RT Cave Rule #2: Modest men feel stupid about coming to the ER, especially when they are perfectly fine, so make them feel like they did the right thing, even if you have to tell a white lie.
A man came into the ER tonight with obvious Atrial Fibrilation. Needless to say I was called to do an EKG on him.
"And, why are you here today?" I ask as I'm typing information into the computer.
"Oh," he said nonchalantly, "I've been feeling kind of funny all day, but I had to work." He smiled as he said the last part.
Dr. Krane came in. She said, "You mean you've been feeling crappy all day and you didn't go to the doctor?"
"Well," the patient smiled, "I took my blood pressure last night and it was normal, but when I woke up this morning it was high. But, you know, I had to work."
Hmm, so work's more important than your life. Talk about having your priorities straight.
I finish the EKG and hand DR. K a copy, who gives it a cursury glance and then looks at the patient. "So can you feel your heart beating fast?" she asked.
"Where do you work?"
"I'm a truck driver." Wow, that makes me feel better.
I do a lot of EKGs, and a lot of them aren't even indicated. Many times, when I tell the patient his EKG is normal, he says, "I knew I should have stayed home, but my wife made me come in."
"Hey, don't be thinking that way," I tell them, "You did the right thing by coming in."
Sure most of these chest pains are indegestion or some other abdominal ailment, but when that EKG shows something is wrong with the heart, especially when it's in its early stages, that man thanks his wife for saving his life, or at least he should.
But when he's had chest pain for two days, and nobody made him come in, and he really is having early signs of The BIG ONE, he'll be making a trip in here anyway, and he will be blue from the nipples up, with a tube in his throat, a bloated stomach from a botched CPR attempt, and a no hope for seeing the next day, let alone the next minute.
This happens more often with men than women, but Lord knows there are some modest women out there too.
So my man today with the AFIB has red eyes and smells of alchohol.
"When was the last time you had a drink," Dr. Krane asked.
"Oh, I had one last Wednesday."
The doctor shook her head. Like, this doesn't happen every day at Shoreline Hospital.