I met my patient when he was boarded and collared, on a stretcher in the hallway. He is a hispanic man who was recently in a car accident who arrived with a relatively complicated facial laceration. He speaks a tiny bit of English, I speak a tiny bit of Spanish. He is a nice man, and somehow we manage to create a rapport.
A while later he’s been moved into a room and I arrive back with the suture kit. Now there is a dirt covered, young, white man in the room with him. My patient’s employer introduces himself to me. This man, no older than me, immediately (and with a lack of social graces) wants to know how long this will take. I told him that realistically we have two more hours. But for him, that just wouldn’t do. Well, sir, your friend was in a car accident. We’ve determined he doesn’t have any serious injuries but he has a pretty bad cut in a pretty bad place. We need to do a slit lamp exam to rule out any corneal abrasions and then will need to sew him up. By the looks of that cut the suturing alone could take over an hour.
Yeah but he still doesn’t understand why it will take two hours. Two hours at minimun, I reminded him. “Okay, but see,” (and he lowers his voice) “I’ve got a van outside full of five guys outside,” (he glances over to my patient), “and there’s no AC. Can you ask whoever is in charge if he can speed the process along?”
Um, really? You have a van outside with five men in it with no AC? Are they locked in? Aren’t they adults? Might they step outside for some fresh air? Must be a completely legal and humane operation you’ve got going on. And b.t.w., I am in charge of how long this process will take.
At this point another med student walks into the room, he’s checking to see if I need any more materials. The boss looks at him. Oh hey doc, how long you think it’s going to take you to do this?
As I secure knot number two Mr. Bossman decides to confide in me about how he once sewed up his knee with no anasthetic. Good work, buddy, you must be really tough.
Suture number three I ask my patient if he’s feeling anything. “Feeling any pain? Need some more pain meds?” Mr. Bossman feels the need to translate for me, “Hey buddy, hurt-o?”
Listening to the conversation next door I advanced another suture through my patient’s lower eye-lid. Mr. Bossman, who was hovering over my every move, was apparently eaves-dropping on the same conversation.
… and do you take any medications at home?
AT HOME? YES! OF COURSE I TAKE MEDS AT HOME. AND I LIVE WITH MY STINKIN HUSBAND. TWO OF MY FIVE WORTHLESS KIDS, FIVE GRANDCHILDREN, TWO DOGS, AND ONE CAT. AND A SON-IN-LAW, EFFING JERK.
… okay, I understand. But can you tell me what medications you are on?
YOU THINK THAT’S YOUR BUSINESS? I CAN’T BREATH. WHO ARE YOU? YOU ARE A DOCTOR? YOU ARE FIVE YEARS OLD. I WANT TO GO TO A REAL HOSPITAL AND I WANT TO SEE A REAL DOCTOR.
I have a smile on my face because seriously, how can you not get a kick out of this stuff? By the pattern of her speech I can tell this woman is having no real difficulty breathing and I know the resident in the room next to me is having the same thought process. I am curious to see how this conversation will play out and to see how he will manage to gracefully worm his way out of her room. I sense my patient’s employer looking at me. Apparently he thinks we’re good friends now. “Wow, you must see all kinds of assholes in this place.”
I secure the last knot and don’t bother to make eye contact. “You have no idea.”