It was a busy night in the emergency department as many nights are. All of the rooms were full and there were 6 to 8 patients waiting just to get back to the emergency department. I hadn’t taken a break in several hours, and though I was hungry I just drank sips of Gatorade and ate handfuls of cashews between patients to keep my energy up and to keep my stomach from growing too loudly at me.
Sometimes during nights like this it seems like the “powers that be” try to mess with your mind. Every time you discharge one patient, two more patients register to be seen. If you discharge two patients, three patients register to be seen. The more you try to get ahead, the more behind you get. Then you start thinking. If I didn’t discharge anyone, th-e-e-en how many patients would register?
Snap out of it WhiteCoat. Looks like another “no dinner” night.
The next patient waiting to be seen was a middle-aged man who was suffering from a cough and sinus drainage for the prior three weeks. The patient was going to be seen by his primary care physician the following morning, but did not want to wait for the appointment. He had been waiting a little more than an hour to be seen. As I opened the door, the man was laying back on the bed watching something on his iPhone. His wife sat in the chair across the room and was apparently typing out a text message on her flip phone. I could hear the Morse Code-like beeps every time she entered a letter.
As I walked in the room, the woman looked up, let out a dramatic sigh and said “F-i-i-i-i-nally.”
I tried to explain. “I’m Dr. WhiteCoat. I apologize about the wait, but it is a very busy night this evening. I’m trying to see patients as fast as I can. What can I help you with?”
“Huh. It’s about time.”
“Ma’am, I haven’t gone to the bathroom in three hours and I haven’t eaten a meal since my bowl of cereal at breakfast this morning. I’m going as fast as I can.” I then turned to the patient and asked “What is it that I can help you with?”
The wife then butted in again. “Honey, can you even remember what’s wrong? It has been a while that we’ve been waiting here.”
That ticked me off. Actually, I was ticked off by the wife’s attitude to begin with, but that comment was it. Rather than lash out, I decided to take a break. “Pardon me. I need to go check something.”
I got up, left the room, told the charge nurse that I was taking a short break, and went to the doctor’s lounge. I emptied my bladder. Then I went down to the cafeteria and got a small dinner plate. I brought it back to the doctor’s lounge and ate while talking to one of the other staff physicians. After finishing my dinner, I went back to the emergency department.
One of the nurses told me that the patient’s wife had been out to the desk to complain during the 15 minutes I was gone. The nurse had ordered a chest x-ray just to appease the patient and his wife. I nodded.
I discharged a patient whose chart had been placed in the discharge rack after labs had come back normal and he was feeling better.
Then I went back into the coughing patient’s room. He was still in the radiology department finishing up with his chest x-ray.
The patient’s wife looked up at me, scowled, and asked “What … is taking you so long?”
I smiled back at her and said “You were right, it was about time.”
Strange. She wasn’t in the room when the patient got back from x-ray.