ER rotation

Bring me another sammich!

That was the request from the Black woman who had been in the ER for I have no idea how long, and was requesting her THIRD chicken salad "sammich". She also made it known that she had insurance so that EVERYONE in the ER department heard her, LOL!!!

The most nerve racking patient was the man brought in for seizures but that went into cardiac arrest 3 times after arriving at the ER. Two things struck me as very unusual. One was that there was only one other person in the immediately area that appeared to be my age or older, and the other was that there was a significant amount of non related "chit-chat" going on during the procedure. And when I say non related, I mean one of the 5 EMTs in the area telling jokes (thankfully not about the morbidly obese patient they were working on). Perhaps I expected to see more seriousness like I see on the real ER TV shows, I'm not sure what I expected to see, but I didn't expect to see Comedy night while a patients life was being saved. Then again, maybe that's how those folks deal with the stress of what they do everyday, because while this patient had a good outcome (so far), others do not. And people do say that laughter is the best medicine........

Unfortunately, I was once again reminded of how much obesity is a HUGE problem in the Black community as only ONE of the 7 Black patients I saw last evening had what looked like a normal BMI. And the woman ordering her third sammich was not the patient with the normal appearing BMI.

The highlight of my rotation in the ER was the White female patient who was 2 weeks post liver transplant, and in the ER with a chief complaint of nausea and vomiting. She was a real hoot, telling jokes about what she ate earlier in the day (and the liquid like effects, LOL) and also cracking jokes on her two kids who were with her in the ER. VERY nice family indeed.

I came away from the ER with a VERY different perspective of where I can make a difference as a Doc. To be able to help patients medically and not have to worry about whether or not they can afford a procedure due to having or not having insurance sounds great. Because the one major complaint I have from my experience in IM at the county hospital, was the thought of occasionally only being able to provide "compassion care" as opposed to the level of care that's needed. And that could be a problem for me mentally over the long run. I also didn't have the "back issues" from standing in one spot for an extended period of time in the ER as I did on both my MICU and IM rotations. Yes, I understand that standing in one spot could depend on what medical procedure you're doing, but the (VERY fine Korean) Doc I shadowed only sat still when he was typing his notes into the computer (which he found VERY annoying, LOL). Otherwise, he was up and down for the entire shift and that could work well for me. This experience also reminded me of an ER trip I had as an undergrad premed almost 30 years ago when my ER doc suggested that ER medicine was the best field for many reasons including shift work/leaving "the office" behind when you leave and the compensation being pretty good. He was also an adrenaline junkie which I'm not, though running around does work for the ADD in me, LOL!!! What I like most is that the schedule could easily allow me to have an active research portfolio besides the other perks mentioned by every ER Doc I've ever talked to.

Finally, the one "negative" question I did have was about the "half-life" of ER Docs. And the chief Doc on staff told me that it's about 10 years. But those numbers are based on folks going into ER in their early 30's, I wonder what they are for folks in my age range? I'd imagine that the health of the person involved plays a significant role as does their personality. And honestly, I'm not real worried about that or else I wouldn't even consider it. Plus, I need to be healthy regardless to which speciality I pursue.