Sunday, May 01, 2011

Live Nude Blogging from the ER... (tape delayed)

So it only took about five hours of ER work for the PTSD to come back in full force and for me to ask myself again what the hell I was thinking when I chose EM as a specialty.... But the good thing is that it made me (when the hell was over) get on my knees and thank God that I have managed to escape the meat-grinder.... Because that's what it is, and it IS that largely because doctors are kind-hearted and don't want to fight... In some cultures they would be called 'pusssies', but I have posted on this before..... So, to my day as a guest star in the ER....

To bring you all in let me present you with the old classic, the positive 'Throckmorton sign'... Yes, I have addressed it before, but here it was come by honestly, and I think you all can see that in this Xray the penis definitely is pointing to the side of the lesion.... This is not how my day started, but when I saw this Xray I knew I had a blog post...

But there's more. Turns out you can't even drive drunk on your own property in your own ATV... The police were called and came to the guy's bedside and wrote him a damned ticket.... Have a nice day, sir... Go figure (he was Otis Campbell drunk).

But this only followed on the heels on the latest surrender from the provider side. We no longer have a 'Doctor's Area' where we can keep our drinks and food... Unlike the patients, and families of patients in the ER, who can eat and drink in the rooms where we cut into people and stick them with central lines and such, we now have a 'hydration station'... Here's a picture....

You know, I wouldn't mind at all about the hydration station if I had just finished high school and was working for an hourly wage at some noble endeavor, but, it's like, you know, omigod!! Jenny McArthy gets national pub regarding her wacko views on vaccinations and autism while having her servants peel grapes for her and me and my pals, after 7 or 8 years of post college training, have to keep our refreshments within the taped lines (between patients cursing us and administrators walking through the ER like they have a fucking clue what is going on).

But the day did not disappoint for pathology.... I mean it's not everyday that you see an open calcaneus fracture... Poor lady will never walk right again... We just can't fix these very well... And it was open... looked like someone had shot her with a 0.38 (notice proper numerical notation as demanded by some shithead organization that now rules us) caliber pistol under the malleolus... The ortho guy thought I was smoking stuff when I told him but after he looked at the film and the patient he had an 'I'll be damned' look on his face.... That's the ER in a nutshell... You will be damned...

Those of you studying to put yourselves in Hell may want to look up "Bohler's Angle" so you can discuss this when you do your Ortho rotation, but for those of you on the street, or in the ER (there's really no difference anymore), you can simply look at this film and say, "Damn".

And then came the woman by ambulance that, after a very skillful and smiley interview conducted by moi about her chest pain, admitted to me that she was simply out of her percocet and valium and I got her to swear that her chest pain had been present for more than 8 hours so I did the EKG and troponin boogie and gave her the weekend supply and kicked her ass out.

And then there were the stupid people who got septic from.... wait for it... getting splinters in their lower extremities oh, five or six days prior (they waited till they couldn't walk to come in and one waited until her percocet wouldn't kill the pain anymore)... And then came the woman on whom the nurses requested I order a 'fecal managment system' (since she was pooping worms and all), and after I jokingly asked one of my favorite paramedics if she owned a weapon (she did), and I asked her to go get it and bring it into the ER and shoot me between the eyes... (jokingly sort-of)... I got to leave... and I was very glad to do so... and FUCK all you people who made this so miserable (see entire rest of blog to figure out who these people are)...

And to the three or four med students out there who want to go into ER... I know you think that being able to tell these stories is going to get you laid or something, but it's not... I mean, it may for a little while, but then when you crawl inside the bottle of Jack, you won't be able to get it up anyway... So do Dermatology why don't ya? Every ER, every time, a fucking jacked-up freak show where all you can do is try to manage the chaos. Medicine? Huh? Thus endeth the rant.


  1. Awesome rant 911, it's just like a Springsteen song (but it's not cool and artsy like his world was). Especially the last paragraph really, just that should drop some ER hopefuls because all you little ones out there, that is just the plain truth of it all.


  2. You guys can't seem to stop talking about how much you hate the job, but no other EM bloggers out there seem to be quite so eager to jump off a bridge as you lot. Maybe the problem is with you guys? Just sayin', either that or the majority are drowning themselves in the cool aid.

  3. golden handcuffs... learned helplessness... making the best of a bad situation.... to each his own... it's worth a shift every month or two to remind myself that most people have normal, fun lives, kinda like i do now practicing outside the ER for less money and better patients.

  4. 911Doc,

    I think you need to consider a job as house physician for a Regional Fibromylagia and Pain Center. You can still see many of hard to forget patients you have treated in the ED, but in a more pleasant environment.

    Holistic treatment in a suburban setting, with windows overlooking a horse farm. 500KG rated power recliners for the patients. Oxycontin facials, Darvocet Cookies, Fentanyl body wraps, MSo4/MgSO4 (take that JC) hot tubs.

    Not sure about job satifaction, but you will have total patient satisfaction.

  5. Glen,
    Capital idea! Gave me a good laugh too... Thanks, but you really need to be more careful with you abbreviations because if some nurse gives 2 grams of Morphine IV (they really don't know doses I guess--- just kidding nurses) your ass is going to burn

  6. Total patient satisfaction? See I caddied for the Dalai Lama on a course in the Himalayas and he hauls off and whacks one... Bottom of a ten thousand foot glacier... Etc... So on my deathbed, I will receive, total consciousness, so I got that going for me... Which is nice.

  7. The difference between when my great uncle was a doc in the 50s and now comes down to two simple phrases. 50s - doc can you please help me. 2000s. Doc, you better damn well help me and don't mess up or I'll sue.

  8. nice to see you 'cat.... and QED.

  9. You've got a "Hydration Station," we've got that whole "No Food Or Drank In Da Lab" rule, plus this fun edict taped to the fridge in the break room:

    "As mandated by JCAHO, all food and drink must be labeled with a name and date. All "expired" food & drink will be discarded."


  10. Spent the whole week at the ACOEP conference down in Florida. One guy (former grad from my school) was telling me about how him and some buddies were setting up some sort of concierge medicine business (they're all EM guys). Seemed like a pretty good idea.


    ..praying that you're lying about the not getting laid thing.

  11. "One guy (former grad from my school) was telling me about how him and some buddies were setting up some sort of concierge medicine business (they're all EM guys)"

    EXACTLY!! Everyone is beating a path out of the ER. And when people start dying it will, somehow, end up being our faults.

  12. Hey Homos...
    Wish I could tell y'all bout my weekend, but then I'd have to kill ya...

    Frank "NOT a Navy SEAL" Drackman

  13. Screw you, Frank, I'm on to you. How much did you need for DNA? Not the whole body on an overloaded helo, what with being down to 3, plus hauling a bunch of computers and crap back.

    I know dang well you guys are pulling a reverse "Weekend At Bernie's" stunt, pretending to 'Bambi that you bumped him off and "burrying" a live guy that you are really keeping sedated, until you can torture him by assigning him to duty in an ER.

  14. "Fuck all you people who made this so miserable." My sentiments exactly. In fact, this is my new mantra for every shift.
    -Steph, RN

  15. Where are you when there's a REAL emergency? My kitten just yanked an earring out of my ear and ran off with it, and I only have 30 percocets left to deal with the trauma.

  16. Jeus- H Christos on popsicle stick Dev... Call 911... Everybody else does.

  17. Devorrah is alive!!! How are ya lady?

    911 sorry it sucks. I still love your stories.