(no subject)

[rivka]

Simple ways to make the ER experience more pleasant and tolerable:

1. Wear an ID proclaiming that you are an employee of the medical school.

2. To the ER doctor only (for God's sake, never to a nurse or clerk), reply "Actually, it's Dr. Wald."

3. Carry a comforting bag of frozen soybeans wrapped in an old T-shirt.

And, most importantly:

4. Turn out to not actually have broken your thumb.


That's the story, in a nutshell, of what I did from 11pm to 1am. (I'm amazed that I got out of a big-city ER in two hours! They have a fantastic step-down system of separately staffed "urgent care" (me), emergency room, and shock/trauma.)

We were packing to go out of town this weekend. I decided I wanted to empty and re-use a big canvas bag we had stowed in one of our non-working fireplaces. The bag jammed in place, and when I gave a ferocious tug, my hand flew up and smashed, hard, into the brick surround of the fireplace.

For several minutes, all I could do was pace up and down frantically waving my hand in the air. (Pain gate theory! The same neurons carry the sensation of movement and the sensation of pain, so it's helpful to give them something to do other than hurt.) I noticed that the pain was accompanied by numbness, and, after a little while, quite a bit of swelling. When it didn't get better after about ten minutes on an ice pack, I headed off to the ER. My finger continued to feel a strange mix of numbness and pain.

My employee status didn't jump me over the line, or anything, but it was nice to be treated like a co-worker rather than a random member of the public who was stupid enough to suffer an idiotic injury. The triage nurse, especially, was friendly and collegial. We traded broken finger stories from our pasts. She walked me over to the urgent care section, where she explained that I would be seen more quickly. There, I saw a resident for a few seconds and an attending for a bit longer. They ordered X-rays.

By the time I got through X-ray, I was beginning to suspect that my thumb wasn't broken. The numbness hadn't been replaced by blinding pain, and the constant icing had brought much of the swelling down. So I wasn't too surprised when the resident popped back in and said, "Just a big bruise!" I was embarrassed, but he assured me that, given that I couldn't see through my skin myself, I was justified in a trip to the ER.

This morning my thumb is still really, really sore. And bruised. But I can bend it, and I can do basic, elementary things like putting on my clothes. I feel very grateful.

Comments

[janetmiles.livejournal.com]

Ow. Ow ow ow.

I'm glad your thumb isn't broken. I'm glad that the ER visit went smoothly.

[therealjae.livejournal.com]

I'm so glad it's not broken! That would have been inconvenient, to say the least

I am also going to bookmark this post to link to the next time some conservative starts bitching that *our* big-city ERs would magically turn into no-waiting-zones if we started allowing two-tiered medicine...

-J

[rivka.livejournal.com]

I am also going to bookmark this post to link to the next time some conservative starts bitching that *our* big-city ERs would magically turn into no-waiting-zones if we started allowing two-tiered medicine...

They... they... they think WHAAAA?

Um. Yeah. In the U.S., anyone who walks into an urban ER under their own power pretty much expects to wait all night. I've always assumed that waits would be shorter if we had national health care, because there wouldn't be so many uninsured people using the ER as a primary care clinic.

[geminigirl]

And you've pretty well nailed the reason that I was so furious that the triage nurse at the ob/gyn's office told me to go to the ER last Friday for menstrual cramps. No. There's a reason I called the office during normal business hours, and using an ER for that kind of care would be inexcuseable to me, and to anyone with any sense of what "emergency" means.

[thette.livejournal.com]

Unfortunately, people with no sense of real emergencies come in here, too. It's enough to keep us amused, and a bit peeved.

But the division between emergencies/trauma and urgent care is a good one. ("Akuten" and "närakuten" in Swedish.) Keeps most of the unnecessary workload off the real emergency rooms.

[minnaleigh.livejournal.com]

So glad the ER visit went so smoothly and that all your bones are intact! Have a great weekend!

[filkerdave.livejournal.com]

Owies! I'm glad you ate'n't broke

[wcg.livejournal.com]

Yeowch! I'm glad you're OK. I imagine it still hurts like all get-out.

[rivka.livejournal.com]

Yep. I was actually surprised by the number of times I was offered pain medication in the ER - either for use while I was there, or to take home with me. I think that's another thing my employee ID (and appearance of middle-classness) did for me, because I can't imagine that they push painkillers as a general rule.

[johnpalmer.livejournal.com]

Actually, when I went in with a much-more-minor-than-I-thought cut, I was asked about pain several times, too. (I'm a bit embarrassed to remember how small it was, but how much bigger it seemed when I was having a hard time getting the bleeding controlled since it was on my right pinkie.)

Now, Chris, with her constant pain issues, had more problems getting pain meds... they had to be able to get in touch with her pain doc or her primary care doc, or they wouldn't give her anything. But they still asked, frequently, for her to rate her pain.

[vito-excalibur.livejournal.com]

Pain gate theory! I had never heard of this, but I remember when I was a kid on the occasions when I fell or cut myself or got really hurt in some way I would get up and go running around the house a few times before I would go in and get the wound washed. Which no one, least of all myself, could understand, because I hated running.

[rivka.livejournal.com]

It's also why it helps to rub your elbow when you've banged it against something, and why people who are rough-housing happily can sustain bruises and not even notice until later.

[tavella.livejournal.com]

I went oh! at that too, because now I know why when I bang my hand or head or whatever, I stomp around going ow! and shaking the afflicted part.

[kightp.livejournal.com]

Ouch! So glad it wasn't broken, but what a way to spend the night before going on a trip!

[edschweppe.livejournal.com]

I was embarrassed, but he assured me that, given that I couldn't see through my skin myself, I was justified in a trip to the ER.

Absolutely justified. One of the things we learned when I took the EMT certification course (many moons ago) was that you cannot diagnose a non-broken bone without X-rays or other imaging. Since DOT-standard ambulances don't come with portable X-ray machines, the EMT standard-of-care for an injury that could be a broken bone is to assume that it is a broken bone (e.g., immobilize and transport).

I'm glad to hear that the injury, though painful, wasn't a break. I do have one potentially silly question, though:
To the ER doctor only (for God's sake, never to a nurse or clerk), reply "Actually, it's Dr. Wald."
Why "never to a nurse or clerk"?

[jerusha.livejournal.com]

Rivka may have her own reasons for this, but my reason for doing so would be that saying it to the doctor says, "I am your colleague, and we can meet and discuss this on a professional level that would not be accessible if I were not." Saying it to the nurse or clerk might seem like an attempt to say, "I am a Very Special Person, and you must not treat me like an ordinary person."

[rivka.livejournal.com]

Jerusha has it. Saying it to a doctor means, "Treat me as an equal." Saying it to a nurse or clerk means, "Treat me as a superior."

Of course, answering a question about "where do you work on campus" with "I'm a psychologist at the ___" is a different matter entirely. I have no problem saying that to a nurse or clerk. Correcting "Miss" to "Doctor" is establishing rank - merely mentioning my profession in conversation is not.

[jerusha.livejournal.com]

I may have had it, but you could actually articulate it rather than writing a novella about it.

[rickvs.livejournal.com]

> Saying it to a doctor means, "Treat me as an equal."
> Saying it to a nurse or clerk means, "Treat me as a superior."

When one is occasionally a patient at a psych hospital, it is also a useful phrase intended to mean, "Stop treating me like a four-year-old."

:/

[jerusha.livejournal.com]

I've also found it useful, in that and similar situations, to establish that when I use professional vocabulary to discuss the problem, it's because I have reason to know and use it, not that I have a) picked up a handful of buzzwords from direct-to-consumer advertising (ptah! Don't get me started!) or b) taught myself about a condition in order to "play sick".

[mjlayman.livejournal.com]

Probably not as many moons ago as I broke my ankle (1983) because the EMTs said "are you sure you can't stand?" The ankle was so painful I asked a janitor for a blanket and when he started to put it around me, I took it and put it under my ankle to support the bones more or less in the right order because that hurt less. Nobody believed it was broken until the X-ray tech asked me to turn over on the table and most of me did but my foot didn't. I had nine breaks in three inches and they did surgery all night.

[jerusha.livejournal.com]

Glad it wasn't broken, and that the ER didn't take all night.

And Amen! to what you said about the ER being busy because of the people needing to use it instead of primary care. Which works in two ways, IME: 1) people with primary-care level problems, but who don't otherwise have access to care, coming to the ER because they can't be turned away, and 2) people with problems that were once primary-care level, but weren't treated then, and which have now become genuine emergencies.

[mjlayman.livejournal.com]

Great that it wasn't broken! I hope it feels better soon!

[ex-serenejo.livejournal.com]

Ouch! I'm glad it wasn't broken.