Emergency Encounters: Admirable

In this brief and simple encounter, the demeanor with which a woman told me what she needed, and why, made her admirable in my eyes.

She was in the ER for dental pain, a common complaint for those seeking drugs to sell or abuse.  The triage note said, "Needs antibiotics for dental procedure." Well, that was understandable. A lot of people don't have primary doctors and need these antibiotics.  Simple enough.

A woman in her mid-twenties sat up on the stretcher as I walked in the room.  She was attractive and yet looked to have a bit of a hard edge to her.  She had a pleasant smile.  While "confident" overstates her demeanor, she was certainly ready for the encounter.

"So what's going on?" I asked cheerfully.

"I have impacted wisdom teeth that I need to have removed, and my doctor told me I need to get antibiotics before I get it done."

"When is your appointment?" I asked.

"I don't have a dentist.  My teeth started bleeding so I have to get them taken care of."

"I can help you with that.  We have a dental clinic here at the hospital you can go to tomorrow."  She smiled gratefully.  "How did you find out about the problems with you teeth," I asked.

"I just got out of prison," she said.  She was not ashamed, but neither was she she proud or indifferent.  It was simply a fact. "The doctor there told me my wisdom teeth were impacted.  He said I needed to take antibiotics before getting them fixed."

"Why is that?" I asked.

"Because I got endocarditis from my previous IV drug use."  She had that same calm and simple demeanor, without any trace of perturbation or expectation.  She had done these things but she had recovered, repented, and started again.

She was a woman who had been through some very awful things, had come to terms with them, and talked to me about them as if she were telling me any sort of banal, yet necessary, detail of her life.

I very much admire her courage, and will think of her when I have to tell others about bad things in my past.  Even more so when I have to face up to something that needs to be addressed. We are made new in Christ.

Emergency Encounters: What Do You Mean?

I entered the room to evaluate a woman in her late 20s with back pain, but that wasn't really the issue. She told me how she taken Plan B a few weeks back and, based on the large amount of bleeding she had, that it had worked so she didn't think she could be pregnant…

I sat next to her and told her the test was positive. She clearly looked distressed.

"I can't have this baby," she said.

I hesitated before I spoke; maybe it was a moment of prayer. "You know," I said gently, "abortions aren't all they're cracked up to be."

She turned her head sharply towards me and her eyes locked on to mine. "What you mean?" she asked.

I continued in a quiet and calm voice, my eyes still locked with hers. "There can be a lot of guilt, sometimes depression, even substance abuse…" I could barely finish my sentence when she responded.

"I know," she said and turned her eyes away from me. She dropped her head down.

She had had an abortion before and knew exactly what I was talking about. But she was in school, and her mother lived in another country. "I can't have this baby," she said. "But I can't have another abortion."

I gave her the number for local crisis pregnancy center and told her to talk it out with them before she made any decision, that she shouldn't go someplace that sold abortions in order to figure this out.

I still pray for her for so many different things depending on what her decision turned out to be.  I hope she's all right, not just physically, no matter what her decision turned out to be.

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.