Probably the most striking thing about working the Emergency Room is how few actual “emergencies” come in. In my time spent at the ER I have only seen a few patient’s that were at risk of dying or at least serious physical injury.
This was clear during my shift last night. We saw people with various ailments, from diarrhea, to chest pain, to a car accident, to a migraine headache. This is a fairly typical shift. However we did see one patient that was very ill. He came in with a low oxygen level, low blood pressure, and he just appeared very sick looking (the doctor would say that he looked “toxic”). Labs revealed abnormal CO2 levels, a urinary tract infection and a possible heart attack.
The man appeared to be septic, meaning that an infection had spread throughout his whole body, and was probably in the blood. Because of his precarious position, the doctor stated something to the affect of “the possible heart attack is low on the priority scale”. The infection needed to be treated rapidly and potently if the man was to survive.
When he left the Emergency Department to go up to ICU, he was in stable condition. I’ll probably never know whether he survived that infection, but I’m guessing he probably did.
Towards the end of the shift, I noticed the waiting room was filling up with people. I remarked to the doctor I was working with, “Look at all those sick people.” What she said next was striking.
“We only saw one “sick” person today.”
She didn’t say it bitterly, but I can’t help but think the remark reflects a general feeling among ER physicians. They see so many patients whose illnesses could be easily taken care of by a family physician, I often sense a feeling of frustration. What can be done about it? I really have no idea. It’s a complex issue, and I’m sure I’ll explore it more in future posts.
