Lights and Sirens and Pimples (7/2015)


I absolutely love our EMTs and paramedics. They often go underappreciated for all of their hard work. They are also some of the few people with stories that rival ours in the ED. I recently asked several EMTs and paramedics about the most ridiculous reasons patients took an ambulance.

Here are the top five:

5.  “I drank too much so I had to go to the ER, but now that I’m here, can I go?”

4.  “My gums started bleeding after I flossed them so I thought I should come in.”

3.  “I heard the ER was renovated and I wanted to see it, but I didn’t have a ride so I told EMS something else. I forget what.”

2.  “I was eating a steak; then I bit my cheek hard. It’s not bleeding, but it really stung so I called the ambulance.”

1.  “I popped a pimple, and it hurts.”

never condone violence, but perhaps in rare circumstances like these EMS should be allowed to lovingly and therapeutically whack people on the back of their heads.

Before I became a physician, I believed anyone inside an ambulance was desperately grasping at life, seconds from the great checkout. I imagined paramedics furiously starting IV lines and doing CPR. The patient, if lucky, might survive long enough to make it to the ED.

Ah, young me, how deliciously naïve.

Let me recap a few patients who have graced my ED via ambulance lately. Because of HIPAA, I will not use names, instead I’ll be using obscure cheeses.

Mr. Gorgonzola receives the award for frequent flyer miles. Seriously, if there were an ambulance/ED punch card, he would be able to trade in his points for his own personal MRI machine. Mr. Gorgonzola looks like a hunched-over hairy grouch, sort of like a hybrid of a chinchilla and Gollum from The Lord of the Rings. He comes in every other day for anxiety, chest pain, or boredom. His vitals are always normal, and he knows most of the staff at a glance. He is seen and discharged over and over and over again. We have tried multiple counselors and case workers and interventions to help. I think he just loves being in an ambulance. I swear I can hear him outside whispering, “My precious.”

Mrs. Brie came in with a chief complaint of “runny nose and cough.” No fever. No productive sputum. No pain. No shortness of breath. She pretty much called it a cold. What upgraded this experience from irritating to thorn-in-my-cornea irksome was she had been seen earlier the same day. Mrs. Brie was prescribed medication to relieve her symptoms, which she did not try. She came back to the ED seven hours later not worse but also not better.

One of the most frustrating encounters was a young guy with a sore throat. Don’t get me wrong; some sore throats require an ambulance for evaluation. Mr. Muffato’s did not. I’m not convinced he actually had a sore throat nor the intellect to outwit a banana.

What he did have was a very entitled attitude. He came in via ambulance (of course), and it took more than 25 minutes before he was seen. I was literally intubating a patient, which the patient saw during his ride past the room. Nurses explained that his physician was in a room with a patient who was actively dying. This did not matter, obviously. He came in via ambulance so he believed he should have been seen immediately.

Mr. Muffato later became irate that I did not treat his sore throat with Dilaudid (the only thing that helps!). Then he became enraged when I told him I was not prescribing Norco for his alleged sore throat. Then I showed him his pharmacy report, which showed which narcotics he had received from multiple pharmacies across the entire state. Mr. Muffato amazingly recovered and left.

I can only assume he went home and smeared his face with olive oil. Why? So he could get a few pimples and come in again … by ambulance, of course.

ambulance