It’s amazing to me how there are 2 wildly different patient groups: the patients who refuse to go to the hospital, tell you “I don’t like to take pills” when their blood pressure is 200/120 and their sugar is 495…and the other group of patients who come to the clinic after 1 day of a runny nose and ask you for sleeping pills, percocet and a pill “to help me lose weight.” Of course, there is a third group of patients who basically do what needs to be done to stay reasonably healthy, but they’re not as funny to write about. Recently I’ve had a run of people who really should have gone to the ER, but didn’t, including:
- Patient who suddenly started bleeding heavily from the rectum “like I was giving birth through my butt.”
- Patient with COPD who has been waking up choking, bluish and gasping for breath since he got an upper respiratory infection a week ago
- Patient with a chronic heart condition, who has been having episodes that involve collapsing to the ground, unable to move or speak
- Patient who had been discharged from the hospital one day earlier, who apparently passed out and was carried to her bed by family members where she remained unconscious for 12 hours.
I’ve been working on my therapeutic intervention for this situation. How do I get the message across without actually saying to the patient “Look, this is when you’re supposed to call a freakin’ ambulance!” I’ve been asking people, “After this happened, did you or your family think about going to the emergency room?” Usually people say “Yes, but…” with reasons such as the wait time is too long, they didn’t want to be admitted to the hospital, or they didn’t think the issue was a big deal. I then follow up with something like “If this happens again, you really need to get help right away at the hospital.” Note to self, readers: sudden, continuous heavy bleeding from the rectum should be evaluated at a hospital, not in your doctor’s office 2 days later.