Working in the ED has made me painfully aware of just how many people there are in the world. I mean, if this many people in a relatively small city are presenting to the ER with "emergencies," and that’s just a small percentage of the population, then, folks, the world is huge. And I say that with nothing but love, of course. I genuinely care about all my patients. But let me tell you, it’s usually the triage notes that give you a quick, if unintentionally humorous, eye-rollable snapshot of the situation's non-emergency. Big shoutout to the triage nurses who write those, because sometimes, you can’t help but chuckle. Like this one I saw not too long ago:
Chief complaint: 21 y.o. male presents with chest pain for one hour. No shortness of breath. History of anxiety.
You don’t need a medical degree to read between the lines here. We see a surprising amount of young 20-somethings complaining of chest pain. I remember this one young man who came in saying, casually might I add, “So... uh I had a heart attack in the car,” and by "heart attack," he meant a sharp pain in his chest that lasted for, oh, 1-2 seconds. And fun fact: this wasn't his first "heart attack." It was a recurring theme throughout his life when he was anxious, though he could not remember the last time it had happened. And just to add some spice to the story, he was on his way to a court date. Hmm... coincidence? I think not.
Needless to say, it wasn’t a heart attack. But hey, chest pain is serious business, and in the ED, you can't not take it seriously. So we went through all the usual steps, following the protocol, because, well, there are certain liability and clerical requirements for anyone that comes in with the chief complaint of "chest pain." He was discharged AMA (against medical advice) as he chose to not have the serious testing done. Big surprise.
But here's the thing: The attending doc, despite grumbling about the sheer number of low-risk chest pains we get, treated this guy with the same level of care as if he were having a heart attack. Not a shred of judgment, just straight-up professionalism. And if he was trying to speak with a hint of sarcasm for my sake, I couldn't detect it. And that, my friends, is one of the most valuable lessons I’ve learned in the ED. Every patient deserves that respect. Even when your gut's screaming, "It’s anxiety, bro," you still smile and say, “Let’s rule out that heart attack just to be sure.” I learned a similar lesson a few years ago during my EMT training, but sometimes it takes another reminder to freshen up that super-power I like to call perspective.
That brings me to a different, but equally interesting, phenomenon I’ve noticed in the ER: the patients' companions. And no, I’m not talking about the incredibly patient ones who come in, looking exhausted but unflinching, as they comfort their dramatic hypochondriac loved ones. I'm talking about the “that’s definitely not an emergency” patients. You know, the ones who present with every ailment in the book and somehow get discharged with nothing but a “check in with your PCP” and a mild eye roll from the attending? But their partners? Pure saints. Those companions endure it all: every question, every “what if,” and still look at their loved ones with total empathy. I’ve seen it a few times, and I’m not ashamed to admit it: I’ve almost teared up. It's just that beautiful.
But today, today I want to focus on the complete opposite of that: the patients who come in with the most unbothered companions. The ones who couldn’t care less about what’s happening, and I’ll be honest, sometimes it’s downright perplexing.
Take yesterday, for example. I was working in the section of the ED where we get patients who probably could’ve gone to an urgent care or maybe just stayed home. A couple walked in, woman looking genuinely uncomfortable, her male companion (Boyfriend? Husband? Friend? Who knows?) sitting there, eyes locked on his phone. Not a glance up. Not a flicker of concern. He didn’t even bother to acknowledge the provider or me when we entered the room. Sure, it was the non-acute aide of the ED but still, you-re in the Emergency Room.
I see this ALL. THE. TIME. And it’s a weird thing to witness.
The real winner was a mother who brought her 4-year-old son in with a high fever and abdominal pain. Now, I feel the need to explain this because clearly it isn't common knowledge, but a four-year-old isn’t exactly the best at answering questions, especially when they're in the hospital with a bunch of strangers poking and prodding. This is when the parents need to step up to the plate and give us the info. But no, this woman was so engrossed in her phone that she barely looked up to answer our questions. I’m talking full-on Instagram Reels, scrolling away while her child is feverish and in pain. At one point, after the resident asked a question, she’d scroll for a bit, then slowly look up, answer, and go right back to it.
Ma’am, we're just trying to figure out what’s going on with your son, can we at least pretend to care here?
These cases make me reflect, a lot. All cases do, of course, but some stand out more than others. They’re the ones that make me question human nature, empathy, and, of course, why on earth anyone would choose to scroll on their phone while their loved one is in distress. But that’s the beauty of the ER. It’s a constant reminder of life’s unpredictability and the strange dynamics between people.
Final thoughts:
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The ER is a place full of drama, both medical and emotional.
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People’s reactions to stress and emergencies can vary drastically.
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And at the end of the day, everyone’s just doing their best, even if that means scrolling through Instagram while their kid's on the exam table.
And, well, that’s why I started this blog. Because sometimes, actually, at all times, I need to get these thoughts out of my head. My boyfriend’s been a great sport about it, but even he’s starting to look at me like I’m in need of a ‘talking break.’ So, this is my break to him. Thanks for listening, folks.
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