Ten ironies and truisms of the ER

1. Really sick people usually don’t have many complaints. They are too sick to. Whether because of illness or trauma, people with life-and-death kinds of problems usually don’t complain much. They are either unconscious or all their energy is focused on staying alive.

2. The converse is also true: people who aren’t very sick but think they are often complain a lot. While I try to remain caring about whatever problem is important to each patient, often the first sign that a patient is more-well-than-sick is that they have the energy to complain articulately or profusely about what troubles them.

3. A corollary to items 1 and 2: at any given time, the most demanding patients (and patient families) are usually the least sick patients in the ER. As noted above, they have energy to be demanding.

4. Once again, the converse is also true: the least demanding patients (and their families) are usually the most sick.

5. The tougher someone’s persona is in the outside world, the more they are likely fall apart over minor trauma or simple ailments. Gang-bangers who were just arrested for trying to shoot someone cry for their mothers when they learn they have to get a tetanus shot; Harley-Davidson riding, leather-wearing, tobacco-spitting, hard-drinking bikers who take minor falls, swear and whine and complain and say over-and-over again “how much is it going to hurt?” when they learn they have to get stitches.

6. People who say they are not sick, usually are. A variation of truism #1, many people who are genuinely sick but do not want to be ill deny pain or problems. These are usually hard-working individuals who want to get out of the hospital and go on with their lives. I have seen men argue that they were not having heart attacks even as they clutched their chests and were wheeled off to the cardiac catheterization lab. Others argue that their new left-sided facial weakness and inability to walk is not that big of a deal and cannot possibly be caused by a stroke.

7. A surprisingly large number of people with tattoos are afraid of needles.

8. People who state they have allergies to non-narcotic pain medications are usually drug-seeking. The list of allergies they provide is a not-so-subtle way to attempt to get the health-care provider to give them the narcotic pain medicine of their choice.

9. People who claim they have a “high pain tolerance” usually don’t. Individuals who can genuinely tolerate large amounts of pain have never had to consider pain enough to conclude that they have high pain tolerances–and hence, would never need to make this claim. On the other hand, people who who are so exquisitely sensitive to pain that they notice it in all of its subtle variations–and seek relief for the most annoying of these–are usually the ones to make this claim.

10. Even the most well-intentioned ER physicians fall prey to dealing with patients according to categories and stereotypes from time to time.

60 responses to “Ten ironies and truisms of the ER”

  1. MF says:

    Annie, I love the line “7. A surprisingly large number of people with tattoos are afraid of needles.” That’s so funny.

    After working the ER, you are more of an expert on people than anyone I know.

  2. Some of these principles obviously apply to other areas in life. I find that the most entitled and demanding students generally aren’t the brightest.

  3. WW says:

    more on #10, please!

  4. Marleyfan says:

    Interesting dialectics, it’s similiar in my world.

    Those who say they are the most busy, are usually the least busy (but temporarily have some things they MUST do).

    Those who say they are not very busy are usually the most busy, often because they take many tasks, and have a hard time setting limits and saying no.

    I agree with WW, #10 could be an interesting post…

  5. GingerB says:

    Sounds true to me!

    My Pediatrician used to say that a kids’ temperature mattered less to him than whether they were bouncing around as usual.

  6. AW says:

    Deal it is… A topic for an upcoming post…

  7. Josh says:


    My experience has been that a fair number of people get tattoos, among other reasons, precisely because they are afraid of needles.

  8. yeah, but a syringe is so much more menacing than a tattooing needle … and it goes much deeper.

  9. Josh says:

    I guess I tend to lump tattooing and piercing together. A piercing needle is a syringe needle, just bigger than usual in most cases.
    Fear is not a rational process, an as such, people react to it in strange ways.
    In any event, in any piercing/tattoo studio, the first to hit the floor is the big guy who “knows no fear”. “Wimps” tend to do just fine. Go figure.

  10. treerat says:

    I have worked in an ER for the past 6 years…It is so true that the more “macho” you are, the more likely you will whimper at the sight of a needle…

  11. nyjfootball says:

    As a frequent ER visitor, the pain scale nurses show me on every ER visit is a joke. What patient will say their pain is a 5 or below out of 10? Higher pain equals more, quicker medical attention generally. I unfortunately deal with a serious illness daily that cause crippling pain. I know what pain is and what isn’t pain. Your missing the word generally in the number 9 statement. That blanket statement is not completely true for everyone.

  12. Doctor Bee says:

    Numbers one through four are also true in the outpatient department setting (ie. my clinic).

    Great list!

  13. theFreako says:

    is this a blog for over paid ER worker to cry and moan? This is coming from people that let sick people die in the ER room. stereotype like this makes me sick. Also, when i said “people” i am generalizing. There are good hearted ER, nurse and doctor out there, but for most are all money grubbing moaning crying lil *****.

    Good day.

  14. no says:

    I think there is a difference between the ability to tolerate pain and the inability to feel pain. Some people may not feel much pain, but some people feel the pain and have the ability to tolerate it. And then there are the people that feel pain and can’t even tolerate a tiny bit…

  15. Cerium says:

    “theFreako” Thats just plan offensive. If your money grubbing you don’t work in the ER. They have long stress filled hours. They have the job of keeping dieing people alive. You talk about letting sick people die in the waiting room? If anything thats a direct cause of people abusing the health services. Trying to save money by waiting too long or not buying health insurance so whenever they have to see a doctor they clog up the system.

  16. Tank says:

    Right on. I am an R.N. on a large pediatric unit at a hospital designated a Level One Trauma Center. Annie, you are spot on my sister. The same truisms can be said of our pediatric population. The quiet patients are the ones to watch. Teenage boys are the biggest babies on our unit. The newborns fight the hardest. A sure sign of an abused infant is one who lies quietly in his crib all day, and of course, there is no parent with this child.

    And, to “the freako ,” do you know how little hospital employees are paid? Do you know that the days of making decent jack as a nurse were over 15 -20 years ago? Do you have any idea of the stress we are under to “meet the budget?” Managers do not care about whether or not patients receive quality care, they care about their budget being on track, so as to make their tasty bonus at year’s end. We work understaffed constantly, if we try to unionize, we are fired, if you complain, managers make it clear to you that there are “20 of you lined up out back for your job.”

    Be kind to hospital workers. Please.

  17. john smith says:

    So the moral of this story is, when you’re having a heart attack or other major injury and you go to the ER, pretend like you aren’t hurt at all.

    And then don’t be upset if they let you sit in the waiting area for 3 hours until you drop dead, because you didn’t speak up.

    GREAT ADVICE! if you want to die.

  18. rebecca says:

    I have to say I used to be scared of needles. But then I had a few tattoos, a few piercings, and I have changed my mind. Shots no longer scare me, tattoos don’t hurt at all. But peircings and iv’s hurt like a bitch!!! I cry when I think about having to get an iv. My hubby, now he had surgery on his thumb and passed out while they were numbing it. It was hilarious, he’s a soldier too!!!!! But a big tough guy, so of course a little tiny 18 gauge needle would make him pass out.

  19. Tim Wager says:

    I think it’s telling that the critical comments here ignore completely #10 on the list. Before you take a swipe at the author, try re-reading that one and see how it changes your response.

  20. doc will says:

    All very true. Also, as a society we should disregard the usage of the pain scale, because of its disgusting subjectivity. I often just ask on a scale of 1 to 10, what’s your pain, 5 is slamming your hand in a car door; 10 is getting hit by a bus, the bus reverses back over you and parks then all the passengers get out and laugh at you (then I smirk and say “you’d be unconscious). Typically, I get a more realistic response.

    Another tip, in the same realm as the drug seeker statement is this: when you’ve conned the doc into giving you all the morphine in the pyxis, don’t be asleep the next time the nurse checks on you to check your pain level and say it’s a 10 still. People in terrible pain don’t sleep.

    Another funny ER truism is when parents bring their kid in after a day or so of not having the wherewithal to force fluids on the kid freak out after I order a bag of fluids.

    And finally, as it has been written before… We can’t, unfortunately, cure stupid. It’s a terminal condition, with a grim prognosis.

  21. Skeptical Guy says:

    Another truism:

    An ER doc is a jack-of-all-trades and master of none.

    They generally don’t know jack. Why? Because they are taught by people who don’t know jack — more senior ER docs. They never spend any time on services of specialists (like cardiology, gastroenterology) with rare exception of a few months during their intern year on internal medicine or OB/Gyn. And have you seen an ER doc try to examine an eye?

    If you think you might be sick with something serious, then demand to be seen by a specialists. It is your right as a paying consumer.

  22. Fred says:

    Like I heard once from an ER doc, “The bleeding always stops–Always.”

  23. Skeptical? says:

    Skeptical guy, you are completely wrong. I spent 6 months of every year in specialty training during my residency and yes, I can examine an eye. You find me a specialist that will come in at 2am in the morning to see the patient and I’ll gladly call them. And by the way, 50% of our “paying consumers” aren’t paying.

  24. […] Десять трюизмов из кабинета первой помощи greatwhatsit.com […]

  25. noah django says:

    re #8: do you mean they’re junkies, or that they are faking or they hurt themselves on purpose to get these drugs? If not, then why do you care? If they’re legitimately hurt, they might as well get their choice. it’s a controlled environment and you are monitoring the dosage. and no, I’ve never used pharmaceutical/narcotic drugs either in the hospital OR recreationally. but here’s the news: EVERY civilization and every segment of society has used drugs in some form since there have been humans. making “drugs” an us/them issue (i.e. making drugs profitable by keeping them illegal) is what keeps your ER flooded with those gangbangers crying for mama, and keeps the CIA doing embarrassing things in our name worldwide.

    If you were merely stating a truism and meant no political overtones, then I apologize for creating them. But if your point was to demonize patients due to outdated and harmful morality, i’m unimpressed.

    As for doctor “Skeptical?” : sure, the guy you’re responding to was out of line, but the reason my half isn’t paying is because we’re either broke or uninsured. You could re-cant your hippocratic oath to heal the sick regardless, but then you wouldn’t be a doctor anymore, and until you find another (good) job, that puts you and your family in MY half, doesn’t it? Sorry profits haven’t been so high this quarter, pal.

  26. spotd dawg says:

    I’m an RN, worked in ER/ICU for 25 years, eventually Director then teaching. Nurses are the whiniest most complaining group of people I’ve ever met. Bitch bitch bitch. Remember the three B’s of nursing? Bitching, bellyaching and backbiting. People with such callous disregard for others ailments and associated complaints should get out of the business, yourself included. The money is OK, the hours flexible, the benefits usually excellent, the work exciting and fullfilling. Stop your whining, you are what you despise.

  27. Only someone has really worked in a hospital setting would know how true this post really is. As far as complaining and demanding patients go, I feel most people like that operate under the philosophy “the squeaky wheel gets the grease”. A great post.

  28. Marleyfan says:

    About a month ago my daughter had surgery for appendicitis. I overheard the nurses gathered together complaining a number of times, and remember wondering if it had to do with the stress of their jobs, and continually trying to comfort and deal with the sick and dying, and the doctors make the major decisions. It may have to do with the law of control. The law of control states that one’s happiness is in direct proportion to the amount of control they have. Maybe it’s that the nurses don’t have feel much control with their patients?

  29. pissedoff says:

    While I generally agree with the above list I must also say by experience Drs downplay/ignore things they cannot immediately diagnose. I have been suffering from progressively worsening headaches for 4 years that have affected my hearing, vision, balance, weight (185 to 158 and dropping) and pain episodes where I long for suicide nearly on a daily basis. Lost my professional job, insurance, house (bankruptcy) and have been forced to live on my 401K (now gone). The only Dx I can get is ‘stress related’, live with it, get over it. There are absolutely NO benefits if you opt out of system (I quit rather than be fired for missing work due to pain for severence and good reference but LOST any claim to benefits/treatments). In my personal experience Drs care only about liability, scoring point with insurers by not ordering tests, and participating in Pharmaceutical kick back schemes. I will end up commiting suicide in the lobby of the local clinic in the next few months when it becomes totally unbearable. My vet is more caring and sympathetic than ANY human MD I have seen.

  30. kj says:

    I have seen BOTH sides of the ER and there is NO arguement…Annie is right on! My 16 years as a hospital employee and 10 years as a caregiver to a very sick son (teen/young adult) and based on experiences of 4 different sized hospital ER’s/ED’s. When I wheeled my son in unresponsive and turning blue…THEY ACTED IMMEDIATELY–passing all others in line. When he could answer questions himself, the response was quick, but not instantaneously, allowing for proper triage protocols to take place. Many hours I spent “waiting” in the ER’s watching “others” who were there and miserable because of a toenail infection or lice…most were self inflicted long standing miseries due to their own neglect. They put off doing something about it early on using less costly medical services, & then they come and want instant relief Pleazzzzzzz!

  31. Marleyfan says:

    You sound like your going through a tought time.And while I really feel for you, I suggest that you keep looking for “Dr Right”. I switched doctors about ten years ago to one of the most compassionate people I’ve ever met. In fact when I went for a physical recently, my doctor had tears in her eyes after I told her how better things are. While contemplating suicide, have you considered looking for a good mental-health provider? There are many different medications and treatments to try…

  32. so lost says:

    So, so true. Thank you for posting this.

  33. Dave says:

    “Skeptical Guy” is ignorant. Once you have diagnosed what kind of “serious” illness you have, go ahead and make an appointment with the specialist. Seriously man, I hope you don’t show your ignorance in a non-anonymous setting.
    For anyone who works in an emergency department, this list is quite on the mark.

  34. christopher says:

    I agree about the comment where vets are more caring and compassionate than most doctors these days. In a society where suffering is just another way to profit from people, compassionate health care is hard to find. I know it’s not always the doctor’s faults. In an ER, we’ve been downgraded to mere numbers and wrist bands and ailments. Not people suffering in need of care.
    Is it abused? Sometimes. But it’s a sign of the bigger problem. If more people had access to decent health care and preventative health care, there wouldnt’ be so many ’emergencies’a and ERs wouldn’t be so packed and turned into a cattle call.
    My general physician is right now. A great doctor. Every unfortunate ER visit I’ve had (legitimate complaints…atrial fibrillation, broken bones, head trauma) I’m still treated as if I’m just a nuisance to them. “Oh, God. Another F’n patient. I gotta go do some more work!”
    When we can solve our health care meltdown and when we can convince people that suffering is a venue for people to make millions of dollars per day, only then will we level the playing field.
    I do think it’s morally wrong to lump people into mere cliches if you deal with them on an emergency care basis. As any real doctor will tell you, the rule of thumb: “First, do no harm.” As in, let them writhe in pain because you SUSPECT they’re faking it. Let them wait 4 hours when you SUSPECT it’s not a real fracture, and so on.
    ERs are a joke in the United States compared to the care I’ve had in Europe. And while it’s generally not the fault of the nurses or doctors, it’s still a fact.
    So maybe you guys could be a bit more patient and understanding with us knowing that we’re walking into a zoo where many times we’re treated like dogs or cattle. OOPS…there’s that reference again.
    My dog is always well taken care of quickly and with competent care. When they talk down to him, at least he doesn’t understand what they’re saying. When they tell him that the pneumonia he got is his own fault because he didn’t take care of it properly, he just looks at them and smiles.
    I wish I could say the same for myself when I have the unfortunate need to visit an ER.

  35. Dave says:

    34 wasn’t me.

  36. you’re kidding!

  37. I think AW needs to add another number for people who troll the web looking for websites where they can complain about doctors. what does that kind of behavior say about them?

  38. PB says:

    “with great exposure comes great responsibility” spiderman (sort of)

    Yikes Annie, how are you?

  39. AnnieFan says:

    Call ’em all Mudbloods Annie!

  40. Barbie Girl says:

    I’ve been an ER nurse for 33 years–now I work in a recovery room but once and ER nurse, always an ER nurse. Rule # 1–AIRWAY–if you don’t have an airway, nothing else matters, always and forever, no matter where you are. As the Queen of Triage, I can say that all the “truisms” are right on the money. I agree with # 22 (Fred)–All bleeding stops, eventually! I love the ER and taking care of the inner city poor. Now let’s talk about ER language–GOMER (Get out of my emergency dept), and Quotes from patients.
    “3 AM–I was just minding my own business and someone drove by and shot me.”
    “i be passing clogs (clots)”
    “I done fell out (passed out)”
    “i need a technical shot (tetanus shot)”
    “I’ve been swooped (assaulted)”
    “i’ve been vomicking (vomiting)”
    “i have to ax (ask) my mom”
    “where’s the baffroom (bathroom)”
    “I’ve been drippin from my piece”
    “I think I have gunkorrhea”
    Care to add to the list?

  41. Barbie Girl says:

    I forgot one–“I’m taking psycotropical pills”

  42. Sceptical says:

    Ah, anecdotal evidence. Even with 50 years of anecdotal evidence, it is still inaccurate. People must keep in mind what this is; observational evidence. It is not scientific.
    As an example: Maybe one ‘gang banger’ has cried over a tetanus injection, but it was so significant it got in this list. What about all those people who fearlessly had injections? Or people with tattoos — perhaps 100% of people scared of needles also have tattoos; but what percentage of people with tattoos are scared of needles?

  43. Dave says:

    The power of your logic is fucking devastating, S.

  44. Lizzie fenwick says:

    I have 54 tattoos, and I’m also a tattooist. I am terrified of needles. Not Tattoo needles, but hypodermic needles. They’re two totally different bags of apples. Hypodermic needles are hollow and much larger than any tattoo needle. Not only that, but tattoo needles are less invasive, and they draw very little blood. Plus, when I’m getting tattooed, noone is trying to jab a big needle in my VEIN. Tattoos are only placed 2.5 layers into the skin, unlike hypos, which go all the way through and then into a vein.

  45. […] the “The Ten Ironies and Truisms of ER” by Annie […]

  46. Mark says:

    Down with top 10 lists!

    Up with scientific method!

  47. dave says:

    random thoughts:

    veterinarians are compassionate because their patients can’t talk back, are generally innocent / blameless, have people that really really care about them, and most importantly, always have money to pay.

    traveling nurses get paid ridiculous sums of money, get to travel the country for free (deciding when to move on), and get their rent paid. …on the downside, they tend to get stuck with the crappy shifts.

    ‘all bleeding stops… eventually’ was coined by a surgeon.

    the easiest way to get an ER resident into the trauma bay is to yell either ‘intubate!’ or ‘chest tube!’ at the top of your lungs.

    alcohol is the direct reason or plays a major factor in over 50% of trauma activations.

  48. Dave says:

    People! Basic commenting etiquette: Pick a handle that has not been used by someone else, then stick with that handle except in obviously jokey circumstances. If you’re not sure whether a handle has been used before, you should lurk for a few days and maybe read stuff from the archives before piping up.

  49. Lyn says:

    AMEN! I have friends who suffer from chronic illnesses and I can assure you that the ones who hurt the most complain the least.

  50. […] quote share from Barbie Girl the ER nurse on The Great […]

  51. […] the Digg link to Annie’s “Ten ironies” post was the big story here, but Wendy’s “Sex talk” and Bryan’s […]

  52. Leslie Spires says:

    As a mother of a chronically sick child, from infancy to adulthood, and a veteran of emergency rooms, clinics, surgery, recovery rooms, waiting rooms, doctor’s offices, nurses, nurse practitioners, physician assistants, GP’s, surgeons,anesthesiologists,lab workers, pharmacists, clinics, waiting rooms, nurses stations, etc, etc. The most true statement that can be said is this: watch, listen, ask questions, read up on conditions (medical library – librarians usually very helpful), ask to see the chart, check the medical bill (daily if you can) always have someone with the ill person and stand your ground. You or your loved one is the patient; it doesn’t matter what other people think. If the hospital, clinic, physician or nurse doesn’t add up, has an attitude or complains; fire them and find another.

    There is a vast number of competent, caring and professional medical people out there – cut your losses and move on. It’s you or your love one’s life; protect yourself with knowledge and strength. You are the only one who is going to do it.

  53. […] read more | digg story […]

  54. rosanna rosannadanna says:

    I am a chronic pain sufferer with documented diagnoses including but not limited to multiple chemical sensitivities and several medication allergies that range in reaction from hives to difficulty breathing to swelling up like a balloon. I have been refused treatment in a local ER because they said I was drug seeking. The problem is that I am limited in what I can take because I have a history of gastric bypass, which negates taking nsaid drugs, and I am allergic to all sulfa-based drugs. What works for my atypical facial pain, allodynia, occipital neuralgia, chronic migraines, photosensitivity and phonosensitivity is as simple as 2 shots in the butt…2 mg of dilaudid, and 50 mg of phenergan because the dilaudid makes me sick as a dog. I only go to the ER when I have no other option…when I’ve taken all I can at home and the pain is so bad I can’t sit, stand, lay down, or move without pain.

    I have been mocked by the nursing staff, refused medications (other than Toradol, an NSAID, which I can’t take), and told lie after lie. I’m not stupid. I have exquisitely sensitive hearing and I have heard the staff discussing me like I’m some kind of idiot.

    I think the medical community needs to remember that out of chronic pain patients on narcotics for pain management, less than 4% end up addicted or engaging in drug-seeking behavior. I wish, for the ones who treated me so badly, that they would have the opportunity to be in the kind of pain I am in on a 24/7 basis and be denied what they needed so they could go home and sleep for the first time in 3-4 days simply because of an archiac, preconceived notion that anyone who asks for a specific narcotic pain control must be an addict or looking to become one.

    The current attitude of much of the healthcare community needs an adjustment. If you’ll give an epidural to a pregnant woman so she won’t hurt so much in labor but you deny pain relief to someone who lives with that pain all day, every day, and loses often far more than you can imagine because of that pain, something is wrong. Very wrong. It is a sad statment on our priorities and a slaughtering of the Hippocratic Oath which says that physicians should first do no harm.

  55. clk says:

    The last time I went to an ER, I left determined to kill myself, as I could see no other way to stop the pain: if it weren’t for friends & family who intervened and found me a doc who actually cares if people are in pain (the first I’ve met among many dozens), I wouldn’t be posting this…

  56. Legend says:

    Well, you obviously put a lot of thought into this. But, to your observations and conclusions, all I can say is :so what?’. You’ve been playing the game of “Pin the Tail on the Junkie”. Maybe some fun for you doctors and other health professionals, but, really, if other doctors take you seriously, all you’re doing is cutting down the number of people in pain who seek help at the ER. And, do you ever give enough drugs to get someone addicted? Not likely. In recent years, it’s become a kind of sport with doctors, especially those working in the ER.

    But, these ideas have been passed around for quite a few years-in fact, my 91-year-old father , who recently had to have his gall bladder removed, actually slowed down his recovery-by refusing pain medicine. He lost so much mobility, that his doctors are having trouble with his recovery. I’ve seen him-obviously uncomfortable, finding it impossible to find a position in which he could relax. At first, I was angry at the hospital staff…it seemed as if their “philosophy” concerning pain relievers was similar to yours. But then, one of his nurses told my sister and myself that she had “finally” persuaded him to take a pain pill-but, since he accepted them so infrequently, they were still having trouble getting him to move, and improve his muscle tone. He remains hospitalized-we can just hope he sees the reason for, and necessity of, pain relief.

    Me? Yes, I’ve had trouble with chronic pain. No, I haven’t always acted wisely. I was even convinced that I was a junkie-until a wise person-no, not a doctor, nurse, therapist, but a parole officer noticed my pain, and insisted that I get help for it.

    I still encounter problems with under treatment. That is what causes most “junkie-like” behavior in true pain patients.

    It seems that no one wants to know what we have to say-although they’ll listen to you-after all, you’re the experts! I don’t know why-I doubt if you’ve ever been in so much pain, and so sick and tired, that you’ll do anything for relief.

    More on my experience can be read here. You should really try to think, before you post. You write well, and, no doubt, even some chronic pain sufferers will enjoy the idea of those addicts who scam the system “getting theirs”. But, if you succeed in misdiagnosing even one legitimate patient, you may be contributing to a crime, suicide, or, at least (or is that most?), to a person’s not getting help-or worse, thinking he/she doesn’t deserve it, and the painful way is the better one. In short, someone may end up having less of a life than they could have had-because of this game you’ve decided to participate in. I’ve lived 54 years-a full half in chronic pain-and, trust me, the painful way is not the virtuous, noble, or superior way..

  57. Michael Berkowitz says:

    I am an engineer. We are trained to be articulate. So excuse me if I try to tell you what I am feeling and where. You can tell little from poking and prodding. That is why physical exams have been shown to be pretty much a waste of time. I was raised to be as specific as possible and to keep command of the English language even under the worst circumstances. So, if I am not visually broken or otherwise obviously injured you are going to mistreat me (two meanings there in case you don’t understand). It’s nice to know what to expect.

    You and those like you are small minded individuals who probably got into medicine for the wrong reason. You need to spend some time with patients that are sick and in pain but can articulate their feelings. Try a pain management clinic, cancer ward or an orthopedic surgeon’s waiting room. They are full of people who can communicate but are probably ill. Do you have any idea how much pain a pinched verve root at C6-C7 can generate? I do. Does it make me inarticulate? No, I am just in pain; my vocal cords work and my engineering training says be specific. Those clinics are rarely open at 1:00am, so where else should I go?

    Has it occurred to you that we dislike the way you treat us? Has it occurred to you that you cannot know me or how I react to pain from a 5 to 5 minute consult? Has it occurred to you that as you run back and forth from patient to patient that you miss things, forget things and sometimes get confused as to which patient is which. That is when I have to remind you why I am there and you give me an annoyed look. I am just as annoyed as you are.

    I wnet to an ER complaining of facial numbness and problems breathing. My PCP sent me there to get a CAT scan. Oops, I was able to talk and there were no broken bones or visible blood. So I was treated like the non-ER patient: I got the CAT scan, some and they sent me home. The CAT scan, later showed I had had a stroke. But using your logic that diagnosis just couldn’t be possible. I was articulate, conscious with no visible signs of trauma.

    Some of the problem is created by you and your kind. At 1:00am (again) the ER is the only healthcare resource (a big articulate word, look it up). You train your advice nurses to send anyone to the ER who might be sick or hurt (mostly to avoid being accused of malpractice). Doctors and nurses will not speak to patients about symptoms over the phone, you always say “come in.” Then you wonder why some of us aren’t unconscious and can speak. If you do not like the way your system works design a better one, don’t just complain. Also, set aside your unprofessional prejudice and treat all of us as scared hurting patients in need of care.

    You need to rethink why you are in medicine. As it is now I will risk dying at home rather than being mistreated by the likes of you. But then you will like me; if I am brought in unconscious not only am I compliant but I fit your image of the ONLY type of patient that should be in the ER. Sadly, I will also be closer to death but at least compliant.



  58. Juliana says:

    I didn’t read all of the comments, but I just wanted to reply to #9, I do have a lot of pain, and a very high tolerance for it. How do I know? Because the Dr’s and PT’s who have treated me are shocked at how little I respond to outside painful stimuli. After dealing with my chronic pain for a few years I broke my finger- only I didn’t realize it till it was swollen up to four times the size, because compared to my leg pain, it was at the bottom of the 1-10 scale.

    I understand working in the ER is a hard and sometimes thankless job, but if you work in one, remember that just because 9 out of ten people in pain coming into an er might be looking for a high, there will be that one that truly needs your help, and though what they feel might be invisible to you, it does not make it fake.

    Thank you to all my Dr’s, nurses and PT group who all believed in my pain, and are finally, with the help of a spinal cord stimulator, helping me recover my life.

    9 weeks post op
    8 weeks with no pain killers!!!