I try not to be superstitious.
I’ll walk under ladders while shattering a mirror pausing only to let the black cat casually stroll in front of me. No big deal. The full moon doesn’t cause me to freak out on a shift because “oh no here come the crazy people.” Nah, that’s all a bunch of hooey (or Dewey or Louey (Click here, watch to video at time 4:00).
But, you know what terrifies me more than Penniwise the Clown during a shift? Incredibly nice patients.
Most people come into the ER having a bad day. I don’t expect people to be effusing a boisterous chipper attitude. Granted I do that at work, but that’s just how I roll, I never expect this from my patients. But, when I take care of a patients that is truly kind, sincere, and pleasant, I always have a little bit of trepidation because I fear something terrible may be happening.
It may be a selection bias, since more often than not, people in this category rarely come into the ER frivolously. Now I can hear the less experienced of you saying “What? People come into the ER for things less than emergencies?” Let me assure you, yes, yes people do.
I treat people who rush to the ER with complaints of “urine pain for 30 minutes.” Yesterday I saw a patient with “mouth pain for 1.5 years.” My level of surprise for dumb complaints has atrophied, died, been cremated and sprinkled over the Pacific ocean. What’s that? Your 2 year old sneezed and you came in? Sure, let me help you. Oh he sneezed two weeks ago and you happened to be nearby and wanted him examined, you got it. What’s that? You are worried a squirrel gave you rabies? Oh, and I see you managed to capture the animal and bring him in to my ER in a shoe-box. Great. None of this phases me.
But the following patients caused goosebumps and a chill down my spine.
The extremely nice young couple with two kids and the mom who has already “beaten” breast cancer once coming in with nagging shortness breath for three weeks. Terrified.
The gentlest, kindest grandpa in the world accompanied by his cherubic grandkids, laughing and smiling. He just wants to get this darn painless blood in his urine checked out. Uh oh.
Or, more recently, when I cared for the normal, nice, concerned family whose mom started behaving oddly, forgetting things over the last month, and started losing weight, and oh by the way she actually had some blood tinged cough about a month ago that her doctor was working up… now I’m scared. And, unfortunately, I’m usually right to be scared.
I wish the three cases above were made up. I wish any of the three of them ended well. Unfortunately, being and ER physician means giving bad news.
Perhaps that is where the superstition starts. Everyone hates making others sad, and giving bad news to people I identify with hurts more. Invariably the families have an upbeat “just getting it checked out” approach, expecting something benign as the cause for the problem. I then come in and decimate their optimism with the cruel tragic reality of their disease.
Of course I want all my patients to be kind, polite and happy. However, crushing expectations of honest, good people dampens even the best of days.
But, in retrospect, I think that happiness and optimism is contagious. I refuse to be the pessimist. The day I don’t hurt inside after giving terrible news to a nice family is the day I need to start questioning myself.
Till then, stay positive.
Speaking of positivity, I don’t think I can watch this video without smiling, you’re welcome :).
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