I had the unfortunate need to go to the emergency room this weekend with my 4 year old, thanks to a protracted Saturday night of vomiting that didn’t respond to any of the things I normally do to help at home.
My husband took her at 4 am, which is usually a pretty quiet time in the ER. Imagine his surprise to find the waiting area full- totally full- of groaning zombielike walking dead, all convinced they are dying of swine influenza. Granted, this is a real possibility, especially in our area, but man, could our kid have worse timing?
By 7 am, she still hadn’t been seen, so I went down to the hospital to trade places with my husband since I had had at least a couple hours of sleep. The nurses had taken pity on my daughter’s sad state and given her a room and an evaluation by the time I arrived. I waded through an even bigger throng of pathetic looking people, holding my breath, and found one unhappy 4 year old being hooked up to an IV line.
She had already had blood drawn, and I was just in time for the obligatory radiographs. A few things had yet to be done. The nurse told me, rather apologetically, that the doctor had done what he always did in these situations and ordered a full battery of tests, some I was OK with, others I was less so. Being the sole doctor with an army of patients queuing up, I understand that he didn’t have much time for lively debate on the topic, but I was sitting in that cubicle for hours and had nothing else to do except come up with my own treatment plan.
I told the nurse that I was not happy about test C, didn’t feel it was necessary and would ultimately be painful and traumatic more than helpful, and she agreed. “We” (gesturing to the other nurse) “tried to talk him out of it, but he has his way he likes to do things.” The doctor orders it, and the nurses and the parents have to actually deal with the painful part, so it’s no skin off his back, right? So I told her to decline it.
Well, that got the doctor in the room. “Hi, mom,” he said, a slight, jittery guy like most ER doctors I’ve met seem to be, breezing in with his chart and his script. “So, you don’t want to do Test C?”
“No,” I replied. “You can get the same information by doing it with Test D, and I’d like to do that instead.”
“But blahblahblah,” he said, starting to use medical jargon.
“Yes, and blahdibladiblahblah,” I retorted, also using medical jargon.
This is when he blinked, I’m sure trying to decide if I just read a lot on the internet or what, and ultimately, I think, concluded I was a nurse. That is always the first assumption doctors make when talking to a female who knows medical words, and I don’t offer up an alternative explanation. Nurses are pretty stubborn and opinionated- and I mean that in a complimentary way- so it’s easier to let someone think that. He was too busy to argue, so he left.
We did Test D, which accomplished exactly what I figured it would, and after 9 hours of sitting around, we ended up with a diagnosis of “gastritis.” Which is medical for “stomachache.” Makes me long for my awful days in the veterinary ER, where the most I had to leave people waiting was maybe 2-3 hours on days we were understaffed to come to similar non-conclusions.
I saw the doctor one more time, right as he discharged us. “I’m giving you a prescription for Pepcid,” he said.
“Nope,” I replied. “Zofran.” And he did.
I’m not a pushy person, I swear it- but time and experience has made me realize in some situations you do have to question and argue, and I say this both as a patient and as a doctor who does get challenged at times. Either there is a good reason for what a doctor says or not; sometimes it’s just rote, sometimes it’s cover-your-butt practice, sometimes it’s convenience- but at the end of the day, you make the decisions; a doctor’s role is to help you make the right one.
