Saturday, April 30, 2005

Nationwide Torture Tour

The offerings were nearly nonexistent. With the last of our patients admitted to Medicine we were able to kick back and enjoy a bit of each other, a bit of the night, some sane conversation. It was a slow night with the ambulances pouring in at a quiet pace. We gathered at the computer station and chomped down some potato chips with Doritos. All that was missing were some pretzels and we would have been in heaven, a king’s feast.

As the pure exhaustion blended with the carbohydrates, we experienced what can only be described as an amphetamine high. A tiny refuge before the alkaline tide would hit. In our delusional state we kicked around ideas as to what we would do had we won the lottery. The group exploded with laughter as I described what would be a nationwide tour where I would stop at each city, call for an ambulance and then, as I arrived at the ER, pretend to be extremely sick while giving absolutely no hint as to the cause of my illness. I would live my life as the ER resident’s worst nightmare, pure emergent tormentor.

These ER docs had a lot of experience dealing with this character and each had their own input on what the conversation would sound like. I took the liberty of writing down a synopsis of that conversation here. Those of you in the health field will probably enjoy this while the others may have a hard time understanding some of the subtle humor. I suggest you give it a try anyways.

It’s 3 a.m. in Wichita, Kansas. The Madman, half drunk, reeking of alcohol and sweat, is brought into the ER on a gurney complaining of pain.

Resident (R): Sir what’s wrong?
Madman (M): I’ve got PAIN, everywhere.
R: where does it hurt the most sir?
M: Everywhere.
R: You need to be more specific.
M: OK, it hurts all over.
R: When did it start?
M: A half hour ago?
R: What does it feel like?
M: Kind of dull, all over my chest and my left arm.
R: Are you having trouble breathing?
M: Yes very much.
R: Are you nauseous? Did you vomit?
M: Yesterday I vomited after I ate that nasty fish.


R: Does the pain stay in your chest?
M: No
R: Where else do you feel it?
M: I feel it traveling down to my stomach right here in the lower left.
R: How long have you had this pain?
M: About a day or so.
R: What does it feel like?
M: It’s like someone’s stabbing me, I guess.
R: Have you been vomiting?
M: About an hour ago I vomited.

(Pause. The Resident, perplexed)

R: On a scale of 1 to 10 how bad is the pain?
M: It’s bad.
R: Yeah, but on a scale of 1 to 10 how bad is it?
M: Really bad.
R: yeah, but on a scale of 1 to 10?


M: It’s bad.


R: Do you have any other medical conditions?
M: yes, I have high blood pressure and some other things.
R: Have you ever had any trouble with your heart?
M: No.
R: Were you ever hospitalized?
M: Yes, once but it was really short.
R: Do you remember for what?
M: No, they didn’t tell me.
R: Where were you hospitalized?
M: In Ecuador.
R: And you don’t remember for what?
M: No.
R: Do you take any medications?
M: About six or seven?
R: What are they?
M: One is white and this small. The other is yellow and round, you know, the yellow and round one. I take them every day.
R: Do you know the name?
M: No, my doctor has all the names, call him.
R: What’s the name of your doctor?
M: Dr. Carmen.
R: Where is she located?
M: In Mexico.


R: Are you from Mexico?
M: No, but that’s where I had the operation?
R: What operation?
M: The one on my heart, after my stay in the CCU.


Well, this goes on forever and it’s a real downhill slide. I think I’ll write one of these every once in a while for fun. Many of you can probably relate and I’m sure you’ve seen worse. Heck, many probably meet this patient every single day. Maybe, just maybe, I already won the lottery and you’ve all been meeting the Madman on his nationwide torture tour.