Tuesday, January 12

Not Quite As Angry as Before

I've calmed considerably. Although an article in the today's NYTimes does lead me back to healthcare reform and lingering anger over why I pay out my ass for insurance and have no control over the cost. I wish I knew the answer but even if I did it would be nearly impossible to act on it because so much of the US economy is tied up in the delivery of over-priced "healthcare." Is it possible that a "sweeping" reform could simply be a smoke screen that shrouds other more important issues?

On another note. The spring semesters begins tomorrow and I am excited to get back into the swing of things. I've been working on an interesting project in our lab the past week of so that is tied to a directed study class I'll be taking this year. Hopefully I will get enough research experience in to at least know if it is right for me. This is an important semester for me, just like all the others at this point, because I'm getting into the meat and potatoes of science. Hopefully I can keep up and remain excited about it. I don't think it will be a problem because it seems that the more I learn the more I don't known and the more I want to learn. It that makes any sense.

I've always enjoyed challenging myself and my long held beliefs. I think everyone should take time to rethink what they hold dear and learn all they can about it if that is even possible. Conflicting views have always interested me and I think that is why science is something I can learn and relearn and continue to learn because the answers are never as clear cut as they seem. Anyway, another week of trying to improve is in progress and I'm still enjoying the ride. Here's to another opportunity to study and learn and grow with hopes that it never gets old.

Sunday, January 10

Just Take Them to The ER

At what point does a paramedic get the power to tell someone to Fuck off? Do you have any idea how much money this would save emergency departments. I am sick of political correctness and the assumption that everyone should get treatment in an "emergency."

You want reform. I'll tell you what reform should look like.

911 dispatcher: Medic 20 respond to an unknown medical at 397 bullshit st. apt. 1297.
Me: Fuck

First Responders: Yea, he's on the 12th floor. No elevator, so you should take your stair chair.

Me: You know, they have two feet and I only have one back...

(Paramedics walking up 12 flights of stairs with a 30lb bag, 20 lb monitor, 15 lb stair chair and 10 lb oxygen bag and an unmeasurable amount of disgust.)

Patient douchbag: I can't move. I've cut my toenail to deep and it is bleeding. I need to go to- big fucking hospital 20 minutes away- because my doctor is there and he is the only person who can treat me.

Me: So, let me get this straight. You cut you toe nails tonight (2:30 A fucking M) and your big toe on your right foot is bleeding so you can't walk?

Patient: Oh yea, I can't stand because it's hurts like hell and you know I am a diabetic.

Me: Ok, is there anything else going on? Surely to God you really didn't call me because of this?

Patient: No, I just can't walk because my big toe is hurting so bad. I'm afraid that it will get infected and they will have to amputate my foot. I've seen you before and you know that I have diabetes. You know that and I've looked on the internet it says that diabetics are at a higher risk for infection.

Me (thinking): Did you notice the articles on smoking and eating like hell until you can't breath and weigh over 300 lbs could be detrimental to your health?)

Me: Ok, your toe isn't an emergency. I can clean the cut and bandage it with antibiotic ointment. If you have any signs of infection tomorrow then you should call your family doctor and make an appointment so they can evaluate you appropriately. That way you could see your doctor and wouldn't have to leave your house tonight since it's a blizzard outside and there is already six inches of snow on the road. You know there is a good chance we may not even make it to0 - big fucking hospital- tonight because of this.

Patient: I'm not sure. I have medicaid and it will pay. You have to take me to the emergency room now because I called 911 and I don't have a ride that will take me to my doctors office two blocks down the road tomorrow.

Me: Ok, you know what, I really tried to be nice. I can't believe that you would call 911 during a blizzard at 2:30 in the fucking morning because you cut your big toe with a pair of toenail clippers. I am not going to carry you down 12 flights of stairs and pray that my driver will be able to navigate unbelievable road conditions putting both of our lives in danger to take you the emergency room were they will tell you the same thing I just told you. I will bandage your foot and you will call your doctor during normal business hours and get an appointment because that is the most appropriate action that should be taken.

Patient: I knew Obama would wreck the healthcare system. I'm going to sue you, your county, your OMD, your OMD's group, the county, the state, the federal government and the president because my I should be able to go to an emergency room on any whim and get exceptional treatment anytime of the day!

Me: Well go ahead, because the new legislation says I can recommend that you should - go fuck yourself- get the most appropriate medical care. I am protected by new laws that says I won't loose my job and you can't call an ambulance chasing lawyer to defend you. Thank you for calling and I hope everything works out ok.

Fantasy I know. In reality- because this really happened to me- I carry this big stupid motherfucker down 12 flights of steps into a blizzard and drive to big fucking hospital during a blizzard at 2:30 in the morning because I can't say no.

Real reform would stop this abuse and give better training to prehospital personnel so they could triage patients and advise them of the most appropriate action. I know this is only a tiny reason the American healthcare system is broken but reform must begin somewhere.

Why does an emergency department have to absorb the cost of ignorance?