I woke up in a surprisingly somber mood this morning, and I think that a lot of it was due to yesterday's unsuccessful delivery. That stuck with me a lot more than I thought it would. However, I talked with the doctor that went with her to Tuba City, and everything turned out fine. The biggest concern, of course, was that she would deliver in the ambulance. But, thankfully, that didn't happen. She actually delivered vaginally when they arrived, which was a big surprise to everyone involved. The one hour ambulance drive either relaxed the mother-to-be (or jarred the baby) enough to shift everything into place.
My first patient of the day was a nice old lady who came in to the ER with swollen legs. I was convinced that it was a pulmonary embolism, a deep vein clot, or something equally serious. Then my attending physician came in, looked her over, and told me that this was a nice old lady with swollen legs. Motrin should do the trick. Apparently, not everyone who comes into the emergency room is suffering from an actual emergency. Who knew?
The next patient was a woman who stubbed her toe. ER. Stubbed toe. I was sure that this was someone looking for some free narcotics. I was way wrong. Here's how our conversation went.
Me: "Hi, how are you doing?"
Her: "Well, my toe is killing me."
Me: "I'm very sorry to hear that. There's not much that we can do for a broken toe, though. Would you like something for the pain?" (Knowing full well what the answer would be.)
Her: "Not really" (Huh?) "Could you just remove the toenail?" (Double huh?!) "Oh, and I have to be back at work by 4" (Where's the hidden camera?)
I did not see that one coming. However, both sides of the woman's toenail were so ingrown that they nearly formed a circle as they wrapped around. The upward pressure from the bruise under the nail must have been excruciating. So I told my attending, and we got the toenail kit.
The toenail kit was essentially a small spatula and a pair of pliers. The spatula went between the toe and the nail, and the pliers did exactly what pliers do. I nearly passed out.
The afternoon was spent giving school sports physicals to teenagers. I had to ask a kid to turn his head and cough today, and believe me, it is no less awkward being on the other end.
Let's see what tomorrow's got in store.
-M
