic. My two highlights:

    – Being brought into the hospital by the cops in cuffs with my hand slashed open due to a a scenario that I can’t repeat for legal reasons. I remember hearing over the squawking of Johnny Law’s radio that someone woman was yelling about her kid needs help because he was bit by something. I thought my felonious wounding should have taken a back seat to this poor kid.

    – Being brought into the hospital by the athletic training staff because my middle finger was perpendicular to my hand and just chillin’ like that. Whilst sitting there in sweat football practice attire (complete with cleats), the doc is working on my finger when the PD and the Alphabet Boys come flying in to the ER with some dude handcuffed to the gurney. Found out dude was shot 24 times in a bullet trade with the DEA, and the doc said “The finger ain’t so bad now huh?”

    Major City ER’s = Never a dull moment.

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