18 February 2008

Things I've learned in the ER

Things I've learned in the ER
by Sawbones
02/18/2008, 12:42 AM

A child who has been "vomicking" is considerably less likely to have a serious illness than one who has been vomiting. This also applies to children who have previously been treated for "ammonias."

The number of patients in a given room is inversely proportional to the actual medical illness present in that room. If you are in the emergency department with all five of your children, please just go home and drink yourself stupid until they are well. It's what you were going to do anyway, and you'll just save us both a lot of time and hassle.

A child, much like a pet, will wait for a moment of absolute maximum inconvenience to become ill. How does 2 a.m. sound for you?

Child or adult, very few of the things that happen to people who are awake at 3 a.m. are good.

A child's condition will immediately improve by the simple fact of walking through the emergency room door. Don't worry, I believe you when you tell me that the kinetic blur currently attempting to climb up my coat was acting lethargic and inconsolably fussy at home. I've seen this before. And yes, they do this just to make you feel foolish. Little bastards.

A person's likelihood of surviving a gunshot wound or other severe injury is roughly predicted by the DI (Dirtbag Index), which is calculated as the ratio of tattoos to teeth. The higher the ratio, the more likely he/she will survive. This does not actually translate into longer lifespan, as the DI also roughly predicts the likelihood of being shot again.

If you name your child Destiny, Miracle, Precious, or something similar, odds are overwhelming that she will have multiple severe medical problems. If not, it is a near-certainty that she will grow up to be a stripper.

Being named after an alcoholic beverage (Skyy, Hennessy, Courvoisier) tends to correlate with a negative life trajectory.

You have the right to name your child Nevaeh ("heaven" spelled backward) if you wish (yes, this really
happens). I also have the right to believe that you should be surgically sterilized.

Sawbones' Name Hall of Fame (yes, I have proof):

Sir Henri

Franksean (a girl, I should point out)


Dreama Skyy

Ni'gel and Nig'el (twins)

Master and Sir (triplets)


H.T. (stands for Hard Times)



The child with the worst diagnosis is always the one with the kindest, most patient parents.

The child with the worst parents will be damn near indestructible. It's just pretty hard to break a kid. Believe me, I've seen a lot of people give it their best shot.

The child with the most anxious parents will be the one with absolutely nothing wrong.

When working in an ED with multiple doctors, do whatever you can to avoid taking the teenage girl with the headache. No, this isn't sexist, as multiple female doctors have agreed on this point (actual quote: "I hate girl headache.").

And to be fair, I've learned that the intelligence advantage women enjoy over men starts early. Boys outnumber girls at least 2 to 1 among toddlers who come to the ED to have a foreign body removed from the nose.

When I ask if you drink and you answer "one a day," I'll assume you mean one six-pack. For breakfast. And possibly more after that which you just don't remember.

Anything an adolescent says about sex, alcohol, or drug use is a lie until proven otherwise. That, or virgin birth and secondhand drunkenness are much more common than generally believed.

When possible, medical professionals will always describe a symptom or physical finding in terms of food (e.g. "a cheesy discharge").

Doctors are, contrary to what you might think, far more superstitious than the average person. If your doctor is doing a spinal tap on you, look for the second needle available in his pocket (if I have another ready, I won't need it). No doctor will ever use the word "quiet" to describe his ED, for fear of changing that condition. And a solid majority of doctors have a subset of names (unique to the individual) that they are convinced carry a certainty of catastrophic disease for any child bearing them. Mine: Haley, Dakota, Colby.

In medicine, as in other areas of life, doctors are the most opinionated about and have the most heated arguments over things for which they have the least evidence.

There is power, power, wonder-working power in fear. I'm talking instant healing. It's amazing how the most severe symptoms can be cured by the threat of an IV, a shot, or a tube in one's wiener.

It's been a long week of night shifts and I'm a little burnt. Can you tell? I don't mean to scare anyone away from visiting their local ER. On second thought, yes. Yes I do.


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