E.R.

>> Wednesday, June 03, 2009

It was one of the dumbest questions I'd ever been asked. I'm not faulting the woman who asked it--she was working from a script. And I understood why the question was being asked. They needed to know, though how the quantification would have helped, I don't know; it's not like they were setting a target number for a skill check.

"On a scale of zero-to-ten, with ten being the worst, how much pain are you in?"

Well, what the hell does that even mean, I ask (politely, in so many words, maybe I just said, "huh?"). We're sitting in what's basically a cubicle off to the side in the emergency room at Carolinas Medical Center. I'm in triage, which I consider a good sign since I'm clearly not dying, so I logically have to be in the "no immediate need" category. This woman--nurse or technician or administrator or whatever she is--is going through a script with me: allergies, prior conditions, why are you even here, and on a scale of zero-to-ten how much pain, etc.

"Well," she says, "if 'ten' is the worst pain you've ever been in...."

"Four or five?" I lie. Two weeks later, around three a.m. after surgery the previous day and the nerve block's worn off, I will have a much better idea of what eight-nine-ten feels like. But Saturday night in the E.R.? Well, okay, I'm in pain, yes, so it's obviously not a zero, but is it as bad as I've heard childbirth is? Not so much. So, you know, pick the mean result, right? I feel like I do at the eye doctor, being asked if "three" is better than "four" and is "four" better than "one". I'm going to flunk, aren't I, and it will be all screwed up and my fault.

This is my first time on this side of the E.R.; I've brought friends, shown up during a crisis, but never been wheeled around in a wheelchair and left hanging out to wait. Part of the time I'm sitting next to my buddy, Nate, who was one of the passengers in the Bug; he's looking morose and craggy, with what looks like blood on either side of the bridge of his nose. His mom and stepdad are with us, heroically phoning everyone they can get hold of. Sam is being checked out in the back, at this point we're hearing both her arms are broken, which proves to be mercifully false. (We're also hearing there were nine people in the wreck, which turns out to be off by two.) My Uncle Jess and Aunt Debbie show up, making unimaginably good time from Stanley.

Time passes. My right arm swells up all melon-ey-like, which is something it probably isn't supposed to do. This is the wrist they put the sticker-bracelet around. When they applied it, the wrist wasn't nearly as swollen; I said, "So, this means I can get back in the show, right?" when they put it on, and the nurse didn't laugh. This was my backup joke: my first was, "So this means I can buy beer, right?" which I didn't think would have gone over too well. Perhaps I should have gone with my instincts. Maybe not.

After awhile, I get my own little--what would you call it? Room? Observation area? There's a little examining table with a cushion and I get to put on one of those swank "robes" that leave your ass hanging out (or would've if I hadn't kept my underwear on). Occasionally, I see someone. This experience doesn't exactly horrify: it's Saturday night, which I hear (per Messrs. Taupin and John) is alright for fighting. But seriously, it is Saturday and "Race Weekend" to boot, with some grande hullabaloo going on out at the speedway all weekend (as a friend describes it, lots of people are getting drunk while watching a gaggle of people turn left for several hours; I don't get it, either). I'm not in nearly the shape of, say, the gentleman wandering around my vicinity with some sort of IV on a pole trying to negotiate over his meds (clearly some sort of pharmacist, the fellow continues to insist specifically on certain opiates and generally on more). No, my only problems, really, are that my right leg has started to hurt (like my left hand) and my right arm looks a bit like a balloon animal.

The Powers-That-Be decide I need X-Rays and a CT scan. A wonderful woman who's helping set me up for the CT asks me which part of me is getting the CT scan and when I say the right, she incredulously asks, "The one with the bracelet?" She tells someone to cut it off.

The CT scan makes me feel like David Banner. As in Bill Bixby, not the rapper. Okay, it's not really anything like the chair ol' Bixby irradiates himself with in The Incredible Hulk, still, it conjures it in my brain. I lay in the machine with my arm over my head so it can be scanned; I was under the impression these things were loud, but apparently they aren't any more.

They wheel you back and forth in a wheelchair even if you feel like strolling. I perfectly understand all of the reasons why, but understanding things like legal liability and stealthy traumas doesn't make it any less annoying to a stubborn idjit like yours truly who hates asking for things and clings to illusions of independence like a security blanket. I'll refrain from the self-psychoanalysis here, take it for what it is. They push you back and forth and then you wander around your little area for a few hours in between while doctors get around to your scans and charts.

Don, one of the survivors of the wreck who I've known since junior high, who was taken to a different hospital, shows up with his left hand in a splint to check on those of us who went to CMC. It's a good moment, knowing he's mostly alright.

When they decide something is broken in my wrist, they refer me to Dr. Perlik and send a pretty cool guy down to splint me. When I ask if they can just hack my arm off and fit me with a boss pirate hook, he actually laughs.

The wreck was around eight p.m.; I finally return home around 2:30 a.m.

10 comments:

kimby Thursday, June 4, 2009 at 8:34:00 AM EDT  

6 1/2 hours to be seen, tested and get home? If you were here where I am, you wouldn't have even seen a doctor yet. Our last trip to the ER was a 5 hour wait before even getting into a room, followed by another few hours before Bug was taken care of. Now, it was nothing serious or life threatening, and it was a Friday night. I am sure that had it been an accident, we would have gotten in sooner...at least I hope we would have. But...I didn't have to pay anyone and I didn't have to decide what i more important, food or medical attention. SO I guess I shouldn't complain.
SO glad they fixed you up and you are on the road to recovery.

Nathan Thursday, June 4, 2009 at 8:34:00 AM EDT  

I think you've done a much better job of describing the attendant anxiety involved in being asked to rate your pain than I did. It's almost exactly like the eye doctor thing and you sit there thinking, "I'm not the one who went to school for this shit. Why are you trusting me to have the right answers."

In my case, I was wondering if I was supposed to be comparing it to the worst pain anyone had ever felt or only the worst pain II had ever felt. I decided to rate it as much worse than having my thumb slammed in a car door, but not rising to the level of being impaled on a wooden stake.

It's really just not fair to ask the patient...just fork over the strong drug, STAT!

And on another note, you'd think those ER employees would be instructed to laugh at all of your jokes whether they're funny or not. Hey, c'mon...give us a break! We're not exactly in the best condition to be putting on a show but, at least, we're trying!

John the Scientist Thursday, June 4, 2009 at 9:07:00 AM EDT  

"I was under the impression these things were loud, but apparently they aren't any more."

A CT is a fancy X-ray, dude. If its making a lot of noise, you'd better run for your life.

The instruments that are loud are MRIs. An MRI has a big electromagnet that switches polarity at a very fast rate. The little magnetic microdomains that keep getting flipped put physical stresses on the metal, causing to to groan during the procedure.

neurondoc Thursday, June 4, 2009 at 9:32:00 AM EDT  

JTS, you beat me to it. CT scans should NOT be noisy. Noisy = bad, in that case.

As for the pain question, yes we understand that it is sort of stupid. But we don't have magic gizmos like they have in Star Trek that can automatically diagnose stuff (I would so totally love one, though). When I ask that particular question, I preface it with the following: "0 means no pain and 10 is like a passing bear rips your arm off and eats it." It almost never failed in eliciting a smile.

I LOVE your description of a car race. I just don't get it either.

And I am so glad you are feeling better. Good thing you didn't need my services...

John the Scientist Thursday, June 4, 2009 at 9:43:00 AM EDT  

What's to get about the car race? It's not that the drunks are excited about the gaggle of rednecks and Eyetalians going left for three hours, it's that they are all hoping that one of them accidentally goes right and provides some real entertainment.

Those of us who don't have the patience to wait 5 races to see the entertainment skip the bring parts and go to the demolition derby. The ones with the schoolbusses are best. :D

Carol Elaine Thursday, June 4, 2009 at 11:31:00 AM EDT  

The times I've been to the ER (for me and not someone else) were for chest pain and coughing up blood. I was seen pretty quickly each time, just to determine that I wasn't immediately dying. I wasn't, so I ended up back in the waiting room, to wait for hours with everyone else who wasn't immediately dying.

My diagnoses? Costochodritis, ruptured capillaries in my throat (long story) and what was eventually diagnosed as anxiety attacks (which, if you've never had a bad one, pretty much feels like you're dying, especially if you don't know what the hell is happening).

neurodoc, that is a brilliant way of prefacing the level of pain question. I wish my doctors had done that.

Random Michelle K Thursday, June 4, 2009 at 12:14:00 PM EDT  

I'm glad that you got treated relatively quickly (for an ER) and that at least some of the docs and nurses laughed at your jokes.

FYI, I've noticed that doctors and nurses are often reluctant to laugh at a single joke you make, because they're often not sure you're joking around. But if you keep on joking or make really obvious jokes, they'll usually laugh with you. (In your example, my guess is they didn't want to laugh in case you'd had an undiagnosed head injury or were in some other way out of it, and were being serious.)

I've spent lots and lots of time in the ER, and also in urgent care facilities, which I'll choose over ER if given the choice.

Because of this experience, I tend to carry a few things with me at all times (or in the car). First and foremost a book. Second, however, is a deck of cards. I've played lots of games of cards and hospital rooms and waiting rooms, and it helps immensely.

Of course, a trip to the emergency room is a family affair for us: when I busted by head after passing out my husband and both my parents showed up. And then proceeded to mock me unmercifully. Because that's how we deal with stress: humor.

It doesn't make the time shorter, but it does make it easier, especially if you can get the patient either laughing or involved in a card game (assuming they're not bleeding too much for cards) the experience is a lot less painful.

Ilya Thursday, June 4, 2009 at 2:24:00 PM EDT  

Not that it was a laughing matter, but looking back at the experience with levity has got to be therapeutic. Glad you're doing better (judging by the size of this entry :-) ).

Eric Thursday, June 4, 2009 at 3:08:00 PM EDT  

Favorite Morrisey line: "I can laugh about it now, but at the time it was terrible."

This was written in three sittings. Today's hurt me. May need to take break, pushing too hard. (Incl. comments. :-( )

Dr. Phil (Physics) Thursday, June 4, 2009 at 4:28:00 PM EDT  

Funny, I look at a car race and see a perfect balances of centripetal, normal, aerodynamic, friction and motive power forces, balanced along a trajectory...

What?

Dr. Phil

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