8.19.2009

a farewell letter

dear moron patient,

do you too have fluff between your ears like the puppets of Avenue Q? you leave me with no choice but to assume so.

goodness, where should i start? shall we go into detail about that time you came with a week's history of lower back pain that was getting so bad you couldn't get out of bed? you know, it might have helped if you had taken some sort of pain relief at some point during the week. the walking thing might have been less painful. it would've also saved you about three hundred bucks to call the ambulance to bring you in.. well, the taxpayers i guess. and it also would've saved you a two hour wait to be given some paracetamol and ibuprofen before getting sent home.

what about the time you giggled your way into the department with your boy in tow to tell us that your netherbits were accidentally chomped on and you're now left with one nub less?

or that other time where you've had a few weeks worth of anal pain. shush, don't tell me, i don't want to know. that's what your gp is for. to treat your damn hemarrhoids. or wikipedia. good on you for braving the crowded waiting room for the past five hours. there was a reason why you were triaged as a category 4.

i guess this next one wasn't really your fault. you just picked a crappy gp to trust. why else would your gp send you to the emergency department at a bit past eight on a sunday night so you could get an xray of a wooden splinter in your finger just to see how deep it is. that being said, why did you listen to him instead of pulling the splinter out with tweezers like we eventually did, 4 hours later?

you should be ashamed of yourself - what kind of parent notices that the backing of the earring on your two year old daughter is starting to disappear but waits three more weeks until it completely disappears before thinking it might be time to remove that offending earring? your daughter is now going to be literally scarred for life. look at those dressings on her ear covering where we had to gouge out that earring backing!

and please, try to hang onto those memories tighter. the next time another doctor asks you if you've seen anyone for your cough of two weeks, do not look blankly at her and say no when you have just been to the same emergency department less than 24 hours ago for the exact same complaint. bloody liar. and when accosted with this information, please have the decency to admit that you're just an idiot forgetful instead of insisting that no doctor saw you that first time. and when further reminded that you were indeed seen and discharged by a doctor, learn when it's time to give up instead of complaining that you weren't sure who saw you but whoever it was only spoke to you from the end of the bed. you. bloody. fool. i'm sorry you had to find out that you were deaf this way. after all, i greeted you the same way i greeted all other patients. "hi my name is amy. i'm one of the doctors and i will be looking after you today." everytime i say it, i feel like a masseuse or an airline hostess but i put up with it for your sake. so don't you dare tell me you don't know who the hell saw you. i had to fumble through the folds of fat to reach your tummy and i had to listen hard to hear your distant heart sounds. i sat next to you to take your history and found you the cordless phone so you could call your husband to pick you up. don't you dare tell me that whoever it was that saw you spoke to you from the end of the bed.

ohhh, it's only been a short six or seven weeks since i've been here this year but oh, you have opened my eyes so. i didn't think they could've gotten any bigger but you proved me wrong.

if i had things my way (and i assure you that many of my colleagues would agree, for this was one of their wishes i've usurped), there would be a sign that covered all those huge shiny ones with the big red cross on it pointing you towards the emergency department. this new sign would boldly command you to keep on driving past, do not stop, do not pass go unless you fulfilled these next criteria - that you must have a saturation of 60% or less on room air, acopic at your nursing home, have an ejection fraction of 5% or less and still continue to smoke, unable to walk into ED, be an octogenarian or older and/or be bipap dependent. only then, are you allowed to step foot into the emergency department, let alone the rest of the hospital.

luckily for you, i have yet to receive news of any job promotion granting me such power to change presentation criteria. in the meantime, i wish you all the best in your endeavors and try not to win any darwin awards.

sincerely,
your caring doctor

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