Tuesday, September 21, 2010

Farmer's almanac

I guess part of the problem of being a dreamer is crashing and burning when reality smacks you in the face.
Case in point: I'm even getting jaded by the quirky and peculiar people of my little rural town.
Now, I'm not sure if it's me, or if it's just that simply that society has gotten more petulant, but, for highlights:

One man came into my emergency department (I'm going to emphasize this was an emergency department in a hospital; not a walk-in clinic, not a family practice clinic) telling me he hadn't had a poo in about 16 hours, basically since the night before.
"Besides," said he, "you guys are here anyways, so I thought I'd check."
"Well sir," I replied, "technically, I am only here to care for emergencies."
"This IS an emergency!" quoth he.
Suffice it to say, I quickly dispatched him from the emergency room. I warned the nurses if he showed up again, I'd give him a bowel prep, and will forever banish the notion of his being constipated ever again.

Another brought her adult daughter with a long-standing seizure disorder, worried that she was "about" to have a seizure... over the past eight hours. Wanted to 'drop her off' so our nurses could watch her overnight, 'just in case'. Ridiculous, thought I; my RNs are not Registered Nannies. Speaking to the adult daughter, who felt unwell, but certainly not definitely pre-seizure, was annoyed that her "overprotective" mother brought her in without asking her opinion on the matter - she herself felt well enough to manage at home, and certainly didn't feel she needed to be in hospital - dispatch.

One woman brought in her teenage son, that, not only had he already seen his family doctor several days before, and already had Xrays done, AND had another appointment with the family doctor the very next day, had a sore arm. Which was just a sore arm - dispatch.

The one legitimate thing I did deal with, however, was a true anaphylactic reaction - hives, swelling, throat closing, losing air, the whole kit and kaboodle. And it was great, cause we saved him (Though, admittedly, if the patient had been actually carrying an Epipen around with him and had been using it, it likely wouldn't have been as dramatic).

Another great interaction that I had was completely unexpected. One woman, who had gone for her routine mammogram a month ago, had been called back for special views, some unusual masses were seen, and it was recommended that she go for biopsy of those masses. I stepped in at this part of the story, so I arranged for her biopsies to be done on a semi-urgent basis. The patient then wanted to come in to speak to me. "Oh no," I thought, "she's going to rant and rave about how slow and incompetent I and the system are, or she's going to freak out and blubber all over me about how she's going to die, or something to that effect along that spectrum. Great."
Turns out, she was the first EVER rational patient that I've seen in this scenario. She's leaving for a short vacation tomorrow, so isn't able to accommodate a biopsy to be done for another week and a half. She feels that she would like to go on vacation anyways, as she figures, it's already been a month in the making anyways, and besides, if it does turn out to be bad news, she would have rather have gone on vacation while she still could. RATIONAL! Loved it. Cringing all the way to the clinic door, and finding a rational patient inside was a complete revelation.
But the story turns yet again; she then informs me that her faith is stronger than illness, and she is willing and able to handle whatever God throws her way - bravo for her! I then also reminded her that illness and death are but temporary things, to which she agreed and was even more satisfied in her decision to go and enjoy her vacation with her family. Kudos to her; she single-handedly reminded me that, like pearls in mud, sometimes there are people out there that make sense in the world.

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