A note from the other side of the doctor-patient relationship

April 26, 2008 at 3:40 pm (Uncategorized)

  

A few months ago I was involved in a car accident.  My vehicle was T-boned at an intersection by an elderly man who was driving an SUV.  I was thrown into a railing and was pinned inside of my car.  I needed a few seconds to realize what had just happened.  I had enough mental faculty remaining that I could pull out my phone and dial 911.  I remember that there was blood quickly dripping from my head, as well as shouts from nearby pedestrians who were trying to see if I needed help.

Paramedics arrived almost instantly but were helpless to do anything because my car was pinned between the SUV and the rails.  Because of the impact, the doors in my car were sealed shut and could not be opened.  Firefighters had to push back the SUV, breakthrough my windows, and then saw through my passenger side door to get me out.

My neck was a little stiff, my hip hurt like hell, and I was still bleeding from several spots on my face and head despite all of the pressure I had been putting on them with a paper towel.  The paramedics successfully got me out, put a C-collar on me, and tied me down to a backboard.  I told the lieutenant that I was a medical student and I wanted to go to my university’s hospital.  I figured that if the paramedics let the attendings know that I was a student, I would get quicker service.  I reminded the paramedics again on the trip to the emergency department that I was a student at  the approaching hospital and that they needed to let the physicians there know.  Otherwise, I was probably going to have to wait several hours before being seen, despite having just been pulled from a totaled car.  One of the EMTs laughed it off and try to assure me that anyone who comes in from a motor vehicle collision would be seen instantly, regardless of his educational status.

I’ve mentioned before on this website that my university’s affiliated hospital is an urban medical center that caters to a largely uninsured population.  Its emergency department sees over a thousand new patients every day, effectively triages them, and provides care to whoever needs it.  The dedicated physicians and nurses do all of this despite the numerous abuses of the system by the patients who come here.  Unfortunately, due to all of these visits, the time between walking in the door and getting a physician’s ear for five minutes can take up to three hours.  I warned the paramedics that I was going to be in for a wait if they didn’t alert the staff there that I was a medical student.

In the past, whenever my classmates have needed emergent care, they simply pull out their student ID and precede to instantly seeing the attending.  Unfortunately, I had been hit on a Saturday night and did not have my ID with me.  The paramedics never did tell the physicians that I was a medical student.  And I ended up staying in triage—tied to a backboard—for over two hours before finally being seen.  Since I had so much free time on my hands, not being able to move and all, I used the stopwatch feature on my wrist watch to see just how long I would wait.  I was right; the paramedics were wrong.  I was there for a very long time.  So long, in fact, that a police officer was able to arrive from the scene, take a statement, and then issue a ticket with the other person’s insurance information available.  The only person from the hospital who came to talk to me during that time was from finance.  She only wanted my insurance card.  I told her that I was a medical student only to have her brush it off by saying, “They will take care of it.”

During the wait, I really felt as if I needed to use the restroom.  I tried to flag down the nurses to let them know that I had to pee.  No one was paying any attention.  As people in scrubs walked by, I would say, “Excuse me, miss, could you help…” and then watched as the person ambled by without so much as looking at me.  I thought about all the times I had ignored patients in the emergency department who try to get my attention for food, water, a trip to the bathroom, or whatever else was on their mind.  I always ignored them, too, because I assumed that they were psychotic.  And here I was, receiving the same treatment.

When I finally did get to see the physician, he was greatly annoyed that I had to stay out in triage for so long.  Our hospital’s rule is that medical students and residents get seen instantly.  He was frustrated to learn that no one had bothered to talk to me from the medical side in the entire time that I was held to the backboard.  In the end, I didn’t suffer any broken bones.  I didn’t even need stitches.  I couldn’t receive them anyway.  So much time had passed that I was ineligible for any kind of suturing.  Luckily, the bleeding had stopped anyway.  I was sore for the next few weeks, had a little difficulty walking because my hip was in so much pain, and now have several prominent scars on my head and face from where broken glass cut me during the collision.

I saw life as our patients see it: scared, wondering when I would be seen, and greatly annoyed that finance got to me before anyone in healthcare did.