“The guiding principle of all caregivers should be to know the patient, hear the patient and respond to what matters to the patient. It should make no difference where you practice; any provider can do this. Emergency departments can’t hide behind the excuses of “we’re too busy” or “it’s too chaotic” to avoid meeting this standard.” Dr. Yeh
It was just after 6 p.m. on Dec. 7, 2011, when I went to meet a colleague for dinner in Washington. It was dark and rainy, and I was about a third of the way across the intersection when I heard a thump and felt a sharp pain squarely in my backside. It took me a few moments to realize I’d been hit by a car. Before I could make sense of the situation, I had flown through the air and landed on the street.
“Are you OK?” a man asked me. I was so stunned that I said nothing – highly unusual for me.
When the emergency medical technicians arrived, they placed a C-collar around my neck and positioned me on a backboard for the short ride to the hospital.
The admitting team rushed me into an exam room, where they asked if I was having any pain. It seemed an odd question, seeing as a car had just plowed into me. Yes, I was in considerable pain, I told them. An IV was inserted, and the morphine began to flow.
A doctor came in and began an exam to detect risk of life- or limb-threatening emergencies. Then came a brief evaluation to ensure that I could come out of the C-collar and off the backboard, a visual inspection for external bleeding or misaligned bones, and an assurance that my heart and lungs were functioning normally.
I told the doctor that I had severe pain in my knee and backside. She ordered a CT scan of my abdomen and pelvis as well as a chest X-Ray. Wasn’t she going to examine my knee and backside?
When the tests were completed, I was wheeled out of the exam room, still flat on my back. By this time, roughly three hours after the accident, the emergency department was chaotically busy, and all of the rooms were filled, so I was parked in the hallway. A new round of clinicians stopped by my stretcher. “Well, everything looks fine on your tests,” the head clinician informed me. “There’s a little bleeding in the muscle around your hip area. We just don’t know if that’s going to continue, so we want to watch it. We’re going to admit you.” I gasped. I was still in denial that I had any serious injuries.
An inpatient bed wasn’t available, so I would be “boarded” in the hallway until one opened up.
I lay there on my gurney for nearly 15 hours with my BlackBerry, my cellphone and a morphine drip, watching the bustle of hospital traffic around me. Several times, my blood pressure was taken. When the pain returned every two or three hours, I caught the eye of hassled staff members and had them tell the nurse, who would come by to give me an infusion of morphine.
I felt alone and was struck by the demeanor of some hospital staff who rushed by. It seemed as if they were deliberately avoiding eye contact with any of us poor souls waiting in the hallway, lest they be interrupted and asked for help.