With less access to primary care and multiple gatekeepers adding to the expense of health care, perhaps EPs should be the final stop for many ED patients.
Last spring a group of physicians and medical societies filed suit in
federal court to overturn a state law that bans healthcare professionals
from asking patients about whether they own a gun. On first blush, it
seems like the reasonable and responsible thing to do. The government
has no place in telling doctors what they may or may not ask a patient,
“Did you know that sleep walking will get you disqualified from the
Navy?” I asked my wife in response to her usual “What did you do today?”
interrogatory. It was drill weekend and I had just finished one of my
rare day shifts serving at the Naval Academy clinic.
Over the years I’ve gotten many calls like this one. “Will you look at
this case? Something very bad happened and I think someone screwed up.”
They seldom say it quite that bluntly, but that’s what they mean.
One day, many years ago, I was sitting in front of the television
when an emergency news bulletin broke in. There was a major water leak
on Broadway and 34th Street in New York City, not far from where our
family lived. The camera faded to a big hole in the street with water gushing
out of it. There was the usual crew of nine men looking idly on, but in
the hole, there was one man digging frantically. His head bobbed up and
down, shovels of mud flew through the air.
It was my first night at a new emergency department, so I was just
getting used to the system and the people. Everything seemed to be going
along smoothly. The staff was great and very welcoming. The patients
were pleasant and generally not so sick as to create a stressful first
“Hey sweetheart,” my wife said cheerily as I stared into my coffee. “Today’s your day.”
“Huh?” I said blankly. It had been a long night and all I wanted was to eat my breakfast in peace and go to bed.
“It’s your birthday, silly.
Have you ever arrived at the hospital for your shift with the sinking
feeling that the odds were stacked against you? Sometimes it’s a quick
look at the ambulances lined up waiting to drop off patients. If I walk
by the waiting room I can sometimes get the feeling of whether people
are waiting patiently or whether there is a sense of anger and
I came up the companionway of our boat, ready to take over the night
watch from my daughter who was standing alone at the helm. “I see that
the wind has freshened,” I said cheerily. This a term sailors use when
it’s blowing like crazy.
Working the night after a holiday is always a bummer, especially
Thanksgiving. I usually eat so much turkey, dressing, mashed potatoes,
and pumpkin pie that I start to resemble the unfortunate bird himself. But my wife always drags out the Christmas decorations to
get a head start on the next season. Every other year I’m spared from
this duty as it is my turn to traipse off to the hospital for another
shift. Thankfully, it’s usually quiet. I guess most people are laying
around stuffed like I was. But a few make it in to the ED with the usual