Friday, September 28, 2007

"I'll Walk it Off"

I covered a local high school football game tonight at the request of one of my orthopedic colleagues. I love football.

I show up at the game and see the same kids that were in my high school 29 years ago or so. There were band geeks who thought they were cool, a kid with a pink Mohawk (very retro dude!), a nearly out of the closet Marilyn Manson clone, and then the teams, and the cheerleaders, and the dance squad, and the fans.

This game is played out with a whole lot of passion and effort and it went down to the last seconds and it was not very good football, but still, I was struck dumb with the following.

In the early fourth quarter I went out onto the field to assess a player from the other team who had an ankle injury. The coaches from both teams were out there and both teams took a knee and took their helmets off and the stands got quiet and everyone was concerned and it was so different from the ED.

So the kid is really hurting but he does NOT have an obvious fracture. I talk to him and do and exam on the 40 yard line and he gets helped to his feet and to the sidelines where he is taped up. Then I start my ED doc's spiel... "You may have a fracture, you probably need an Xray either tonight or..." when the player says, "Doc, I'm good... Don't make me sit... I'll walk it off."

Walk it off? What? Huh? Don't you need an Xray? Don't you want to apply for disability? Don't you want pain medicine? I can write you an excuse if you like?? Huh?

I left the game with renewed faith in about 4% of our population. Thanks kid.

11 comments:

  1. It's ok.

    We had an "ankle pain for 3 weeks" tonight. Looked perfectly normal, but of course he had 10/10 pain. Xray was negative. Air splint, crutches, Lortab script and work note dispensed.

    I'll see your 4% and raise you 96%.

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  2. With my jarheads, I can usually tell whether the individual is exaggerating / malingering, legitimately concerned, or if i need to forcible make them sit down and stop. Unlike my stupid senior corpsman who "walked it off"... till he couldnt walk it off anymore, then found out he had a hairline/stress fracture in the ball of his hip.. funny, thats not one your supposed to walk off.

    Military medicine is the best.

    Doc H USN

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  3. If you've ever worked in a rural ranching area you'll find that those ole boys and gals are tough too. If you can get em to the ER that's a start, they tend to be very stoic and usually just want to get the hell out of there!
    Some bullriders are weenies though. Rodeo cowboys are not the same as ranch cowboys.

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  4. absolutely. have taken care of rodeo cowboys with broken ribs and hugs lacerations from a bull, have taken care of ranch cowboys crushed by large animals, farmers with fingers gone etc...

    me: "i need to give you some pain medicine and anesthetic to stich you up."
    cowboy: "stich it up doc, i don't need no medicine. gotta get back to it."
    me: "yes sir."

    God bless 'em.

    love 'em.

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  5. The other day, my friend stepped on a nail while working construction (like where it was really jammed in there) and used a utility knife and pliers to pull it out.

    Or maybe he was just trying to impress me.

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  6. Yep. I was a little intoxicated while hearing the story, but it seemed he bent the part of the nail that was sticking out at an angle to get a better grip and cut around the nail and just yanked.

    He also did something similar with a giant splinter that went clear through the finger when he was roofing. He said all that needed was the utility knife, a good cut and a yank with the pliers as well.

    No tetanus yet!

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  7. I had 74 year old male who ditched his bike on a curb today....he tried to "walk it off", until he passed out from the 2 liters of blood in his abdomen from his grade 4 splenic lac, pneumo, and 7 rib fractures.

    Still, the fact that he tried to walk it off killed me.

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  8. that's cowboy tough and brittney spears stupid.

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  9. The genuine people are what make things worthwhile when we're all about cynicalled (new word) out from the users/dopers/liars...

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  10. That "athlete mentality" was the thing I enjoyed the most about my years volunteering as the team doc for a hockey team.

    The question the players always asked was "when can I go back in the game"?

    I saw those kids play through pain that I see every day in some ER patients that want xrays, an MRI, pain pills, a week off work, and handicapped parking.

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