METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
I thought some might like to read a recently story I wrote for my facebook fans. I've decided to do some writing since I can not sleep. I hope you enjoy it. It is tiled "I Think We Have An Emergency" under the "notes" section of my profile. Let me know what you think. Names have been changed. It is both fiction as well as non-fiction. It is a story.
There have been a number of moments in my life that you could define as true emergencies. Coughing up blood, a blood pressure sinking below 70/30, a fever rising to 106.9 F, and a medication reaction sending the mind reeling into a full blown fight-flight panic attack. Chest pain, abdominal distention and internal bleeding, as well as a soon to rupture appendix. All events that land me and countless other people into the Emergency Room every year.
Walking into an E.R. is like walking onto a stage of chaos and confusion. Bodies of the living lay on stretchers, wheel chairs, and uncomfortable vinyl seats. The Triage nursing station is draped with paperwork and medical books lingering from prior usage. They scramble from one case to the next while attempting to ensure a "code" of methodology tempers that visceral chaos. A woman screams, while waiting for a CT scan of her head: Probably an inter-cranial bleed -- deadly, and can be incredibly painful. An alcoholic slumps on the floor of a hallway, having woken up and gotten off the stretcher which the Nursing assistants vehemently demanded he stay in, before they surrendered to his unwillingness to cooperate. He vomits, and the putrid smell emanates through the hallway.
Physicians rarely make direct appearances near the waiting room unless they've come to discuss a case with a family member who recently arrived following an ambulance. Some of those visits are followed by the words "In-spite of all our intervention, your sister, brother, child, mother, father, friend had no pulse upon arrival. Your ______ has died. The emotion barely sinks in. Some look at the floor as the news hit them. Some emerge with denial, attacking the doctors statement as a lie, or simply incorrect. I've seen enough of it, and the inevitable conclusion is painful. The physician tries hard to neither abandon them, but neither stay beyond the point in which other patients may suffer without their attention. This balancing act is difficult but an integral force to be reckoned with.
Back and forth they all hustle quickly attempting to remain calm, polite, efficient and surprisingly, compassionate. Unfortunately this isn't always the case. Logic, objectivity and sleep deprivation often leaving physicians abusive, irritable, even incompetent as they try to surpass the 36th hour without sleep, living off power bars and coffee.
With all of this said, you may wonder how I came to know such a world. Well..................
This part of the story begins in my large victorian home, where I and my family live. I reside on the second floor independently in my own apartment. I had been tethered for weeks to an IV line pump, which supplied an intravenous central line into my arm. The line was inserted into the crook of the elbow -- just like when you have blood taken, only this line was long and was threaded accordingly into the arm and all the way up through the vein into the Right Atrium of the heart. IV antibiotics flooded my body, saturating it to the point in which we hoped a slippery little cork-screw shaped bacterium might find it unpleasant and up and keel over.
Sadly, during this period of therapy, I'd begun suffering seizures, difficulty breathing, swollen joints and hands, unrelenting chills and fevers which refused stubbornly to respond to aspirin and Ibuprofen. As the cold wet cloth was laid upon my head, my mother sat 20 degrees away in a folding chair. Her face was pale and her muscles frozen into a picture of concern and determination. For week the argument circled. "Stop treatment, this is going too far!" she'd plead. I'd ignore her plight and tell her that getting this line put in was possibly a once in a lifetime attempt. Physicians are not quick to order PICC lines for Chronic Lyme Disease patients. After all, why would you give high-dose IV antibiotics to a disease that doesn't exist? At least that's how they see it. I felt the risk to benefit of holding out would be worth it, and in the end.........maybe I was right, or... maybe not.
"Michael, your fever is out of control. You've lost over 25 lbs in a short period of time and your dying. We must admit this is not working. Please allow me to call an ambulance."
"No, I'm fine. I'll take care of it" I clung to each word, not truly believing what I'd said.
Fast forward: The Ambulance arrived, questions and answers were given -- Chronic Lyme Disease? Really? "How awful" the Paramedic stated emphatically. This was no "boring" call for their nightly agenda. A chronic infection combined with a fever of unknown origin is a lightning rod of controversy and quite obviously a great opportunity to learn something new. The paramedics were kind, focused, objective, yet sympathetic and spoke appropriately when I voiced concerns.
As I was wheeled into the E.R. I became suddenly overwhelmed with weakness, convulsions and panic. My blood pressure was dropping fast and I spoke quickly through shortness of breath:
"I need help now, I waited too long and now I'm going to die. I'm dying."
I was quickly wheeled into what I can only assume was a room designed for high priority trauma or patients nearing death. People who are suffering myocardial infractions, massive burns covering their bodies and twisted contorted bones from a drunk driving accident.
I laid on the table, and a doctor introduces himself to me saying "Hello I'm Dr. Johnson." I recognized the name. As my body spasmed and my speech stuttered:
I said "Mi-kkkkkk-eeeeee with the dog? Is that you M-....i...ke? Dad.....neighbor?"
Mike immediately recognized my name and said
"Yes Michael, it's Mike. I'm going to save you, it's ok. You're not going to die here tonight. We will find out what is causing your problem and admit you to the hospital immediately."
Mike Johnson was a neighbor of my father. Occasionally Mike would stroll past the house during the summer time while I polished my father's car in the bright sunlight.
Mike would stop to chat and say "Hey Mike, how's the car coming along man?" "Oh
"How have you been feeling?"
"Oh I'm surviving. The Lyme just won't submit. It's a stubborn son of a *****."
"Hang in there buddy, tell your dad I said hello."
"Will do Mike, good to see you as always."
As Mike hovered over my dying body, the nurses inserted IV lines, attached EKG pads to my chest and took samples of my blood and urine. Each was very gentle but urgent in their movement.
As I lay there my mother came up to my side and told me that the doctors were working as fast as they can. They think you have an infection probably. but aren't sure whether it's something you already had or something recently acquired. They don't know how the infection would have gotten in just yet.
"Michael, it's Dr. Johnson, are you still with us?" Mike tapped my cheeks and pinched me into consciousness again. Tears streamed down my face as I began to sob "Please Mike, don't let me die man. I've fought so long and I can't fail. I can't go out like this man."
"We're going to get you taken care of, just hang in there buddy."
As blood cultures returned and nurses flew back and forth, Mike told me "Listen, we need to perform a lumbar puncture. Your blood counts are elevated excessively. I know it's going to be hard on you. You're sensitive to pain. We need to do this to make sure this isn't in your brain, whatever it is."
I resented Lumbar punctures but at Mike's request I was more inclined to at least comply.
Numerous attempts were made to insert the extremely long needle carefully between the spinal columns where it would hope to meet the surrounding spinal fluid which encases the spinal cord. With each thrust, they failed to enter correctly. Mike decided it was time to stand me up with assistance and lay me over a supported curved table. It reminded me of the machine I used to strengthen my lower back when I was in high-school weight training electives.
The needle slid in smoothly, and then immediate spasms and pain surged through my body; the pain coursing like a runaway train causing me to grit me teeth and finally scream in agony.
"Arrrrrrrrrrrrrrrrrrhhhhh, pull it out! Get it out of me!"
The needle had penetrated my spinal cord by accident. No permanent damage occurred but the pain was profound.
"Michael, I'm really really sorry but this LP just wasn't going to be easy, and I'm sorry I hurt you."
I quickly accepted the apology and begged to be placed down again on the table or a wheel chair where I would slump over. The LP came back shortly and showed that no infection had entered the brain.
Now, enough about my story. This is not and was not about me! This is about Emergency Care!
Emergency Rooms are filled with people with sniffles, children with french fries stuck in their noses, and patients with chronic long standing illnesses which aren't life threatening at that moment -- although to each patient their suffering is real and feels life threatening. Each human being desires to be recognized and taken care of quickly for their child's nosebleed, or an open laceration which isn't bleeding out too badly. Chronically ill patients who have lost control and can't cope anymore seek answers to questions that countless other physicians couldn't satisfy.
The wait times are long in most Emergency Rooms, especially on Friday and Saturday night when the drunks, car accidents, and other drug overdoses arrive.
These physicians are expected to make life and death decisions immediately. They're trained not in handling people with Chronic Lyme Disease, but rather brain hemorrhage, a perforated bowel due to a gun-shot, and so many other injuries that need "Emergency" attention.
So the next time you go to the E.R. think about why you're there -- if you're conscious at all -- and consider the feelings and constant demand that is placed on these first-line of defense physicians who are attempting to treat a vast array of conditions. They're expected to make diagnoses which they simply can't always make correctly -- and often they must file discharge papers even when they wish they could spend more time on a seemingly complicated case. They see death often. They make mistakes which lead to some of these deaths. They mourn. They hide their fears and tears which they often do experience. Some patients they like, some patients they dislike. They prefer less complicated cases vs. Chronic cases of the elderly or people like myself with co-morbid conditions, also known as "Multiple" disease processes.
Emergency: If someone isn't breathing, has lost consciousness, has no pulse, and is screaming in pain, it's time to call 911. It's time to go visit the overworked, sleep deprived physicians at your local E.R. If you are as fortunate as I -- you will come across a very sincere, polite, intelligent physician who will do what they can to stop the bleeding, ease the pain, and reassure you that they'll do their very best.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
I have a new story that "sort of" hits upon the same note as the last one. Perhaps this will satisfy some of you.
Coincidentally, or perhaps fate, landed me in the ER two nights ago. This is my note of thanks to the staff at the hospital. It reads like a story, and so you might enjoy it.
To the Mercy Hospital Emergency Room Staff working [03-11-11], I hope this letter finds you well rested, contented, and most of all satisfied with the work you perform each day. Somehow I'm certain you'll see through my well wishing as both sincere and a bit ironic.
On Friday, March 11th, I was wheeled into the Emergency Room by my very nice step father. I don't recall much at that moment as I was certainly in and out of consciousness from the internal bleeding that provoked my visit. To the best of my ability I recall being met by the Triage nurse who asked me a slew of questions that I couldn't quite comprehend. I think I handed my VISA, of all things, as proof of identity: social security and a variety of other facts. As my head hung, bobbing, I could vaguely see the rows of seats which I can only assume were filled with patients with everything from infected hang-nails to paper cuts; each patient impatiently hoping "their" Emergency would earn them a quick entrance and exit.
I was quickly introduced to a Nurse Practitioner by the name of Bill, a very tall yet kind man. He wheeled me back, ensured that I was registered and slapped a blood band and patient name bracelet across my wrist I waxed and waned seeing white lights flashing as he asked me about pain. Pain, pain, pain, it's all I heard all night. How wonderful! To have ones pain a priority was not something I've been accustomed to in all the years I've been ill. Yet, Bill asked, and I replied. "1, maybe 2, I'm fine" I said. Still, I felt the life in me lifting as the blood loss continued. To keep me engaged, Bill conversed with me. Bill told me he had 18 years of experience and liked the work he did. I told him "I'm glad" because being in the hands of someone who didn't wouldn't exactly be in my best interest!
And with all that said, began my night drifting thru some corridors and living your life vicariously though I were a patient.
When I tumbled into the uncomfortable bed beyond the curtain, I was grateful that I wasn't worse off: a trauma victim or worse your typical annoying drunk who got into a domestic dispute. I was a legitimate Emergency. Hence, I didn't sit outside nursing my aching paper cut. Bill handed me off to another nurse who questioned me at length my reason for coming, and I couldn't quite recall for many moments. Ah yes, aspirin. It's a life saver to some, a pain reliever for many and in my case a life stealing platelet fiend. It was a mere 6 aspirin: 3 in the morning, and then 12 hours later, another 3 on Thursday evening which led to my downfall. That's all it took for the blood to flow, orthostatic hypotension to materialize, and near-shock to set in. Profuse bleeding internally from the intestine with lovely maroon and bright red life washing down the drain would have led me to the morgue, rather than that uncomfortable bed had it not been for your immediate attention and proper care.
Katie, Christine, and a number of other nurses were too kind to me once I was set to bed for observation, IV saline and proteomics got me on my feet again, literally. I could answer your repetitive questions with a bit more coherence. You tried to find me pillows, blankets, and best of all wash pads to clean the mess of me. From a 2 a.m. call for a G.I. consult by phone, the kind -- yet incredibly overworked PA (whose name I can't recall, and I apologize) did her best to figure out how to take care of me. The Gastroenterologist, annoyed at best with a late night call - was worthless with an incompetent diagnosis about hemorrhoids. It's not uncommon to hear "It's nothing, discharge him and send him home" mentality. The P.A. and I looked at each other in disbelief. She saw me, she saw the blood, she knew. Let's face it, how many times has some sleep deprived on-call doctor gotten ****ed and proclaimed an assumption as matter of fact. Many of you on the front lines know better when you hear a line and end up ignoring it and following your own proper judgment.
It's quite frustrating working in an Emergency Room sometimes, isn't it? No matter how routine it seems. I know that from all the years of visiting them. By now you might be wondering why? Well, let me explain briefly as possible: Chronic Lyme disease is the bane of all infectious diseases in modern medicine. The controversy, the smug denial, and the inept reasoning to avoid reviewing the scientific literature demonstrating that the infection -- once established firmly in the central nervous system -- can remain resilient and persist in-spite of seemingly adequate antibiotics is hardly new. It's hard to fathom that good science is swept beneath a carpet, but it happens all the time. That's how I learned what it's like in the ER. Aspirin, my dearest friend, helped me cope quite a lot with the aches and pains of living with this illness. When pressed for information by three different Physicians Assistants who saw me, not one of you judged me for having the illness, nor for using something to treat the pain. No one rolled their eyes, or gave me a lecture about my position. I deeply appreciate that.
And so, I have a great deal of experience with Emergency Rooms, yet, yours was kind to me. When I asked to go home, each nurse smiled and said "Nope, sorry." When I asked the PA, I was shut down immediately, "Nope, You're being admitted." No, no, no. It's all I heard as I watched the big white clock on the wall tick by a minute at a time. Yet, I knew very well the reasons. I don't need to be a physician -- though that was my intent before I became disabled -- to see the care and compassion aligns with caution and appropriate decision making. Patients like me are a dime a dozen, we want to go home and we whine as though we were children in a backset of a car ``Are we there yet?! You knew better and that's why I came to you for help.
Boredom: Watching you rush from room to room coping with fractures, pneumonia, bruises and contusions, car crash victims and boozed our alcoholics who -- despite being told repeatedly to stay still wouldn't -- only made me all the more grateful for the effort and time you invested in my care, and theirs. Like a child, I'm sure I was occasionally annoying for being so bored and restless, but I wanted to thank you so much and show that appreciation. I'd have written this note by hand but my handwriting is no better than most of you signing signatures and filling out patient charts.
If I'm fortunate and recover from my chronic health problem, I will inevitably head off into the sunset to study medicine. Then, perhaps I'll be lucky enough to work among people like those of you I met. It's hard work, I know, but it really is a privilege to have met you all. Hang on to that compassion, even as you find that balance between detachment and caring for patients, even those you dislike. That is what impressed me, and you all should be proud.
I hope you enjoy the gift, my rambling, and feel free to pass this note around. I hope all who helped me that night end up reading it and that it brightens your day or night. From Nurse, P.A. Residents, Doctors to the man who smiled as he emptied the trash bins, and the other gentleman who wheeled me from the hospital and waited patiently with me for my ride to arrive, thank you all.
Sincerely,
Michael Parent
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
posted
Michael, your one lucky man...thank God they kept you...take care of yourself...wonderful story...i think you should write a book.. maybe now people will believe... Madge
-------------------- madgen Posts: 342 | From newjersey | Registered: Oct 2007
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