Life Lessons-Assumptions

Life Lessons-Assumptions

I have a life lesson to share with you, a personal “Ah F^*k!” moment. The type of moment that your professional treatment of others, in a good way. You see I started my medical career in Emergency Medical Services as an EMT (Emergency Medical Technician) returning to school two more times advancing to the Paramedic level. I thought it was a natural transition after graduating from another 4 years of schooling as a Physician Assistant to work in Emergency Medicine. It was a tough time to be a provider in the ER as it was full on opioid epidemic at the time I started.

It was very common at this time to see multiple patients in the course of one shift complaining of “back pain.” Now a lot of people do suffer from back pain, in fact it is the number 3 reason for seeing a doctor after skin problems and joint pains which are number’s 1 and 2. The problem was that a lot of these back pain sufferers may have actually been in pain but their main reason for being in the ER was to get opioid medications. They were either addicts and/or were selling them on the street.  We knew as providers that there were addicts and those selling the drugs, however we didn’t always know what patients were being dishonest and which were legitimate. At some point I know I just started to believe anyone in the ER with back pain was only looking for narcotics. This bothered me personally because I was there to help people and I resented the fact that I was being taken advantage of by some patients.

On the day of my moment it was a typical day of coughs, cut fingers, sprained ankles and back pain. I go in to evaluate the back pain patient and it’s a middle aged woman lying in the bed with her head slightly elevated. I introduce myself and begin to inquire as to why she is in the ER that day. She tells me where her pain is located and immediately I am thinking “another drug seeker.” Remember I already explained that at some point I began to think everyone who had back pain was there to deceive me into giving them narcotics. I asked the patient to sit up so I could examine her back and find the exact location of her pain. As she was struggling to sit up, “acting” like she was in pain I rudely told her to hurry up. As soon as the words escaped my mouth I knew I had blundered terribly and the patient let me know it immediately.  Needless to say this comment received the exact reaction it deserved, anger, hostility and a refusal of the patient to allow me to continue treating her, me knowing she was right. She did not receive the quality care she deserved that day. She ended up leaving the ER before another provider was able to see her. I thought the story was over however a few weeks later at a staff meeting the incident was brought up by the chief of Emergency Medicine and my immediate boss, a person I had the utmost respect for. I found out that a letter had been written to the hospital by that patients daughter explaining how her mother had been in the ER and was treated rudely, her mother had left and gone to another facility sometime later where she was ultimately diagnosed with cancer in her spine. This was the source of her back pain.

Now the moment I spoke the words to hurry up and her immediate response, I knew I had messed up…bad! I had the Ah F%&K! moment. It changed me and how I perceive pain patients. You can’t make assumptions because as they say, “it makes an ASS out of U and ME. All pain is real and every patient deserves a professional, compassionate and empathetic provider. This patient was my life lesson and on the rare occasion I tell this story, I tell her story. Even to this day I feel a sense of shame for the way I treated this patient, for how I let my peers down and this keeps me striving to provide the very best care to each and every patient I see.