“If the Republicans win big they plan to choke off health care reform,” said my wife while reading the morning paper. “That’s what you want, isn’t it?” She’d heard me rant about the long-term negative effects that the recently passed bill would have, and I think she was hoping this election cycle might put an end to it.

When the phone rang at 4:30 in the morning, instead of sleepily reaching for the bedside phone, my wife literally jumped out of the bed. With an elderly parent, she is always worried that such late night calls mean bad news. I, on the other hand, have a more sanguine view of life, and try to avoid any such thoughts that might interrupt a good night’s sleep.

  As a Navy reservist assigned to a Marine Corps unit, my annual training requirement – AKA “summer camp” – usually meant going with my Shock Trauma Platoon to some foreign country to stand by while a Marine rifle company carried out a live fire exercise with the military from the host country.

It was a hot Saturday night and the ED was packed, as usual. All the histories seemed the same: “I was sittin’ on the stoop drinkin’ a few cool ones . . . then he said . . . then I said . . .” Countless cuts, bruises, and possible blow out fractures filled every room.

I believe that the answer to defensive medicine and the damage it has done to our health care system lies in our own hands. We are the ones who establish the ‘standard of care,’ beneath which is negligence. 

 “Hey Doc, where’d you get that costume?” Andrew asked after he instinctively jumped to his feet upon my entering the kitchen. As a midshipman at the Naval Academy he is trained to be respectful, but I guess the ‘costume’ sort of took him by surprise. He and a friend from the academy had just arrived for a visit to our house for the weekend.

This month Night Shift changes gears, publishing a post from one of our favorite medical blogs,

I walked into Room 17 to see a sixty-ish woman who, by the nurse’s triage note, had come to our ER for shortness of breath. A smoker, with a history of chronic obstructive pulmonary disease (COPD). The nurse’s note reflected her suspicions that this patient may have pneumonia.

alt“What the heck are you reading at this hour?” my wife moaned after being awakened by my bedside lamp. She took a moment to clear her eyes and leaned over to read the title on the screen of my computer. “Diagnostic and Statistical Manual of Mental Disorders. You’ve got to be kidding me. It’s 2 o’clock in the morning. You’re the one with the mental disorder.”

Problem: If EPs wait for big organizations to act, they will miss their real need.
As soon as I saw the scale of disaster in Haiti I knew I wanted to respond. But because I was on the West Coast, I was unprepared to respond to the Navy’s call to join the USNS Comfort. I then wasted a week looking for another group, finally joining Team Rubicon, an NGO that had only been formed the week prior by people like me who just wanted to do something.

Take Home:
If you want to be able to respond in the first wave of relief, have a relationship with a team of like-minded individuals or an organization that is ready to respond on a moment’s notice.
“Ma-a-ark,” I heard the distinctive warbly voice upon answering the phone. It was my mother-in-law, Peggy, better known as Mom Mom. When she called my name like that it always reminded me of a beloved hen that my brother had as a pet when we were children. “My stomach still hurts. I’m not feeling any better?”

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