Hackles Up

The city in which I work is probably, I would say, medium-sized. We have our own collection of restaurants, cultural events, sporting arenas with minor-league teams, several hospitals, and four major colleges.

You would think that our city would be large enough to not run into patients whom I have treated in the ER, but this is simply not true. There are way too many places to be recognized.

"Hey, doc," they'll say to me in a Walmart line, "do you remember me? You treated my hemorrhoid in 2003?"

Oh, that's right. Of course I remember you now. NOT! And please, sir, whatever you do, don't show me your buttocks to refresh my memory.

I do seem to have a good memory for people's faces, though, and even a better memory of their illness (as long as it's more recent than 2003!). I am much more likely to remember your heart attack, the cauliflower growth on your ear, your thickened, fungal toenail that grew overnight, or the way you cried when our most-skilled nurse put in your IV (along side your ten inch forearm tattoo!) than remember your name.

And, for the most part, if I am not pressed for time, I do enjoy seeing some of these former patients. They are usually gracious and complimentary--who wouldn't enjoy that? We don't get a chance to follow-up with ER patients like an office-setting practice does, so I appreciate hearing about how they are doing and what worked in successfully treating their illness.

There are, however, a few circumstances where I would rather not be approached.

For one, the gym. I appreciate my gym-time immensely and rely on my workouts to keep me centered. Since I have treated multiple patients who frequent my gym, I usually wear a baseball cap pulled practically down to my upper lip to remain incognito. The only problem with that, besides bumping often into the weights, is I'm not quite sure if people are looking at me because I look familiar to them or because I look like the ultimate dork.

My other issue about the gym is this: if you see me standing naked (pre or post-shower) in the locker room, please let me finish what I am doing (translation--let me get some underwear on!) before you approach and share with me. Especially if I'm bent over drying my toes! I'm not shy, really, but rarely can someone give me a good hemorrhoid or constipation story in less than ten minutes. If it is a heart attack or stroke story, I know I'm committed for a good 20-30 minutes. Let me tell you, I can grow a whole crop of goose bumps like you've never seen in that time!

So, obviously, the gym is out.

My only other issue is that I do not want former patients to share if my kids are with me.

A few years back, I was on a date with my three young kids. Just me and my kids. We had ourselves a nice meal at The Olive Garden and then went to the movies. On our way home, we stopped at the local Target to buy fingernail polish (for Daddy's famous manicures) for the girls.

A woman who works in the pharmacy section of the store is a former patient. In fact, not only have I treated her multiple times, but I have also treated her troubled, teenage children several times. The last time I had seen her was at her daughter's bedside. Unfortunately, her daughter had to be transferred to a psychiatric hospital for further care.

Now, I have never had any bad interactions with this woman or her children and, in fact, I remember having gone out of my way to show them extra kindness because of their many problems. However, as a result, this woman has tailed me through the store on several prior occasions, giving me updates, sometimes graphic, of their follow-ups. I remember being quite uncomfortable, at times, through these conversations.

On this particular day, as the kids and I were holding hands and happily walking through the store, I was hopeful that I wouldn't run into this woman.

Wrong. She spotted us almost instantly.

She came running up to us from behind, startling my kids and myself. I said hello to her and gave her a warm smile. My kids, inherently shy with strangers, crowded for space behind my back. I skipped their introduction.

"I know you'd want to know about my daughter," she started, speaking quite loudly.

"I sure would," I said quietly, kindly, "but maybe another time when I'm not with my kids, okay? We're on a date and just ran in to pick out some fingernail polish. I sure hope she's okay, though."

"Oh, sure, she's okay...now," she answered, gruffly. She didn't stop there, though. She started to tell me, in embarrassingly explicit language and detail, how her daughter had acted-out and had gotten into more recent trouble.

As she spoke, I could feel my protective hackles coming on. My kids cowered into the back of my legs, gripping my pant-legs and tugging me into them.

I interrupted her. "Maam," I repeated, now emphatically , "I am on a date with my kids and, frankly, don't feel comfortable with how you are talking in front of them. They don't need to hear of your daughter's problems."

"Well," this woman said, somewhat affronted, "they need to learn about this stuff sometime." Learn what? I thought. About your daughter's acting-out? Or, from you, how to use a swear word? Either way, I don't think so.

"No, maam," I answered, struggling to keep my cool and smile, "you're wrong. My kids don't need to learn about your family problems. And they don't need to hear such explicit language, from you or anyone. I would never condone this type of language in front of them."

The woman huffed and seemed slighted, but I didn't care. "I wish your family well," I said with sincerity, "but I'd appreciate it if you let us keep moving here. Have a good day." Without waiting for a reply, I eased my hands into my children's backs and guided them onward, toward the make-up aisle.

Although I've seen this woman several more times in Target since that interaction, I have not seen her or her children in the ER since. She does not approach me anymore, either, although several times I have nodded a "hello" to her. I do hope her family is well.

I often wonder if I handled this interaction appropriately but, at the end of the day, I need to protect my kids in the way I deem necessary. They don't deserve the intrusiveness of my job. And they certainly don't need to learn their swear words from Daddy's former ER patients.

Would any of you handled this interaction differently?

There is a silver lining in all of this, though. At least I wasn't standing naked in a locker room when this conversation happened!

As always, big thanks for reading. Next post will be March 3. See you then...

Another Notch In The ER Cot

I know there is a "mile-high" club for airplane travelers who are, to say the least, adventurous and daring. But is there a club I don't know about that involves an ER treatment room and the flimsy cot in it?

The other day, during another busy shift, I walked into Room 31, ready to treat a new patient. What I walked into, however, caught me off-guard. In fact, I think I blushed. And after everything I've seen and treated in the ER over these past years, to get me to blush is a major accomplishment.

Lying in the cot, covered by a thin papery sheet, was a very "loving", shall we say, young couple. They were in the midst of some passionate maneuvering--four tangled arms wrapped around one another, shirts rumpled and pulled up, shoes kicked off to the side of the cot, and mussed up hair. My timing couldn't have been better. Lucky me. A front row ticket to an amateur peep show.

Maybe in my twenties, I would have been more enamoured about this situation but, to be honest, I'm in my early forties now--the only thing I felt was a little frustration. And, guessing from my warm cheeks, embarrassment. Well, some wonderment too--who in their right mind looks around an emergency treatment room and gets "in the mood?" Is it the gowns? At least this explained why the room curtain and sliding door were closed.

I cleared my throat and skipped my usual greeting. 'What's going on in here?" I asked, trying to sound like my father, stern and all-knowing.

Surprised, the girl sat up. "Oh my gosh," she giggled, hardly embarrassed, "we got a little bored after waiting for so long to be seen."

"I'll tell you what. I'm going to step out of this room for one minute, and when I come back in, I expect you to both be presentable. If not, you will both be escorted out of the ER by security. Do I make myself clear?"

They both nodded their heads at me, the middle-aged doctor who interrupted their cheap thrills.

I walked back to the nurses' station shaking my head. I wasn't buying the bored routine. Each patient room has its own television, complete with a remote control and more cable channels than I get at home. Each room also has a filled magazine rack and its own telephone for local calls. We even have available wireless internet if someone is so inclined to bring in their laptop with them. Outside of a pillow, a warm blanket, and a two-day old turkey sandwich with fresh lemon jello, what more could a waiting patient want?

Obviously, some privacy. And some form of birth-control.

I found the nurse for Room 31 and after making her aware that our patient had just been actively trying to get pregnant in our ER, we both walked back to the room together. Maybe, we joked, they would name the baby after one of us.

The curtain and sliding doors were both open. We walked into the room. The twentyish male companion was sitting meekly in the corner chair, the patient in the treatment cot. They were both dressed.

This time, I introduced myself and their nurse. "So," I said, after introductions, "which one of you might be the patient? Because from what I walked in on earlier, I would think that neither of you is sick enough to visit us in our ER."

After some putzing around, we got to the reason. The patient, it turns out, had missed her period and came to our ER for a pregnancy test. Yes, I am being serious. She got sent to the ER's acute-care side instead of our express wing after telling the triage nurse she had abdominal pain, thinking it would get her seen faster when, in fact, it tripled her wait time. The triage nurse, trying to move things along, had ordered the pregnancy test and some basic blood work.

There must be a higher power--her pregnancy test was negative.

This whole scenario, though, got me thinking that maybe there was some club I wasn't aware of, a club that nobody filled me in about since they know I work in the ER. This isn't the first time I've caught a couple fooling around in a cot. It's happened before and I would be disillusioned to think it wouldn't happen again. The common denominator, though, seems to be that they are all younger people, ranging from their late teens into their twenties.

I guess that rules my wife and I out. Initially, after catching this last couple, I had started making plans to take my wife to our ER to spend the night and find out what we were missing. And I was going to splurge, yessirree. No regular treatment room for my honey. I was going to get us one of those big trauma rooms with the really sturdy cot. Warm blankets. Cable TV. Pack our own sandwiches and pillows. Get a baby-sitter for the kids. All I had to do was register one of us, embellish some medical symptoms, give our insurance information, and the room would be ours.

"Hey honey," I would have said, "pack up your suitcase and jump in the car. I'm taking you on an overnight excursion. You don't need to pack a nightgown, either. Where we're going, they have plenty of them." If those prospects didn't intrigue her, what would? "Oh yeah," I'd add, "don't forget our insurance cards!"

In the midst of all this planning, though, it hit me--I probably wouldn't get a good night's sleep in the ER sharing a trauma cot with my wife. And, as I think I mentioned, I am in my early forties now. I held both my hands out and weighed the situation. A good night's sleep at home versus joining some obscure "notch in the ER cot" club. I yawned as I thought about it and with my yawn, the answer came quite easily.

So, this brings me back to my original question. Is there an ER club similar to the "mile-high" club that I don't know about? Do I really want to know? And does it have a nickname? I do like "notch in the ER cot" but I made that up on the fly--I would hope the name would be something better and more original than that.

Finally, if any of you are members to either club, keep it to yourself. I don't want to know. Now, if you'll excuse me, I'm going to get a good night's sleep.

As always, thanks for reading...next post will be Friday, January 8th. Let me know if you think of any good nicknames...