Monday, March 7, 2011

Tales from Intern Year: 22 Short Films about the ER

2000: I arrive at the hospital, bright eyed and bushy tailed.

2005: I realize I forgot my stethescope at home. Fuck!

2012: I arrive at the hospital again, somewhat less bright eyed but equally bushy tailed.

2020: I pick up my first patient, a woman going through alcohol withdrawal.
Woman: "I'm going to have a seizure."
Me: (checks her pulse, which is 65) "No, you're not."
Woman: "I really am."
Me: "I don't think so."
Woman: "I definitely am."
Me: "OK fine, here's 1mg of ativan."
Woman: [falls asleep]

2200: I see a guy who cut his leg open with a bandsaw. After cleaning it off, the wound is judged to be "too deep" for me to be allowed to suture it by myself. Lame. At least I got to cause him lots of pain by injecting inside the wound with lidocaine.

2230: I'm discussing my shifts with the PA on duty. When I tell him that I have to do five 11-hour overnight shifts in a row, he says, "Wow, that really sucks!"
And I think to myself, "Hey, yeah... that DOES really suck."
I spend the next half hour wallowing in self-pity.

2300: Suicide attempt. 16 year old bipolar girl swallowed 50 Tylenol... not to kill herself, mind you, but just to "get sick or go into a coma". I spent a while talking to her. That poor girl was a mess.
Attending: "Is there a diagnosis code for bad fashion sense?"

2345: Most uninteresting patient ever. Guy who can't pee has foley catheter placed. Tries to take shower and foley falls out. Patient comes to ED. I write order that says: "Put in foley catheter." Learning value: 0.

0030: Baby with fever. There is nothing I hate more or suck at worse than looking in little screaming baby ears.

0130: Guy from prison with vomitting and diarrhea after eating some burritos. Apparently there were two other prisoners in the back of the ED who ate the same burritos. It's a prison diarrhea outbreak.
Prisoner: "Can I have some orange juice?"
Me: "You want orange juice? But I thought you're nauseated and you can't stop vomiting?"
Prisoner: "Yeah, but isn't orange juice, like, medicinal?"

0200:I discover that the box of free candy I've been taking candy from the last few days actually has a sign that says "$1 each".

0300: Woman who just had abdominal surgery presents to ER with abdominal pain. She didn't take any of the painkillers that they gave her after the surgery. Maybe I was misinformed, but I heard having your belly cut open kind of hurts. (I'm being a little overly sarcastic, but I later found out that the symptoms the woman had were exactly what the surgeon told her to expect.)

0330: Woohoo for testicular pain, especially when associated with lots of psych comorbities and no health insurance.

0400: Girl who accidentally poisoned herself when she locked herself in the windowless bathroom and tried to clean with a new mold remover product. What did she think was killing the mold? Sugar water? (OK, I've done it too.)

0430: I take a half hour break, where I hide in the family conference room, drink a glass of water, and eat three marshmallow cookies. I feel guilty for it.

0500: Woman with severe migraine who looks like she's in a hell of a lot less pain than I'm in right now.

0530: At this point, I realize that although I feel really dizzy and tired, if I pass out and fall to the floor, they'll have to scan my head and I'll never get out of this fucking emergency room.

0535: Another screaming baby with fever.

0600: 16 day old baby boy who has little boobies.
Me: "I wouldn't worry about it. It's very common for newborn babies to get a little bit of breast enlargement due to the mother's hormones during pregnancy."
Father: "Are you a pediatrician?"
Me: "Uh... no..."
Father: "Well, we want to get a real professional opinion."
[I bring in attending.]
Attending: "I wouldn't worry about it. It's very common for newborn babies to get a little bit of breast enlargement due to the mother's hormones during pregnancy."
Father: "Oh, thank you, Doctor."

0630: Hypertensive guy who woke up with arm numb, now resolved. Differential: transient ischemic attack vs. arm fell asleep.

0700: "Well, the sun is up. I guess you can go home."


  1. Boxes of candy ARE free when you are on 5 overnights in a row, despite what any signs may say.

  2. You actually got to go home after 11 hours? Hon, you don't know how good you had it!

  3. Marshmallow cookies? Sounds wonderful...what are they called?? Do tell

  4. "0500: Woman with severe migraine who looks like she's in a hell of a lot less pain than I'm in right now."

    I blew coffee out my nose when I read this snippet. The whole post is like a cartoon in word format. Love it.

  5. I feel your pain. Really I do. Especially with the little kid ones. It's one of the reasons I try to avoid going over to the peeds side of the ER when I can help it.

  6. i empathise with u totally... and reading it makes me remember all the torture iam going thru but in a good mood!

  7. nice post!! I spent last Thursday afternoon looking in screaming infant ears. I was viewing tympanic membrane roughly 0.00000002% of that time (about 1.3 seconds total for 5 sets of ears).

    I do NOT want to do peeds.

  8. i laughed so hard my stomach hurts! can i get some orange juice?

  9. I am done with day 1 of 7 12 hour overnights straight. I have to be back there in 2 hours and 45 minutes...not that I'm counting, obviously. Not fun.

  10. OMDG: 11 hours was longer than anyone else's shift! The attendings, the EM residents, and med students all did 8-9 hour shifts.

    Mal: It was too long ago and I don't remember what they were called, but they were gross.

    fortytwo: By the end of my ER rotation, I used to dread those shifts with every fiber of my being.

  11. Why is it always the 16 do with no problems come in at 6 in the morning? I just don't get it.

  12. This was fantastic, but for some stupid reason I thought these were years until I got to 0030. I was quite confused why you'd still not "be allowed to suture it by myself" after 200 years of practice.

  13. I love the 6am visit for neonatal gynaecomastia.

  14. I was considering emergency medicine until I realized that it was just medicine, sped up, light on the rapport, with a healthy dose of "how can you consider that an emergency!".
    That being said, I did enjoy the minority of cases where I could actually help someone.

  15. 2300: 50 Tylenol - doesn't 100 or so pretty much fry your liver? Did she have any damage with 50 tabs?
    "Is there a diagnosis code for bad fashion sense?"
    hmm - maybe got dressed during 30,44,45,48,65 or if all else fails you could probably use 470 . . .

    0400: Is mold remover as bad as mixing ammonia and chlorine cleaners?