Scared Clean

You could hear the coffee maker gurgle on this side of the ER amongst the beeps of monitors happily watching their patients and employees talking between themselves about their weekends. The smell of fresh coffee wafted through the air which is always a welcomed smell. At times you only smelled urine and the peppermint scented cleaner. Make no mistake though, that pleasant smelling coffee could burn a hole in your stomach the moment it slides down your throat. Even with this information, our nares were enjoying the break from offensive odors.
It was nice and calm, which is rare AND odd. We get a little suspicious when it’s quiet and calm. That is why we were able to relax when Mr. V became upset and started yelling, disrupting the unnatural silence of the ER.
“What the hell do you mean,” he growled with a reddening face. “I’m gonna sue your ass for not treating me! You fuckers don’t know your ass with both hands!” He was so upset, he messed up the insult he venomously spat at Dr. M.
But Dr. M stood ramrod straight with a passive look on his face. Mr. V, a slim forty something year old male with silver temples that stood out against his black hair, was a frequent flier and had been marked as a possible narcotics abuser. Dr. M was on the end of this verbal assault for telling him he would not be receiving any narcotic drugs. Mr. V already had received a “pain letter” from our department which tells the patient “no more narcotics”. I looked at his chart. Mr. V claims he’s allergic to all pain meds except for Dilaudid.
Yeah right.

He was also in for abdominal pain which can be a tricky area of the body. Many drug abusers know to use this complaint because of it. We usually CT scan them which, as they may not know, the contrast is hell on the kidneys not to mention the awful amount of radiation their belly will absorb–the equivalent of 500 x-rays in one single scan.
He was in two weeks ago for the same thing…and two weeks before that…and two weeks before that. Every two weeks or so, for the past few months, Mr. V has been in for abdominal pain and we’ve been unable to determine the cause. His loud outburst to our refusal to provide narcotics is only further evidence he’s abusing.
And to think there are people in the waiting room with real emergencies, waiting, because Mr. V wants his Dilaudid.

We knew of his potential outbursts, yet somehow he was in a room with a view. Only curtains surrounded him which let the entire department hear his outbursts. Dr. M took his verbal beating without even flinching. This was typical drug abuser verbal diarrhea. He’s heard it all before. Once Mr. V took a breath, Dr. M stated, “Say what you want, but I’m not giving you any narcotics. You can have Tylenol…”
“Fuck your Tylenol. I want my lawyer,” Mr. V carried on, waving his arms like mad. Dr. M turned and rolled his eyes while Mr. V continued, not caring that Dr. M was walking away from him.

We met Mr. C in the hall as he was being transfered to the cath lab for treatment of his recent heart attack. He looked at little pale, but smiled and waved as the tech pushed his bed. Then his hand dropped. It was an unnatural drop and the monitor screamed for attention at the same time. Mr. C was in v-fib.

In two large strides, Dr. M was at his side. “Lets go,” he yelled to no one in particular. He raised a giant fist while paddles were readied and slammed it into Mr. C’s chest with a sickening impact. The monitor didn’t change after the precordial thump. As readied paddles were handed to Dr. M, he announced the voltage, “Clear,” and shocked Mr. C back to life right there in the hallway for everyone to see. Everyone smiled since most codes don’t end with a live victim. Even though we were out in the open, there was only one witness.
I looked down the hall and saw Mr. V craning his neck to see. He sat wide-eyed and silent, staring at the bed where Mr. C now started to comfort the area where Dr. M had hit him.

Mr. V silently eloped from our department. We haven’t seen him for months. Maybe he’s going to another department for drugs? Maybe he’s dead. Perhaps what he saw jolted him badly enough to realize what he was doing. Hopefully so, but probably not.