Random Vignettes

3.30am

"I want to see the doctor."

I glance at the speaker briefly from my hidden vantage point in the room adjacent to the triage desk. He is a middle-aged man, unkempt and dishevelled with wild hair.

"The doctor will be with you shortly," the triage nurse says, "but first I have to ask you a few questions. What brings you to the ER?"

"I want a full body checkup."

"Ummm okay... we don't do full physicals in the ER," the triage nurse says. "That's something you need to speak to your family doctor about."

"OK, but can I still see the doctor?"

"Yes," the nurse says, "but I'll have to do a set of vital signs on you first."

He acquiesces and she performs the necessary before slipping into my room and handing me the chart while rolling her eyes.

I set aside my charting, pick up the chart and enter the room where the man is waiting.

"I'm the doctor," I say. "What seems to be the problem?"

"I want a full physical," he reiterates.

"Why do you want a full physical?"

"For my own peace of mind," he says. "I was drinking downtown and the next morning I found this. It's bothering me a lot because I don't know how I could have gotten it."

He rolls up his sleeve and shows me his forearm, where a small bruise about the size of my pinky fingernail is evident.

I arch an eyebrow. "Perhaps you banged your arm accidentally."

"No, I don't remember that."

"Well," I say, "I don't think that's anything I would be terribly concerned about."

"Still," he says, "I'd like a full physical exam just to be sure. Bloodwork, tests - "

"Sir," I say firmly, "we don't do full physicals in the ER. That's something you need to talk to your family doctor about."

"Okay," he says. "I just thought I'd try."

And with that, he flashes me a crooked grin, grabs his coat and walks out.


4.45am

Hic.

Hic.

Hic.

My patient's problem is evident almost at once.

"I - hic - can't stop - hic-cuping," he says forlornly.

"How long has this been going on for?" I ask.

"Hic - two - hic - days and I can't - hic - sleep."

He outlines the things he's tried - every old wives' tale one can imagine.

The triage nurse, I'm told, had also tried her version of scaring his hiccups away, asking him if an 8hr wait to see me might help. Alas, her efforts have been in vain - and anyway, the wait tonight is only an hour. I scribble some orders in the chart for some Maxeran, then return to tell my patient what the plan is - an intramuscular injection to stop his hiccups.

Forty seconds later, when the nurse arrives to give him his shot, he's stopped hiccuping.

She gives him the shot anyway.