By the time I hurriedly finished suturing the jagged facial laceration of my young trauma patient, sweat was pouring off of me. It was a complicated repair, certainly, and it was somewhat difficult for me to find a position of comfort. But the room wasn't hot and I wasn't really concerned about the patient in front of me or the quality of my work. I was thinking of the patient I had sent to the CT scanner some 20 minutes prior, and the full waiting room was weighing heavily on me as well.
The fact that I hadn't been called out of the room by a panicked nurse was reassuring, I hoped, but I honestly wasn't sure that my patient would be alive by the time I returned. And yet, without the scan, I had no more interventions to attempt and nobody to call for help. Sometimes it isn't even clear which organ system is causing a patient such horrible distress. I'd already done three EKGs, afraid it might be his heart. They were mildly suspicious, but not diagnostic of anything. I tried to perform an ultrasound, but the patient's rapid breathing, severe pain, and large girth made the study almost worthless, so I aborted the procedure because I honestly thought the patient was either going to die right in front of me or pretty darn quick if I didn't get some answers fast. So with some hesitation and dread, I sent him off to the CT scanner ("where patients go to die").
But I'd already anesthetized the disfigured face of my young trauma patient prior to the arrival of this trainwreck, and I needed to complete the repair before the sensation returned. Having a few minutes to spare, I charged in and did my best despite the rush of adrenaline that made my hands tremble a bit.
As I sprinted back to the shock room, I was pleasantly surprised to see that my other patient had stabilized, and the CT scan ultimately gave me the answers I needed. It appeared that he was going to be OK, at least for the time being.
To the patient with the stubbed toe, all I can say is this: when you see an agitated ER doc running around the department barking orders, soaked with sweat and fully charged with adrenaline, it might not be the best time to express your displeasure regarding your waiting time. Can you not see that I'm doing the best that I can?
But I am truly sorry for yelling at you. Please come back and see us.