Close Encounters of the ER Kind

Twenty years ago, I worked as an emergency room registrar during the midnight shift. The nonprofit hospital offered charity care and a trauma center, so a wide range of patients sat in front of my bullet-proof window. These medical encounters were sometimes sad, sometimes frightening, and sometimes ridiculous. Some required patience. Some required a good sense of humor. All required prayers.

The emergency room would ebb and flow like some sort of patient riptide. Wait times depended on the severity of those seeking treatment. So, someone experiencing chest pain would trump someone with a tick on their testicle. During downtime, when registered patients resembled party animals eager to celebrate the opening of an ER door, I noted my experiences.

Some patients came in for wacky reasons. But in their worrisome minds, it warranted a trip to the ER. Here are some:

• A mother brought in her teenage daughter, who looked as pitiful as a wilted house plant. She had a string of floss dangling from her mouth. “The floss is stuck in her teeth,” the mother told me. The doctor easily tugged it out. The girl’s mother became indignant when he refused to prescribe her daughter pain killers.
• A young woman approached the ER registration desk and asked with an air of urgency, “Could you please direct me to a telephone? I need to call 911.” She politely refused help and thanked me for directions to the payphone.
• A senior citizen fretted that his flatulence, although of normal frequency, made the air unfit to breathe. He didn’t say his family had concerns about being asphyxiated, but he implied that his intestinal vapors had the potential to trigger near-death experiences. He wanted the doctor to prescribe something to disarm his firepower.
• A female patient seated in the triage room adjoined to the registration area told the nurse, “I want the doctor to examine my foot. I might have the start of a blister.”
• Overly concerned parents bring in their not-so-sick children and expose them to the waiting room’s bacterial stew. Four sisters, energetically chasing one another, had colds but “it’s been three days and their noses are still running!” Or “Johnny has a tummy ache.” Well, Johnny is slurping a soda and wolfing down a giant Snickers bar while he waits with his eight siblings and parents, who just ordered a monster pizza.
• An elderly man and his wife registered for lab work. They were to bring in fecal and urine samples. In front of my window, he plopped down a bucket jiggling with about a week’s worth of crap, and she plopped down a pail brimming with about a quart of pee-some sloshing out. Let me tell you-the crossfire of fumes were epic.

The ER staff often had to assess psych patients who were inebriated or agitated. As they registered, I tried to calm them or coax a smile. When I couldn’t, I prayed.

• A rampaging psych patient came in by ambulance. He threw the consent forms for treatment onto the floor. An EMT from the ambulance returned the forms to the patient, now ranting in the ER’s psych room, and ordered, “Read this!” Then she said, “Sign the white sheet and I’ll give you pizza. Sign the yellow sheet and I’ll give you pop with the pizza.” He relaxed and signed. Later, when the doctor tried to get him to sign an admission form, the patient exploded with profanity. The doctor yelled, “You’re mine now!” and pink-slipped him. Never underestimate the power of pizza.
• A psych patient registering at my window said a nurse passing behind me laughed at him. She hadn’t, but he worked himself into a seething rage believing she had. He had a headset on with music blasting beyond his ears, so I tried to distract him by commenting, “Your choice of music is very interesting!” He snarled, “It’s music about killing people. Right now, I feel like I want to kill people.”
• A young mother’s threats to harm herself and others echoed throughout the ER. Security came to help. After she’d been sedated, I entered her room to obtain her signature on an admission form. Her hostility fueled her suspicion. She read the fine print and barked out multiple questions. I answered quietly and respectfully. She finally signed with oversized swirling letters. I remarked, “Those are the most artistic loopy loops I’ve ever seen!” She smiled broadly and asked, “Do you really think so?” I studied her signature, saying, “Oh, yeah.”

Then there’s the bathroom humor. This is all part of what hospital personnel must deal with, so please forgive me.

• A male triage nurse had to address an overloaded Chest Pain Unit (CPU) toilet after a patient used it. The nurse told me, “There’s a bowel movement the size of a submarine in the toilet!” When he couldn’t flush it through, he called maintenance, and said, “The well-known family of this patient is expected to visit this guy in the CPU soon and the bathroom has to be operational!” The maintenance supervisor refused, saying “I can’t do anything with a damn turd that size! You’re on your own.” So, the nurse fetched an IV pole and, in his own words “beat the sh*t out of the huge log” and flushed the toilet clear. The IV pole ended up under a bed.
• And, yes, there is a butt box of items pulled out of rectal canals. One generous male donor, apparently strolled around his house naked and then accidentally sat on things. The first time he visited the ER he had to have an Idaho potato surgically removed from his rectum. The second time he came in to register, he mumbled, “Blah, blah bologna ‘uck in throat.” However, he told the doctor he had a water-filled coke bottle stuck in his anus. The doctor, a muscular bodybuilder, couldn’t pull the bottle out of the patient’s spasming rectum. So, the butt box trophy had to be surgically removed.
• An ambulance crew had the ER staff laughing hysterically. They delivered a young man, who passed out in a bar, to another local hospital’s ER. The patient couldn’t be aroused, so the nurses cut off his clothes. He’d taped a jumbo-sized sausage to his left leg that extended from his crotch to just above his knee.

Impatient patients and patients with suffocating body odor were equally challenging. God bless the nurses.

• An older woman, by no means feeble, contested every registration question before answering. I’d quietly ask a question and she’d spit out her response. Back and forth we went, me being pleasant and her snapping like a rabid dog. When she complained about her aches and pains, I offered empathy while painstakingly helping her complete her paperwork. Finally, she shoved her signed consent forms under the window, walked away, and growled, “You’re nice!”
• A thirtyish woman in a wheelchair complained of hearing bells. She repeatedly fake retched into an empty bucket and impulsively scratched between her greasy snarls of hair. Lice can’t grasp slimy hair, so filth likely caused the itch. Her legs were oozing and festering with sores and her feet were swollen and peeling. A decomposing roadside deer smelled like a bouquet of daffodils compared to her. When she signed consent forms, she commented, “I might as well kill myself.” I wanted to share kind words with this poor woman, but my airways refused to let in any more stench.
• An ambulance crew brought in a middle-aged woman and wheeled her directly into a private ER room with sliding doors. A rain of maggots dropped from the dirty, tangled clumps of her hair. The wormy larvae were swarming over and under her soiled clothes doing what maggots do: eating, pooping, and secreting digestive fluids. Because of her toxic odor, nurses rotated in and out of her room every two minutes to clean her up.
• An obese man crowding 500 pounds asked to be treated for alcohol addiction. His foul scent permeated the entire ER, especially the waiting area. Potential patients left quickly or waited in an adjoining room. After he made himself comfortable in an oversized wheelchair, he scooted up a hallway leaving a thick trail of molecular stink bombs. A security guard with a sinus infection wheeled him back to the triage nurse, who showed exceptional kindness to him.

Unfortunately, there were heartbreaking cases.

• A seasoned ER doctor, experienced in dealing with critical and dying trauma patients, had to inform the family of a middle-aged diabetic woman of her death. As the doctor approached the Family Room, where relatives are updated with the status of their loved ones, his hands visibly shook. Apparently, caring medical professionals aren’t desensitized to grief.
• One night the wait to be seen crowded four hours. People with mostly minor complaints, like crotch itch, grumbled loudly and often. They didn’t know the ER staff had been desperately trying to revive an infant and couldn’t. He lay still on a trauma room gurney. A nurse smoothed his soft puffs of hair and positioned his head to the side. His angelic face rested above the blue and pink afghan nestled under his chin. His parents viewed him in the quiet of an empty ER, the mother clinging to the child’s teddy bear with clergy nearby.
• The ER secretary called me, saying, “A gunshot wound to the head is arriving in five minutes!” The waiting area quickly filled with the victim’s acquaintances. Two men escorted the victim’s mother, whose legs threatened to betray her, to my window. Hyperventilating, she dropped her head down to her hands and moaned, “Oh, Lord! Oh, Lord!” She had to register her adult son and sign the consent forms necessary for his treatment. The young man, who only lived a short while, had a bullet enter through the top of his head and lodge in the center of his brain.

Medical professionals use their hard-earned skills to help patients entrusted to them no matter what is wrong, no matter how they smell, and no matter how they act. But a medical degree isn’t necessary to share the healing touch of kindness or say a prayer. A gentle smile, warmhearted words, and patience for those in need are righteous works we should do because it’s compassionate and it pleases God.

James 1:19-20, NAB

Know this, my dear brothers: everyone should be quick to hear, slow to speak, slow to wrath, for the wrath of a man does not accomplish the righteousness of God.

Proverbs 12:25, NAB

Worry weighs down the heart, but a kind word gives it joy.

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