What did you say?
It was well after midnight and things had begun to settle down in the ER. It was one of those nights that ebbed and flowed like a roller coaster. We would go from rush, rush, rush with seriously injured people, to a few patients who really had no business being in an ER at all. Emotions were leaping sky high and then settling into the bottom a of ditch.
I am no longer surprised by anything that happens in an ER. There was a 23 year old woman who came in because it was that “time of the month” and she just didn’t feel good. I hate to tell her the shocking news....”That is Normal”, it is not an emergency.
We had just sent two patients to the ICU because their situation was life threatening and life for them was on that balance bar between “living” or “dying”. These were the patients that need the help of the ER.
Suddenly there was quite a ruckus going on in our ER. Two sheriff deputies came in with a young angry prisoner. The prisoner/patient was very thin and he appeared to be mad at the world and everything in it. He was kicking and spitting and yelling obscene things as they basically dragged him to the bedside. He was handcuffed and his feet were shackled at the ankles. Even though he was tethered on all four limbs, he struggled and wriggled constantly. The prisoner was clad in an orange jumpsuit that said “Mobile County Jail” on the back. This man was finally forced onto the gurney so that he could be examined, yet he would not lay still and he tugged and twisted continually. His nurse grabbed some leather restraints to strap him down and the physician on duty walked over to his side to begin his work. The patient was sweaty and looked very tired, and I felt such empathy for him for a brief moment.
Then he began screaming at the nurse that he was going to F...her when he got untied. Next he looked at another nurse and said “When I finish with her, I am going to F... you too, you Bitch!” The ER physician told him to calm down so we could check his injuries, he said “Hell No, you Mother F...er, I’m not calming down!”
I looked passed this loud, screaming, patient and saw the little 78 year old lady who lay in the bed closest to him. She looked totally mortified. I knew she was afraid and I stepped over and closed off the curtain so that she could no longer see the goings on. I said, “it’s going to be ok Mrs. Carson, they just have a young rowdy patient, but it will be taken care of and everything will be ok.” I added, “You are safe”. She remained silent, but she nodded. I saw her big eyes and her unnerved expression, as I patted her hand, then she assured me that she understood.
Our physician, Dr. A., who was attending this un-attendable patient, said "we will need a urine sample for a drug screen". The patient said, Oh HELL NO, I will NOT give you my piss!” At that point, Dr. A calmly said, “Ok, that is fine, sir, we will come in and get it”, as he turned to the nurse and said, “Cath him”. The patient started screaming even more vile and detailed scenarios of what he was going to do to the two nurses who were taking care of him. It was difficult to hear his words. Dr. A. withdrew the female nurses and sent two Male nurses over to care for this patient.
Moments after the male nurses walked to his bedside, the prisoner/patient began screaming “I will F... your wife, I will F... your mother, I will F... your sister, your daughter!” I could see the pressure building in the faces of those male nurses and I feared a battle was about to take place. The tension was so thick in that ER it could be sliced like apple pie.
Dr. A. stepped back over to the bedside and he ordered lots of sterile gauze pads. The minute they were handed to him, he had one of the male nurses to put them into the patient’s mouth.
Our unpleasant patient still tried over and over to scream but he was very muted and his words could hardly be heard much less understood. It was a mumbling garble of soft sounds coming from his mouth. Everyone’s nerves were suddenly calming from the tension that had been building up to that point.
Dr. A. stepped very close to this now silenced, rude patient and smiled. This caused the prisoner/patient to be newly enraged, but though he tried to scream, only soft garbled sounds came out of his mouth. This guy wanted to get at Dr. A so bad, there was no doubt about it. By this time we had hospital security at the bedside as well as the deputy sheriffs that brought him to us.
Dr. A. leaned over close to his ear and said, “I can’t hear you”. The patient tried to raise up and he kicked and jerked all that his restraints and chains would allow. Meanwhile Dr. A continued to smile at him. That enraged this patient even more and he struggled even harder to move and to speak, without success. Dr. A. said, “Did I hear you say you are sorry?” Of course this guy was not sorry for what he had said. He only wanted to say more vile and disgusting things to us all, but thanks to Dr. A. he would not have that opportunity.
After a while, this patient relaxed and fell asleep. He was treated for the injuries he had sustained in a jailhouse fight (which he provoked). His urine tested positive for narcotics and cannabis, which was no surprise. He still was not a nice person when he awoke, but he was more subdued than when he arrived.
I thought of this young man (he was 24) and I hope that he got his act together. He was like a runaway train headed straight towards a violent death if he did not get help. I realize you cannot help someone who is not willing to admit they have a problem and not interested in changing. But oh how I wish Dr. Phil or someone could have intervened to save him from his hate-filled life of destruction.
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