No Words

The other day was like amateur night in the ER.  Bogus “hurt my arm 2 weeks ago, need pain meds” guy from a town 40 miles away, one with a hospital and ER of it’s own, incidentally.  Carried a 44oz Styrofoam cup full of soda into the triage room with that horribly injured arm but when I began questioning him about his symptoms, he began to writhe in pain and whimpering.  Piss poor actor. 

In a few minutes after getting this rather odiferous individual out of my triage room, comes yet another pre-triage sheet through the slot with the same last name on it.  This is something people do.  At least in our area.  They all come to the ER together like a sporting event.  Friends all sitting around the living room watching TV and Jerry Springer gets over and nothing good on so they load up and head to the ER to kill some time before Walker, Texas Ranger comes on at 4, or something.  

The other triage was hurt arm man’s tweaker mother.  The family that smokes rocks together, stays together.  They were both so fucked up they could barely put any sentences together.  Drug-seeking, I suspected but they weren’t at themselves enough to even get any appropriate symptoms or stories straight in their heads.  Her chief complaint was lice for which she’d treated herself with olive oil and dog flea shampoo and then, as a last resort, lice shampoo.  Okay.  And?  Let me guess.  You’re here for admission to our adult psych unit?

Soon after, we got a 22-year-old girl in who’d fallen off a horse.  Abraised her great toe and broke her radial head right off.  In the words of Walter Mattheau, fortunately for her, she’d had a few glasses of whiskey just prior to the accident so it wasn’t as painful as it might have been.  She kept us in stitches with her nonsense.  Her blood alcohol was 165.  Funny gal.  And not a faker.  And too drunk to act.  What’s not to like?

Then the thorn in my side.  A 70-year-old man who came in for a 2-week history of constipation and weakness.  No obvious distress.  I had to bite my tongue hard during that triage.  The whole time.  He really got under my skin and I had to fight hard to not ask him what the fuck he thought he was doing in there wasting our time.  I was busy in triage for the rest of the shift but I could see him come out to the desk every once in a while wanting to know how much longer it was going to be.  I couldn’t believe this guy, coming into the ER for  something he could have fixed by going to Walmart and buying some colace.  Hadn’t called his doctor.  Couldn’t even remember his doctor’s name.  He was still there when I left at the end of my shift and I forgot about him except a mental note to use him in my writing as an example of ER abuse. (Something about his case really irritated me). 

The next day I was at work and I heard the unit secretary talking about a CT report.  In the ER, the xrays and CTs are all read by the radiologist in person, if it’s during daytime hours, or remotely if it’s after hours.  The results get called to the ER doctors as soon as they’re read but the actual transcription isn’t usually done until the next day and then prints out on our copier.  So I’m hearing the unit secretary talking about a patient with cancer and on and on until I realize she’s talking about that guy from the day before, the 70-year-old.  She’s got the CT report in her hand so I took it from her and read it. 

Masses in his liver, bladder, around his aorta and, probably the origin, his prostate.  Clearly terminal.  Clearly very soon.