The first time it happened, I was attempting to put staples in the head of a young little boy.
I had numbed up the area and we were going to restrain him because he wouldn’t sit still on the cart. He was kicking staff, shaking his head, and screaming. The father refused to allow us to put the child in a “papoose board.” Instead, he stated that he would hold the child still. As I began placing the staples, the child screamed when he heard the staple gun clicking. The father became angry.
“Are you sure that he is numb?”
“Why don’t we numb him again just to be sure?”
After we were done injecting more anesthesia, I let the father watch me touch the child’s scalp with the edge of the needle to show that the child was not feeling any pain. We then began putting in more staples. And the kid still fought us with all he had.
By the time I was done, I had placed six staples. Unfortunately, one staple was misplaced due to the child’s kicking and screaming on the bed. I told the father that I needed to remove one staple and place another one.
He pounded his fist on the bed and yelled “you have to be fucking kidding me.”
I became a little upset. After all, he was the one who wouldn’t let us put the child in a papoose. So I asked him “What is it that you would like me to do?”
He stared me straight in the eye and said “How about doing your fucking job?”
No, I didn’t staple him in the eyeball.
I considered discharging the child without replacing the staple, but it isn’t fair to do a bad job on the child because of the dad’s uplifting demeanor.
So I had three people come in and hold the child on the bed while I quickly removed the misplaced staple and placed another one.
Then I smiled at the dad and with a big grin told him to “have a nice day.”
The second episode was a little different.
A patient came in with repetitive headaches. She had short, sharp bursts of pain to her temple and jaw lasting 30-60 seconds and then resolving spontaneously. I first considered cluster headaches, so I gave her Imitrex, but it did not improve the symptoms.
I then tried high flow oxygen and Toradol. Still no improvement.
I ordered a few tests and then gave her some IV morphine.
When I went back in the room to check on her, she still only had minor improvement. I told the patient and her husband one of the other possible diagnoses could be trigeminal neuralgia and that we would try another medication to see if it would help. Then her husband chimed in.
“Why don’t you just admit her to the hospital? It is obvious that you are not doing anything for her down here.”
“Well, actually we have done multiple blood tests, we even did a CAT scan, and she has gotten four different treatments for her headaches. I’m not sure why you feel that we are not doing anything for her.”
“Look at her. She’s still having pain.”
“I see that. I am trying to help her.”
“Well maybe you ought to try harder.”
“What would you like me to do?”
“I don’t know, I am not a doctor.”
“Well when you are saying that were not doing anything for her, there must be something different that you would like me to do. So what can I do differently to try to help?”
Then he pulls the little toothpick out of the corner of his mouth, nods his head, cracks a smirk, and says “How about you do your job?”
“Oh … well … what part of my job and my not doing correctly? I would be happy to try to help if you could just tell me what I should be doing differently.”
He furrowed his brows and said “I already told you, I’m not a doctor.”
“Okay. It’s just that when people make statements that we “are not doing anything” when we have actually done quite a bit, I want to make sure that there is no other treatment that they believe is appropriate and that we have not provided.”
Then the patient looks at me and goes “Why don’t you shut the hell up and get out of here.”
No I didn’t bring back a strobe light and start blasting Metallica on the radio.
She got a prescription for some Tegretol and a referral to a neurologist.
And I learned to never ask a patient or a family member what they would like me to do for them.
This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on DrWhitecoat.com, please e-mail me.