Somebody needs some coffee

I’m standing at the counter at the nurses’ station doing my paperwork. We brought in a man with chest discomfort; he’s in a room just within earshot. He has a history of LAD occlusion. As is understandably common with such more educated patients, he said his discomfort has subsided, but was equivocal about it, calling it “zero to one-ish.”

The staff is getting him set up, and I can hear the hubbub of EKGs, him undressing, gurney rails clicking into place, etc.

“I’m Dr. <insert name>. Tell me what brings you to the ER tonight.”

It’s 3am. I zone out for a few seconds as writer’s block sets in.

“No! I will NOT accept that answer! It’s either yes or no! You either have discomfort or not!”

He sounds downright angry. A couple of nurses at the station and I exchange puzzled looks.

“Whoa… AH-GGREH-sive…”

I’m not a doctor, and I get that he’s trying to decide whether or not to medicate the patient, and he needs his history, but take it easy on the poor fellow. Grilling him about whether he’s subjectively rating his discomfort a zero or a one seems a rather academic exercise with this particular case. Given all the details of his complaint tonight, does his management really hinge so much on his rating of the discomfort that he needs to be yelled at as if he’s a willfully difficult teenager? This guy is, in all likelihood, probably barely keeping it together, wondering and worrying, first and foremost, if needs another cath, perhaps even fretting that he should have shaved*.

*His groin

2 thoughts on “Somebody needs some coffee”

  1. Once again the pain scale shows it’s uselessness. As does the poor job we do (at all levels) in teaching how to evaluate cardiac symptoms.

    What if the patient had no pain, but dyspnea? Give them an Albuterol treatment and tell them it’s Asthma?

    Oh, on top of being poorly educated, the doctor is an asshole.

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