Decades and Decades

I think in most ER’s the triage nurses take great pleasure in documenting the patient’s chief complaint, word for word. I don’t blame them as people come in with some just ridiculous stuff and it’s often quite funny. Chief complaint of my last patient last night “I’ve had chest pain for decades” Really? Decades? but you chose tonight to come in? at 615am? So naturally I was a bit biased walking into the room, expecting some bullshit story of why this decade long pain now needs to be treated with dilaudid. But, I was actually surprised by the patient. She was a primordial dwarf (do a google image search if you need to) and had one of those voices where it was all high pitched and cute, like her lungs are permanently filled with helium.  And she was all sweet and nice when we talked, but… her story was all over the place, but…she did seem a bit cognitively challenged,  but…she looked like she was off the street (already wearing hospital socks), and she kept going on and on “my pain, my pain, my pain”, but… she had never been here before, so to make this run on sentence finally end, I was torn. Is she just “different” or is were my initial jaded suspicions correct and she is narcotic seeking and trying to dupe me with this cute little super nice squeaky voice that you can’t help sympathize with act? She had traits of each, person in pain needing help, street person looking for a quick fix,  pulling me in two different directions.  So I just bit the bullet, “What makes your pain go away?” (Please don’t say dilaudid, please don’t say dilaudid). “Well, when I was in the hospital before, they gave me nitroglycerin and that seemed to help” (HALLELUJAH!) It would have broken my heart last night if she just been trying to take me for a ride. Imagine the feeling of your sweet old grandma asking to borrow $5 to play bingo, but then seeing her buying heroin from the corner dealer, that was the disappointment I was on the cusp of feeling.  But I didn’t have to, she wanted nitro, and it worked, it made her pain better. Faith in humanity restored.

About ER Jedi

I’m a resident doctor in Emergency Medicine and I’ve learned during the past few years that 1) I’ve had some pretty amazing experiences 2) I have a very bad short-term memory. So this blog is just a place for me to write about some of these experiences, from the ER, medical school, the wards and life in general. At least that way I’ll have some idea as to where I’ve been all this time. A scrap-book of sorts, a place to vent, organize some clinical tools and post a few good songs I’ve heard along the way.

Posted on December 7, 2011, in Zen. Bookmark the permalink. 2 Comments.

  1. Commenting only on the first aspect of your post, but we had a chief complaint in the chart when I was a resident that read “I’ve got fluid up to my titties.”

    The drug seekers here prefer demerol, guess it’s a regional thing.

  2. Sometimes we donot imagine about the suffering of a patient.Well i am not a doctor but i have seen such cases so many times when i go to my family’s doctor clinic.This is bit funny thing when such type of patients come to doctor and say like that.

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