Everyone deals with and handles pain from injuries ( and illnesses) differently. While a 5 year old laughs hysterically (WITHOUT medication) while watching 'Madagascar' (as they wait in their hospital bed), a grown man can be dropped to his knee's as he sucks his thumb, throwing a tantrum for more pain med's...
We have those patients who refuse to answer our questions because they "hurt SO bad", but then as soon as we mention a specific *INSERT LOCAL ER HERE* as our destination, become more lively than a drunken NFL crowd. Some "pass out"... these are the one who make us pick them up; lift them & carry them up/downstairs all after having called 9-1-1 on their own; packed an "overnight bag" (since they "ARE going to keep me, I know it") and wander around the house aimlessly, collecting everything but the kitchen sink, that has somehow found it's way on to their "Sick Bus ride check list" (if you ask us to grab your cell phone charger, I beg to differ with your understanding of "Emergency")
Then...THEN...there are those who refuse to let you help/cooperate with you, like a Leprechaun protecting the map to his pot of gold. The kicker? He fights you too...can you imagine fighting a Leprechaun?? That's like beating a Smurf in a cage fight...
In this case however, this is where Iced Grande & I meet our "Catatonic" Complainer...
"On-scene." -spoken with a raised voice from a distance as our Mic is sticking in it's holster again . I hop out as Iced Grande repeats my arrival to *The Voice in the sky* (Ugh...they NEVER hear me!) As we get our gurney out of the rig, "Firefighter Hides-in-bushes" emerges to direct us to some "secret entrance" to the building. *Brushing leaves off shoulder* "Follow me guys...eeehm, you two." Iced Grande looks at me...the how the CR*P are we getting the gurney in there- kind of look. Maybe there's a secret tree branch?
After our off roading jungle adventure, we wind down the hallway wide enough for two people walking side by side to get stuck- shoulder to shoulder. There are 4 Firefighters, 1 Doctor, 3 Nurses, the Spouse...& (drum roll please?!) Our "Catatonic" Complainer. Heavier set, middle aged lady who "suddenly" came down with 10/10 pain after being told she wasn't going to receive any more pain medication as her procedure was complete. THUS- Enter 9-1-1: Stage left.
"So, we got called here for 10/10 Abdominal pain. She was here for a routine appointment & was just fine prior, during & just up until they told her she needed to come back for a follow up & that she wasn't going to be receiving any more pain med's today."-Mumbles the LT on the Engine, as he lackadaisically scribbles words (I won't be able to read) on to his report. "Her husband drove her here, they live in *The Town of far, FAR Away*. He is going to follow you up to *INSERT LOCAL ER HERE* of her choice, since she heard it is a good place to go." (First Red flag...there are 3 "Really good" places IN *The Town of far FAR Away*...hmm. And NO ONE requests where she wants to go usually.)
With our gurney pushed up against the wall & surrounded by enough EMS personnel to make our very own rugby team pile up, she walks out- both legs working perfectly; eyes open; purposeful...sounding like an animal giving birth as she stops every few steps due to the "Right Upper Abdominal pain" that is now being held on the left side *2 Steps forward...stop*, now Right lower *2 Steps Forward...stop*, now Chest...interesting.
She sits down. Arms flailing, she fights "Firefighter Trying-to-help-a-lot" as he attempts to buckle the end of the seat belt clinched in his hand, with the one in mine. "Ma'am, we need to get the belts on you so that we can get you on up to get checked out. I need you to let go so we can buckle you in. *Suddenly retracting arms- death gripping buckles in to chest*. Ma'am? Relax your arms please...". *Continues resisting* "Firefighter Trying-to-help-a-lot" glances up at me. We share the same idea. He grabs her arms & lifts them up- with enough force for her to release momentarily so I can get her locked & loaded.
"Okay. We are going to raise you up now." *Fish out of water, flapping*. "Ma'am...we need you to sit still otherwise you're going to fall off of the gurney." *Fish out of water, flapping increasing*...The only upside to this is that the hall is SO narrow, that if she were to knock over the gurney with her wiggling, it would get wedged in like Austin Powers & his 25 point cart turn...not enough space to do any harm.
"I'm going to meet you guys there." yells a quick to get away- MR. "Catatonic" Complainer; already half way across the parking lot, his back to us. "LT Report-drawing-Artist", is malingering behind us as he is now, probably shading in his Pictionary style explanation of her Chief Complaint. As Iced Grande lifts her in, I grab the one & only ORIGINAL drawing from "LT-Report-drawing-Artist", then climb in back.
*Fish out of water, flapping: NOW with "Moo-ing"*...as the doors close, it now sounds like I am in a field, surrounded by a mob of rabid cows. *Rustling* The "Catatonic" Complainer- head where her belly once was, shoes off & straps tangled-up like a rubber band ball. "OK, I'm going to slide you back up where you need to be on the stretcher so that this strap *releasing from around neck* doesn't strangle you...*Rahh- Mooooooooh...Groan...Rustle...Raaaaaahah!!* (It's like National Geographic back here!)
I grab the blood pressure cuff & explain my intentions. Magically she ceases from every previous movement (& noise) long enough for me to get a pressure & release the pressure release dial. But...as soon as I try to check her belly, the farm has returned...as well as the wriggling like before.
"I need to ask you a few questions & confirm some info with you so I can get you going..." As expected...attempt = fail. Try again...same result. OK. *SMH*
"Let's just go." I tell Iced Grande as I pop my head up front. "So...the 5 F's...what are those factor's for? *Raising voice to be slightly above farm noises in the back* I can't remember..." Slightly Puzzled- Iced Grande replies, "the 5 what?". "You know- Female, Forty, Fair, Fertile & Fat?" (Now before you go getting all "Hey, that's not OK to call someone fat!!" Go find your trusty friend 'Google' & search it- "the 5 F's"...yea...that's right- "Fat"- Medically listed factor. I'm not the jerk who wrote it.) "Can you hand me my phone? I need to look it up. With guessing from the LT's pictograph, it would make sense if this was it...just can't remember what "IT" is." *Handing phone back*
Less than 3 minutes goes by. We're half way there...back roads. "Got it, Gallbladder...THAT's right, I knew it was something." Right as I am starting my second sentence...suddenly it's quiet. All except for the heavy snoring now coming from our once 10/10 pain stricken, bovine sounding peach comfortably napping on my gurney. I grab the BP cuff as I check her pulse...she is breathing (obviously- insert SNORE #4). Airway? Patent. Pulse- mellow; calm; regular. BP? Better than mine. I look up to Iced Grande...he smiles in the rear view mirror & turns down the stereo that was set at "Ear Bleed" volume.
*Lightly shaking shoulder* "Ma'am? I need you to wake up so I can get some information from you. *Shaking shoulder a little harder*. She's out. Only draws shoulder away from my hand, turning head away as well. A motorcycle catches my eye out the back window, cut off by the Mini Van with the teeny tiny driver whom only a forehead peeks above the steering wheel. Follow a little closer please?! Thanks! *Dripping with Sarcasm*
I call *INSERT LOCAL ER HERE* to let them know what we have coming. "Catatonic" Complainer- sleeps. As I continue typing my findings, she raises an eyebrow- slightly cracking left eye; rolls her head juuuuuust enough to see if I'm looking. (Yay for peripheral vision ;-) lol) I look at her, eyes only as I start talking to her. As soon as my first word passes my lips, she darts her head back, squints eyes shut & even fights as I try to lift her lids to assess pupils. Awesome...how old are we? 4?!
*Grabbing Left wrist* I raise her arm straight upward...directly over her nose. Que "Arm drop test"...*Dropping arm from above*...I watch. Nope...didn't hit her in the face...faker. A patient who is truly unconscious/catatonic will not be able to redirect or control the location of where their arm/hand is going to fall. BUT! A patient who consciously doesn't want to hit themselves in the face...CAN.
We make the last turn. Park. "Catatonic" Complainer snores. "Aaaand, show us dropping one off" Iced Grande mutters, again with his Barry Manilow voice (Cracks me up!) "Catatonic" Complainer- still snoring.
The bright fluorescent lights beam down on us as the back doors open. We are the only rig, as well as people in the bay. I'm sitting behind her...*Mini Whistle= SUCCESS!* Iced Grande looks up at me. I turn my head slightly as I make the "Listen" motion before he pulls her out. *Silence- broken by occasional rumbling of her tongue flapping in the back of throat/sinuses*. "Nice, the ambulance ride healed her." He responds back.
I shut the doors as we head towards the entrance. "Hey *Pointing with head*, there's her husband." Iced Grande is speaking under his breath...voices in an empty bay carry like a wishing well. I look back, right as he turns back around to disappear back around the corner. "Maybe he will head in to the waiting room when he gets back."
Inside, we get her ready for transfer. The Nurse wakes her up. Before she even opens her eyes...the Farm has returned in FULL FORCE!
I pass on what I was able to decipher from the earlier gifted pictograph from the "LT- Report-Drawing-Artist".
"Mid 40's, Female, Fair skinned, Obese (There...better than "FAT"??) & Fertile (Child bearing years)...sudden onset of Right upper ABD (Abdominal) pain...changes location every few steps. Onset after refusal of additional pain med's by Primary Doc after routine appointment for eval of HEAD...not belly. Stable; perfectly normal on arrival to appointment; through it & symptoms began moments after the "No More Med's" ban was put in to effect. Self ambulatory. Resisted & fought as we loaded her up. Tangled herself up in the straps; refused to answer questions. Fell asleep en route...SNORED the whole way. Failed the Arm droop test. Vitals- better than mine. Husband followed & was outside but left, so should be here in a few to help register her. Pt live in "The Town of far, FAR Away" but requested here. Looks like based off some of her info, she has been bouncing around other *INSERT LOCAL ER's HERE* for pain pills (Seeker...ugh)"
Iced Grande and I leave the ER, gurney wheeling between us. *Dusting hands off in air* Sweet, I am SO glad to be done with her...someone in "10/10" pain won't fight if they hurt THAT bad...they will let you cut their clothes off in a packed Mall, paint their face, dress them in a polka dot tutu & hang them upside down, if you are trying to help!...Ridiculous."-As I type with fingers of fury to get this call done.
We clear & move on to our next...which is where our "PRECIOUS CARGO" call begins.
Later that night, our "Bird of Prey- Mini version" finds us to inquire about the "Catatonic Complainer"... her husband (yea, the one who was half way to his car, back turned to use before we got to our rig? And the one that wasn't behind us en route or the motorcycle mini van shenanigans closely tailing us en route. OR present when we arrived except for the few brief moments from across the Sick Bus bay...yea. THAT guy) called and complained...
"He said he was behind you guys the WHOLE way. And that you guys were making fun of his wife. And that you refused to take vitals or even talk to her. I doubt that happened (Iced Grande and I NEVER get complaints!) but I need you guys to write it up." UGH...I'm already late getting off. Lame. The more the "Bird of Prey- Mini Version" explains- the husband called 4 HOURS AFTER we dropped her off...AND how would he know any of that type of information unless he was either A- in the Rig with us -OR- B: his oh so painfully distressed "seeking" spouse just confirmed her faker status involuntarily...
"It sounded like they were trying to get out of having to pay for the transport...he was a JERK!" Mini Bird of Prey continues. "Not to mention...why would you wait 4 HOURS to call if your loved one was treated SO poorly??"...Right?!
Long story short...our "Catatonic" Complainer walked herself out of the ER 2 HOURS PRIOR to the phone call from her husband, to the "Bird of Prey- Mini version...Never receiving any medications for pain, NO diagnosis, AND having already been in the system at *INSERT LOCAL ER HERE* MANY times for the same after stating earlier that she had never been a patient.
I'd like to take this opportunity to say "Thank you " Mrs. Catatonic Complainer for abusing the system in place to actually do GOOD for those who need it...and by "IT" I don't mean a "FIX".
We have those patients who refuse to answer our questions because they "hurt SO bad", but then as soon as we mention a specific *INSERT LOCAL ER HERE* as our destination, become more lively than a drunken NFL crowd. Some "pass out"... these are the one who make us pick them up; lift them & carry them up/downstairs all after having called 9-1-1 on their own; packed an "overnight bag" (since they "ARE going to keep me, I know it") and wander around the house aimlessly, collecting everything but the kitchen sink, that has somehow found it's way on to their "Sick Bus ride check list" (if you ask us to grab your cell phone charger, I beg to differ with your understanding of "Emergency")
Then...THEN...there are those who refuse to let you help/cooperate with you, like a Leprechaun protecting the map to his pot of gold. The kicker? He fights you too...can you imagine fighting a Leprechaun?? That's like beating a Smurf in a cage fight...
In this case however, this is where Iced Grande & I meet our "Catatonic" Complainer...
"On-scene." -spoken with a raised voice from a distance as our Mic is sticking in it's holster again . I hop out as Iced Grande repeats my arrival to *The Voice in the sky* (Ugh...they NEVER hear me!) As we get our gurney out of the rig, "Firefighter Hides-in-bushes" emerges to direct us to some "secret entrance" to the building. *Brushing leaves off shoulder* "Follow me guys...eeehm, you two." Iced Grande looks at me...the how the CR*P are we getting the gurney in there- kind of look. Maybe there's a secret tree branch?
After our off roading jungle adventure, we wind down the hallway wide enough for two people walking side by side to get stuck- shoulder to shoulder. There are 4 Firefighters, 1 Doctor, 3 Nurses, the Spouse...& (drum roll please?!) Our "Catatonic" Complainer. Heavier set, middle aged lady who "suddenly" came down with 10/10 pain after being told she wasn't going to receive any more pain medication as her procedure was complete. THUS- Enter 9-1-1: Stage left.
"So, we got called here for 10/10 Abdominal pain. She was here for a routine appointment & was just fine prior, during & just up until they told her she needed to come back for a follow up & that she wasn't going to be receiving any more pain med's today."-Mumbles the LT on the Engine, as he lackadaisically scribbles words (I won't be able to read) on to his report. "Her husband drove her here, they live in *The Town of far, FAR Away*. He is going to follow you up to *INSERT LOCAL ER HERE* of her choice, since she heard it is a good place to go." (First Red flag...there are 3 "Really good" places IN *The Town of far FAR Away*...hmm. And NO ONE requests where she wants to go usually.)
With our gurney pushed up against the wall & surrounded by enough EMS personnel to make our very own rugby team pile up, she walks out- both legs working perfectly; eyes open; purposeful...sounding like an animal giving birth as she stops every few steps due to the "Right Upper Abdominal pain" that is now being held on the left side *2 Steps forward...stop*, now Right lower *2 Steps Forward...stop*, now Chest...interesting.
She sits down. Arms flailing, she fights "Firefighter Trying-to-help-a-lot" as he attempts to buckle the end of the seat belt clinched in his hand, with the one in mine. "Ma'am, we need to get the belts on you so that we can get you on up to get checked out. I need you to let go so we can buckle you in. *Suddenly retracting arms- death gripping buckles in to chest*. Ma'am? Relax your arms please...". *Continues resisting* "Firefighter Trying-to-help-a-lot" glances up at me. We share the same idea. He grabs her arms & lifts them up- with enough force for her to release momentarily so I can get her locked & loaded.
"Okay. We are going to raise you up now." *Fish out of water, flapping*. "Ma'am...we need you to sit still otherwise you're going to fall off of the gurney." *Fish out of water, flapping increasing*...The only upside to this is that the hall is SO narrow, that if she were to knock over the gurney with her wiggling, it would get wedged in like Austin Powers & his 25 point cart turn...not enough space to do any harm.
"I'm going to meet you guys there." yells a quick to get away- MR. "Catatonic" Complainer; already half way across the parking lot, his back to us. "LT Report-drawing-Artist", is malingering behind us as he is now, probably shading in his Pictionary style explanation of her Chief Complaint. As Iced Grande lifts her in, I grab the one & only ORIGINAL drawing from "LT-Report-drawing-Artist", then climb in back.
*Fish out of water, flapping: NOW with "Moo-ing"*...as the doors close, it now sounds like I am in a field, surrounded by a mob of rabid cows. *Rustling* The "Catatonic" Complainer- head where her belly once was, shoes off & straps tangled-up like a rubber band ball. "OK, I'm going to slide you back up where you need to be on the stretcher so that this strap *releasing from around neck* doesn't strangle you...*Rahh- Mooooooooh...Groan...Rustle...Raaaaaahah!!* (It's like National Geographic back here!)
I grab the blood pressure cuff & explain my intentions. Magically she ceases from every previous movement (& noise) long enough for me to get a pressure & release the pressure release dial. But...as soon as I try to check her belly, the farm has returned...as well as the wriggling like before.
"I need to ask you a few questions & confirm some info with you so I can get you going..." As expected...attempt = fail. Try again...same result. OK. *SMH*
"Let's just go." I tell Iced Grande as I pop my head up front. "So...the 5 F's...what are those factor's for? *Raising voice to be slightly above farm noises in the back* I can't remember..." Slightly Puzzled- Iced Grande replies, "the 5 what?". "You know- Female, Forty, Fair, Fertile & Fat?" (Now before you go getting all "Hey, that's not OK to call someone fat!!" Go find your trusty friend 'Google' & search it- "the 5 F's"...yea...that's right- "Fat"- Medically listed factor. I'm not the jerk who wrote it.) "Can you hand me my phone? I need to look it up. With guessing from the LT's pictograph, it would make sense if this was it...just can't remember what "IT" is." *Handing phone back*
Less than 3 minutes goes by. We're half way there...back roads. "Got it, Gallbladder...THAT's right, I knew it was something." Right as I am starting my second sentence...suddenly it's quiet. All except for the heavy snoring now coming from our once 10/10 pain stricken, bovine sounding peach comfortably napping on my gurney. I grab the BP cuff as I check her pulse...she is breathing (obviously- insert SNORE #4). Airway? Patent. Pulse- mellow; calm; regular. BP? Better than mine. I look up to Iced Grande...he smiles in the rear view mirror & turns down the stereo that was set at "Ear Bleed" volume.
*Lightly shaking shoulder* "Ma'am? I need you to wake up so I can get some information from you. *Shaking shoulder a little harder*. She's out. Only draws shoulder away from my hand, turning head away as well. A motorcycle catches my eye out the back window, cut off by the Mini Van with the teeny tiny driver whom only a forehead peeks above the steering wheel. Follow a little closer please?! Thanks! *Dripping with Sarcasm*
I call *INSERT LOCAL ER HERE* to let them know what we have coming. "Catatonic" Complainer- sleeps. As I continue typing my findings, she raises an eyebrow- slightly cracking left eye; rolls her head juuuuuust enough to see if I'm looking. (Yay for peripheral vision ;-) lol) I look at her, eyes only as I start talking to her. As soon as my first word passes my lips, she darts her head back, squints eyes shut & even fights as I try to lift her lids to assess pupils. Awesome...how old are we? 4?!
*Grabbing Left wrist* I raise her arm straight upward...directly over her nose. Que "Arm drop test"...*Dropping arm from above*...I watch. Nope...didn't hit her in the face...faker. A patient who is truly unconscious/catatonic will not be able to redirect or control the location of where their arm/hand is going to fall. BUT! A patient who consciously doesn't want to hit themselves in the face...CAN.
We make the last turn. Park. "Catatonic" Complainer snores. "Aaaand, show us dropping one off" Iced Grande mutters, again with his Barry Manilow voice (Cracks me up!) "Catatonic" Complainer- still snoring.
The bright fluorescent lights beam down on us as the back doors open. We are the only rig, as well as people in the bay. I'm sitting behind her...*Mini Whistle= SUCCESS!* Iced Grande looks up at me. I turn my head slightly as I make the "Listen" motion before he pulls her out. *Silence- broken by occasional rumbling of her tongue flapping in the back of throat/sinuses*. "Nice, the ambulance ride healed her." He responds back.
I shut the doors as we head towards the entrance. "Hey *Pointing with head*, there's her husband." Iced Grande is speaking under his breath...voices in an empty bay carry like a wishing well. I look back, right as he turns back around to disappear back around the corner. "Maybe he will head in to the waiting room when he gets back."
Inside, we get her ready for transfer. The Nurse wakes her up. Before she even opens her eyes...the Farm has returned in FULL FORCE!
I pass on what I was able to decipher from the earlier gifted pictograph from the "LT- Report-Drawing-Artist".
"Mid 40's, Female, Fair skinned, Obese (There...better than "FAT"??) & Fertile (Child bearing years)...sudden onset of Right upper ABD (Abdominal) pain...changes location every few steps. Onset after refusal of additional pain med's by Primary Doc after routine appointment for eval of HEAD...not belly. Stable; perfectly normal on arrival to appointment; through it & symptoms began moments after the "No More Med's" ban was put in to effect. Self ambulatory. Resisted & fought as we loaded her up. Tangled herself up in the straps; refused to answer questions. Fell asleep en route...SNORED the whole way. Failed the Arm droop test. Vitals- better than mine. Husband followed & was outside but left, so should be here in a few to help register her. Pt live in "The Town of far, FAR Away" but requested here. Looks like based off some of her info, she has been bouncing around other *INSERT LOCAL ER's HERE* for pain pills (Seeker...ugh)"
Iced Grande and I leave the ER, gurney wheeling between us. *Dusting hands off in air* Sweet, I am SO glad to be done with her...someone in "10/10" pain won't fight if they hurt THAT bad...they will let you cut their clothes off in a packed Mall, paint their face, dress them in a polka dot tutu & hang them upside down, if you are trying to help!...Ridiculous."-As I type with fingers of fury to get this call done.
We clear & move on to our next...which is where our "PRECIOUS CARGO" call begins.
Later that night, our "Bird of Prey- Mini version" finds us to inquire about the "Catatonic Complainer"... her husband (yea, the one who was half way to his car, back turned to use before we got to our rig? And the one that wasn't behind us en route or the motorcycle mini van shenanigans closely tailing us en route. OR present when we arrived except for the few brief moments from across the Sick Bus bay...yea. THAT guy) called and complained...
"He said he was behind you guys the WHOLE way. And that you guys were making fun of his wife. And that you refused to take vitals or even talk to her. I doubt that happened (Iced Grande and I NEVER get complaints!) but I need you guys to write it up." UGH...I'm already late getting off. Lame. The more the "Bird of Prey- Mini Version" explains- the husband called 4 HOURS AFTER we dropped her off...AND how would he know any of that type of information unless he was either A- in the Rig with us -OR- B: his oh so painfully distressed "seeking" spouse just confirmed her faker status involuntarily...
"It sounded like they were trying to get out of having to pay for the transport...he was a JERK!" Mini Bird of Prey continues. "Not to mention...why would you wait 4 HOURS to call if your loved one was treated SO poorly??"...Right?!
Long story short...our "Catatonic" Complainer walked herself out of the ER 2 HOURS PRIOR to the phone call from her husband, to the "Bird of Prey- Mini version...Never receiving any medications for pain, NO diagnosis, AND having already been in the system at *INSERT LOCAL ER HERE* MANY times for the same after stating earlier that she had never been a patient.
I'd like to take this opportunity to say "Thank you " Mrs. Catatonic Complainer for abusing the system in place to actually do GOOD for those who need it...and by "IT" I don't mean a "FIX".
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