Itmark-plaster had been a quiet, peaceful summer afternoon and I wasn’t really looking forward to the chaos that I knew was waiting for me in the ED. Two ambulances were empty with their doors still standing ajar and two more were parked in the parking lot when I arrived. I stopped for one last moment to look out over the harbor before entering the ambulance doors. I took a deep breath and plunged into the department like a fresh substitute in a football game.

mark-plasterThe two women sat quietly in a corner of the busy ED, almost lost in the business of people being shuffled off to get labs and x-rays. The elderly woman sat with her head bowed in prayer or pain while the younger woman looked anxiously at her. Even though the chief complaint was “chest pain” she had been brought in her daughter’s private vehicle instead of an ambulance. 

mark-plasterI picked up the first chart of the night and read the chief complaint. “Suicidal.” You never know what that means. It could be an old man who has sat all day with his shotgun in his mouth and finally thought better of the situation. It could be a belligerent drunk who was thrown out of his house by his wife and knows that he can stay in the hospital over night if he claims he is going to kill himself.

mark-plasterOne of the things I like the most about the ER is that it is the real “No Spin Zone”.  More accurately, it’s the “No BS Zone”. The dynamics are straight forward. It’s just me and the patient. He’s sick and I’m there to help. It doesn’t matter if he smells like moldy gym socks or if he’s completely broke. It doesn’t matter if he likes me, and it certainly doesn’t matter if I like him.

mark-plasterThere were no patients to be seen when I walked down the hallway to get a cup of coffee. But when I returned to the nurses’ station, Heather, one of the regular night nurses, was holding a chart and looking at me, quizzically. “You have to see this guy,” she said. “I don’t have a clue what’s going on.”

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