Role Reversal

I am beginning to believe empathy is hard to embody unless you have truly experienced a patient’s adventure in the medical system. Nothing compares to the feeling of helplessness, vulnerability and insecurity. On Friday night I spent 10 hours in the local ER. I had delayed going for treatment for hours. I went through the differential in my head. I hypothesized tests and treatments. I couldn’t think of anything unique the ER could do for me. Finally the pain was too substantial and a friend drove me to the hospital.

First lesson: never write “abdominal pain” as your chief complaint. This is too vague and NOT treated as emergent.

I was one of the last patients to be called and that was with connections on the inside. When I finally made it to my corner with a curtain, I could immediately tell my physician was not impressed. I actually suspected the first morphine injection to be a saline injection to test me. It was only after several more doses of morphine and residual pain that the physician began to take me seriously.

Second lesson: when a patient asks for more morphine, seriously consider giving them more morphine. It’s not as strong as you think.

Throughout my ten hours in the ER, the physician NEVER discussed a plan with me. I did not know what he was thinking or what he was testing. I was lying in a cold ER in a thin gown. I was in pain, and I was confused. I can only imagine how my patients must feel.

Third lesson: explain in as much detail as possible your plan of action. Do not draw blood without explaining why. Do not use multiple US probes in various places without explaining yourself. A patient’s body should be treated as a temple. Do not violate that temple without at least addressing them.

After several hours, still writhing in pain, I was wheeled to CT. My technician was kind and comforting. He brought me a warm blanket and explained each step to me. We actually had a decent conversation. The test went by quickly and he brought me back to the ER. After another 4 mg of morphine I finally started to doze. As soon as I fell asleep, my ER physician woke me up abruptly and started telling me his assessment and that I would be sent home. I could hardly follow him, and I actually UNDERSTAND medical terminology. I was trying to keep my eyes wide open and hear what he said. In the end, I heard………possibly early appendicitis….you may need to come back….take these pain pills……could be a colonic spasm……maybe gastroenteritis…..ok bye. He quickly rushed back out of the room. Now, I know he is busy. There were several people in the ER. But I just needed five minutes to understand. I’m still not sure exactly what we accomplished in the ER. I’m glad I went but only because I can’t imagine how much pan I would have been in without 12 mg of morphine.

Final Lesson: Do not rudely awaken patients and give them a two minute summary of their problem. If you do, come back once they’ve had a chance to digest and answer questions. Do not assume they understand even if they are familiar with the medical field.

Although ultimately it was a horrid experience, I am glad that I have a new found appreciation for what my patients will experience themselves. I hope that I will be able to maintain empathy even when I am busy and overwhelmed.