Emergency Encounters

These days most large emergency departments have two "sides" to them: the main and the walk-in.  The main side is what we typically think of as an emergency department with the critically sick or injured patients and the dramatic interventions. Some shifts really are like that, though not many, thankfully.  Just about every shift is quite busy doing long work-ups on a lot of pretty sick patients.  I spent sixteen years working on the main side of an emergency department.

Now I work for a hospital in which physician assistants work exclusively on the walk-in side.  This side is usually given some kind of catchy name like Prompt Care, Express Care, or MedExpress to give patients the impression that they will be seen and treated quickly. Well, it is quicker than the main side, usually. In a department with an utterly unpredictable patient load, we not only get backed up, we get some pretty sick patients on occasion, too.

I work in an urban area with a lot of poverty and increasing violence. For the most part, I meet my patients for the first and the last time during our encounter.  I care for many women with procreative health problems. Almost every shift I care for one or more women with sexually transmitted diseases. Sometimes I am informing them about a crisis pregnancy or a miscarriage.  The most difficult encounters are those for which I oversee the administration of methotrexate, a toxic chemotherapy drug, to terminate early ectopic pregnancies.

Many women have had abortions.  Any small amount of prompting leads them to tell their stories of sadness and regret.  They pour out their hearts to me not just because they trust me, but because they need to tell their stories to someone who cares about them and for them.  They are Christ to me, and I pray I may reflect Christ's great love for them.  I will share these anonymous stories on occasion.