Which Patient is Telling the Truth?
February 27, 2008
Patient number 1 is a 40ish man with no medical history that comes in from his job at a construction site where he suffered a sudden onset of right flank pain. Driven in by a co-worker he is barely able to walk in, hunched over, pale, sweaty, diaphoretic, writhing on the gurney, tachycardic and hypertensive. Shortly after getting to triage he starts vomiting. During triage he seems apologetic when he rates his pain a “7 or 8.”
Patient number 2 is a twenty something who is brought in from the parking lot in a wheelchair by a friend, they are laughing and talking on their cell-phones when you bring him in for triage. Chief complaint is a twisted ankle. Despite apparently being able to walk to the car at home he is now unable to walk and has to be brought into triage in a wheelchair. In triage his skin is pink, warm and dry and vitals are normal. He rates his pain a “12.”
Patient number 1 is given Toradol and Compazine IV and has complete relief of his pain. He is diagnosed with a small, non-obstructing kidney stone. Discharged home with prescriptions for Motrin, Vicodin and Flomax as well as a urine strainer.
Patient number 2 is diagnosed with muscle strain. He is offered an stirrup splint and a prescription for Motrin. He is unhappy and demands a pain shot, crutches, work note and a prescription for Vicodin. He is told no at which point he jumps off the gurney and stomps out of the ER in a huff, screaming “I’m never coming back to this motherfucking place.” Another miracle cure, courtesy of emergency medicine.
This is the kind of thing that clogs up ER’s all over our country. America is filled with people that contribute nothing to society but come equipped with a massive sense of entitlement, they want what they want, when they want it, when they want it. Told no, they became belligerent and assualtive, spewing threats toward they staff. Fearing patient complaints or confrontation, more than one practitioner has taken the path of least resistance. Hospital administration, driven by their wish for high patient satisfaction scores, fails to allow MD’s to practice medicine and join JCAHO in forcing us to be legalized drug pushers rather than medical practitioners.
Someday, when there is an epidemic or surge of casualties from a natural disaster or terrorist attack the ER won’t be able to care for those victims because we will be full of patients with ‘chronic pain’ who are seeking drugs.