* * Anonymous Doc

Sunday, November 21, 2010

"While I'm here in the ER anyway, will you..."

No. No, I won't. I won't check your cholesterol. I won't give you a colonoscopy. I won't renew your birth control pills. I won't give your husband a drug test. I won't fill out your son's school physical form. I won't call your boss and tell him we need to keep you overnight (even though we don't). I won't give you a box of band-aids. I won't check your vision. I won't tell them to go ahead and put breast implants in your wife while they have her chest open anyway...

The emergency room is not your one-stop medical clinic, to deal with all of your problems at once. You're here for a reason. Hopefully. We're going to deal with the reason and then you're going to leave so someone else can take your place. We're not going to go through your file and do all of your outpatient checkups, renew your medications, and look at the bruise on your leg. Go to a doctor. Go to a clinic. If it's not an emergency, do not ask me about it. This is the emergency room. For emergencies. Not for elective medical care, maintenance, follow-up checks, or workplace physicals. This is for when you've been shot or you're having a heart attack.

Or you've tried to kill yourself and failed.

And maybe this is a controversial point of view, but I don't really understand why we're making people who actually want to live wait around bleeding to death while we spend our energy trying to save people who want to kill themselves.

We're saving them so they can try again. Or we're saving them but now instead of just being depressed, they're going to be depressed and in a nursing home, painfully recovering-- or not recovering much, and having minimal brain function for the rest of their lives.

If you're a 92-year-old with terminal cancer who swallowed a bottle of Tylenol PM hoping to end it, why are we fighting to bring you back, to a vegetative state, so you can linger for a few more months?

While we leave the guy in the car accident on a stretcher, waiting for a doctor to be free to deal with him.

And, no, I won't clip your toenails while you're here anyway. Go away. The ER is terrible.


  1. I just finished my ER rotation, and...amen.

  2. and from one extreme... http://www.bmj.com/content/341/bmj.c6249.long

  3. Have you ever seen "You Don't Know Jack"? It's the Al Pacino movie about Jack Kevorkian. Say what you want, but I think people should have the right to die. The suicide cases are touchy and I don't necessarily have a firm opinion, but making the choice when, like you said, 92 with terminal cancer should be their choice. It's just a shame it as to be with a bottle of pills in your bathroom and not something more dignified.

  4. I made a suicide attempt once. I pinned a DNR on my chest, and ducktaped a note on my forehead saying, "Suicide. Just let me die, please. I refuse all treatment."
    I didn't get as far as the ER. Vomited up the damn pills myself.
    Wonder if they'd have let me die. Hope so. Still wish I'd made it out. Promised my mum not to do it again.