Saturday . November 16 . 2002 . 1:38pm |
scenes from the e.r. redux So I'm just getting over a bout of self-diagnosed viral rhinosinusitis. Basically, I had a cold, and was producing so much snot and blowing my nose so much that my left maxillary sinus got all clogged up, causing pain and general crankiness. But I've found the secret--the triple cocktail, if you will. Before you go to bed each night, take two tabs of Sudafed, two tabs of Extra Strength Tylenol, and two tabs of Benadryl. (If that sounds like too many pills, just get Tylenol PM, which has Tylenol and Benadryl already mixed together.) You will sleep like a baby and wake up relatively pain and mucous free. Then, before you leave for work, take the same cocktail, minus the Benadryl, so you won't be nodding off at work. Continue until your symptoms abate. Free medical advice, right here. Things here are going well, now that we've gotten over the worst of the ER shift-stacking. Today is my first full day off since the beginning of November, and I'm enjoying it with full-force slacking gusto, sleeping until 11:00 and lounging around, unshowered and in sweat pants. Meanwhile, Joe is sweeping the apartment and cleaning the kitchen. Sweet. Where's my umbrella drink? So what I had been meaning to tell you last week, before I got too tired to update, was that during one of my shifts in the ER, I saw two patients back-to-back that really made me reconsider my career choice. They were, literally, the personification of the two prime reasons that people shun the field of Pediatrics. And I had them both. CASE 1: The Insane Parents (read: mother) Parents bring their one and a half year-old son to the ER. He has caught the viral gastroenteritis (a.k.a. stomach flu) that's been plaguing every other child I'd seen that day. The story given is that he's been throwing up since that evening. It's now 1:00am. MOTHER This is very bad! Very serious! MICHELLE Well now, it looks like he's just caught the stomach flu, which is going around now, lots of kids get it around this time of year, it's no big deal... MOTHER No big deal? My son is throwing up! He's becoming malnourished! He has no energy! Look at him! He can barely lift up his head! KID (Happily playing with emesis basin, goggling at parents and Michelle) MOTHER Also, I don't think his vomiting is normal! It smells very bad! Look, he threw up on my dress before we came in! Does it have a very bad smell? A not-normal smell? (Actually lifts up the folds of her vomit-soaked garment towards Michelle's face so that Michelle can smell it.) MICHELLE (Ducking) Ah...well, I know you must be worried, and I'm not trying to minimize that, but let me assure you that lots of kids get this, I've been seeing it all week in the Peds ER. It's a virus, it will run its course, he'll be better in just a few days, just wait and see. MOTHER Better in a few days? The way he is? Never! He's throwing up! He never throws up! He loves food! Yesterday, he ate five prunes! He loves prunes! Now he's not even hungry! He needs medicine! He needs an operation! Who are you anyway? Get the real doctor in here! MICHELLE (Deep breath in...and out) Now, I know that he might not be feeling very hungry now, or that he might not have as much energy as usual, but remember, he has a little bit of a fever, and that he has a virus. Do you remember the last time you had a cold, or the flu? You didn't feel much like eating then either, right? Well, that's how he feels now. But as long as he's keeping some of his food down and it doesn't look like he's getting dehydrated, he should be fine in just a day or two. MOTHER He's throwing up! He's losing weight! He's gaunt! He can barely walk! I CAN FEEL HIS BONES! (Clutching at child, who looks surprised, and then starts to whimper at her fervent ministrations) MICHELLE He's been throwing up for...seven hours? MOTHER HIS BONES! KID Baba? (Gesturing at bottle) MICHELLE If he seems like he wants food, feed him, but little bits at a time. Not the whole bottle. One ounce, then rest. Then another ounce, and rest. Give his stomach a chance. MOTHER I just fed him eight ounces of milk an hour ago. (Displaying empty bottle) MICHELLE Well, that's good that he was able to take it, but since he's been throwing up, let's try small amounts at a time, otherwise... KID Bleagh! (Throws up small mouthful of curdled milk, then smiles) MOTHER (Bursts into tears) Oh, my son, my baby boy! YOU'RE DYING! MICHELLE So no one else is sick at home except your husband, who also has a stomach flu. No brothers and sisters, am I right? He's your first? MOTHER That's right. How did you know? MICHELLE Lucky guess. And then there's the opposite end of the spectrum. CASE 2: The Spoiled Brat Parents bring their three year-old daughter to the ER because she has a fever. The nurse at the triage desk measured it at 100.7 degrees. MICHELLE (Walking into curtained area, smiling) Well now, who's Emily? EMILY (Ear-splitting shriek at the sight of Michelle. She is a chubby three year-old wearing a little hot pink baby tee with the word "SPOILED" spelled in rhinestones. No, I am not kidding.) MICHELLE Oh, looks like someone doesn't like doctors. MOTHER That's all right mamacita, she's not a doctor. She's just a nurse. EMILY (Ear-splitting shriek #2) MICHELLE (Deep breath in...and out) So Emily has a fever, I hear. MOTHER Yes. For three hours. MICHELLE For three...and...you brought her to the ER. MOTHER Yes. She has a fever. MICHELLE Right. OK Emily, let's take a look here. EMILY (Flailing away from me) DADDY! DADDY! EEEEEE! MICHELLE It's OK, sweetie, I'm not going to hurt you, I'm just going to look and listen. EMILY I HATE YOU! MICHELLE Let's just listen to your breathing first, OK? You want to sit on Mommy's lap? EMILY NO! NO! I HATE YOU! EEEEE! DADDY! MOMMY! HELP ME! SAVE ME! MICHELLE Look, just the stethoscope. First I'm going to listen to Mommy (laying stethoscope on Mom's arm, pretending to listen), and now I'm going to listen to you (puts stethoscope on kid's back). EMILY DADDY! HELP ME! HELP ME! SHE'S HURTING ME! MICHELLE OK, you know what? Why don't we have a little time out, I'll let you...uh...calm down, and I'll come back in a few minutes. Is that OK? EMILY I HATE YOU! NO! GO! GO AWAY! MICHELLE (Plastered on smile) Alrighty, then. But I'll be back in a little bit. (Sound of screams project into the hallway. Then, abruptly, they stop. Michelle peeks back into the curtain area. The kid has stopped crying. Why? Daddy just gave her a ten dollar bill.) MICHELLE (Under her breath) Oh lord. xo Michelle |
