August 29th, 2010 by Edwin Leap, M.D. in Better Health Network, Humor, Opinion, True Stories
No Comments »
Last week a trailer less than a mile from our house experienced a small explosion. Trailers, which seldom explode on their own (without undiscovered volcanoes or CIA drones with missiles) was concealing a meth lab.
What can you say? If I weren’t an emergency physician I’d say, “Shocking! Ghastly! Unbelievable!” But I do what I do so I say, “Huh, how about that.”
I’ve lost much of my capacity to be shocked. I have seen meth users, and probably meth dealers. I’ve known and enjoyed the company of alcoholics and Valium addicts. I’ve cared for murderers and the murdered (albeit briefly in the case of the latter). I’ve been involved in the evaluation of sexual assault victims, car thieves, drunk drivers and child abusers. A meth lab is, in its own way, kind of small stuff.
What does it say about me? I don’t know. It may suggest that I’m cynical. Or it may mean that I’m cold. Or it may mean, as I suspect it does, that I’m just realistic. I know the world is full of drugs and brokenness. The ER, where I work, is just the place where all of it arrives in its fermented, fully concentrated, “contents under pressure” form. Read more »
*This blog post was originally published at edwinleap.com*
August 28th, 2010 by Nicholas Genes, M.D., Ph.D. in Better Health Network, Humor, Opinion
No Comments »
Somebody at Apple likes Goldfrapp. They’ve used her latest album for this tutorial and the sublime Seventh Tree was pictured on the first Apple descriptions of the Remote app. It’s nice when a monolithic institution shows a little personality. Of course, my interest in Goldfrapp is mostly professional: Who else has sung as well about ending up in an emergency department?
*This blog post was originally published at Blogborygmi*
August 21st, 2010 by Edwin Leap, M.D. in Better Health Network, Humor, True Stories
No Comments »
Here’s my column in the August edition of Emergency Medicine News. A person who seems powerless may hold an entire emergency room hostage!
Magic Words: ‘I Have Chest Pain’
Propped in her bed, frail and weak, the little grandma sighed. Her complaints were legion: weakness, poor appetite, poor sleep, joint pain, cough, dry mouth. Her daughter, eyes rolling, was trying to balance three reasonable emotions. She desperately wanted to go home and rest after spending the day in the ER. She truly wanted to avoid her mother’s admission to the hospital, and she was, graciously, sympathetic to the physician who brought the bad news.
‘Mrs. Adkins, I know you feel poorly, and I’m sorry. But I have to say, I can’t find any reason to admit you to the hospital. You’re right as rain. Isn’t that great?’
‘You mean, I’ve been here all this time, and had a gallon of blood drawn, and all them x-rays and a CAT scan, and there ain’t nothing wrong? I can’t believe that. I feel terrible.’ When she said the word terrible, she smacked her lips and looked away. She propped her hands on her lap and intertwined them; and she managed a subtle, but expressive, sniffle. Read more »
*This blog post was originally published at edwinleap.com*
August 18th, 2010 by Shadowfax in Better Health Network, Health Policy, News, Opinion
No Comments »
An alert reader alerted me to this related piece in Slate: “We Can’t Save You: How To Tell Emergency Room Patients That They’re Dying.” An excerpt:
The ER is not an easy place to come to these realizations or assess their consequences. A handful of physicians are trying to change that. Doctors like Tammie Quest, board-certified in both palliative and emergency medicine, hope to bring the deliberative goal-setting, symptom-controlling ethos of palliative care into the adrenaline-charged, “tube ’em and move ’em” ER. Palliative/emergency medicine collaboration remains rare, but it’s growing as both fields seek to create a more “patient-centered” approach to emergency care for the seriously ill or the dying, to improve symptom management, enhance family support, and ensure that the patient understands the likely outcomes once they get on that high-tech conveyor belt of 21st-century emergency medicine.
Emergency medicine and palliative care-certified? That’s an interesting mix. We have a great palliative care service where I work (in fact, it just won the national “Circle of Life” award.) It makes a lot of sense to have a palliative care nurse stationed in (or routinely rounding) the ER, though. I think I’m going to suggest this to our hospice folks.
*This blog post was originally published at Movin' Meat*
August 15th, 2010 by GruntDoc in Better Health Network, Humor, Opinion, True Stories
No Comments »
I’ve internalized all the dogma of medicine, for good and bad.
When I was an EMT, green as a twig in an ER, I learned the basics: For any wound with hair employ the razor, and get the hair away from the laceration so the doc could do a good closure.
So, employment week #3: Eyebrow laceration? Shaved that sucker clean off. ER doc freaked out, and I learned some medical dogma: Don’t shave eyebrows, they don’t grow back. Heard it later, too — all the way through training, in fact. Read more »
*This blog post was originally published at GruntDoc*
