NaBloPoMo - Day 18 - Seriously...?

I haven't watched "Grey's Anatomy" in the longest time, 

but one of the taglines from the show that I remember vividly

was "seriously..?"

It covered everything from boy problems, to work problems, to all general life problems.

Often, when I pick up a chart in the ED, I read the presenting complaint of

(what the patient came into the ED for) and immediately go "seriously?"

Others, I go in and interview the patient then walk out and go... "seriously?"

Still others are given the benefit of the doubt, worked up,

found to have, um, something like meth or cocaine in their system,

to which I say, "Seriously...?"

I really wish I could say it to the patient...

As in,

"Seriously..? You came in concerned that you were having a stroke because

you "couldn't think straight," or couldn't "find the right words,"

and your head and your body hurts and you're not sure why...

Well, let's see... your CT of the head was negative...

your EKG, labs, vitals are all normal...

oh, but let's focus on that drug test:

positive for cocaine

positive for methamphetamines

positive for benzodiazepines

positive for methadone (which you're not prescribed, by the way)

and you wonder why you alternatively:

don't feel right...

have been really tired...

can't seem to focus...

etc...

Seriously...?

People wonder why health care costs are so high...

I think it's in part because of all the patients like this I see on a daily basis...

Today it was like this for three different patients...

All different genders and age ranges...

I can't discount you're not having some physical symptoms which are bothering you,

but if you had initially just been a little honest about your social habits

I probably could have avoided about $5000 worth of a work-up.

Don't do drugs, seriously...

And, especially, don't do uppers which you then take downers for

which leads to more uppers, then downers, then uppers, etc, ad nauseum...

I wish we did have levels instead of just positive/negative for drugs

because I think some patients have perfected the meth/heroin ratio...

However, combining uppers and downers can 

lead to a potentially lethal combination...

Then there's the "what's this on my body...?"

Seriously, you came in for that...?

Day 5 - Suicide is Not Painless

Warning, this post is being written a little tongue in cheek... just a little...

When I got home from work today, I commented to my DH that just once I wish I could get away with writing a post on how to end your life the proper way.   I'd discuss the various options with making sure that every plan met every need and lifestyle.  However, I lamented that someone would probably use one of the ways that I suggested and then the family would find a way to sue me because I had posted the method online.  He answered that there were probably plenty of other websites out there that posted ways, and sadly I know he is right.

Now don't get me wrong, I value life.  In fact, I've made a career out of trying to help extend people's lives.  Also, however, as those who have read my blog for a long time know,  I am a strong proponent of letting people "go to Jesus" when the time is appropriate;  not by their own hand, obviously, but when the body is no longer capable of living a good life.  By the way, is your advance directive written and signed?

But, seriously, sometimes I get so frustrated with the "I'll show/punish/embarrass/one up him/her/my parents/my ex/the jerk down the street by killing myself" dramatics that come into the ED.  Especially the repeat ones with borderline personality issues who can't seem to live their lives (or end them obviously) without a plethora of texts, threats, phone calls with yelling and screaming, coming in with their posse in tow, etc;  all in plain view of whomever is in the vicinity seemingly to announce "Feel sorry for me because I think it's better to end my life than live with these people who don't seem to care about me even though they obviously are just trying to make my life more impossible by being around when I am hysterical like this.  Oh, and by the way, I didn't get my pillow, soda, and blanket like I asked for.  See how horrible my life is...?  I should just kill myself and show you..."

People I've known have committed suicide.  A dear friend died at the hand of someone who killed them and then committed suicide.   I've seen autopsies on suicides during my time in the ME's office, and I know what a knife, rope, bullet, drugs, etc can do to the inside and outside of a person.  In the ED, I've see the devastation of family members who have found their loved ones after the event.  The questions.  The lack of answers.  I understand suicide for health reasons.  I even agree to a certain extent with physician-assisted suicide.

I just don't understand those that play at life and death.  Those that use it to get attention.  Those that use it as a threat to those they love.  It's those people that I want to give instructions to.  However, given their motives, they'd probably still get it wrong.