Some Dude

I won't pretend to have seen it all or done it all in medicine. Not even close.  Not even remotely close.  But, even in my short experience, I have had quite a few internal monologues that I wish I could say to patients.

Here are a few:

•  If you find yourself returning to the emergency department every month for STD testing and treatment because your boyfriend has tested positive for chlamydia again, it's probably time to find a new boyfriend.  Seriously.  I'm not sure if this was written about in the book "He's Just Not That Into You," but I'm pretty sure it qualifies.  Also, this isn't an emergency.

• If you survived 8 gunshot wounds to the abdomen last year, perhaps that was the time to get out of whatever business you are in (p.s. I don't want to know).  Congratulations for surviving a gunshot wound to the cheek this time - it looks beautiful. Are you going to push your luck some more? 

• It was "Some Dude" again this time?  "Some Dude" has been attacking and assaulting innocent citizens across the country for years.  Just this week "Some Dude" stabbed a patient in the arm, hit another with a fire extinguisher, stole another patient's prescription medications, hit someone in the head with a hammer, and yet at the same time managed to secretly drug four people.  "Some Dude" must be really slick because no one ever sees him, knows him, or catches him.  Hide your wives, hide your kids...

• I know, I know, you are an upstanding person who was just minding your own business on the way to church.  You are just trying to work hard, provide for, and be a good role model for your son.  The thing is, I didn't realize that churches are open at 2:30 in the morning and cater to people with blood alcohol levels of 0.24.  I also didn't know that "Some Dude" just hangs out by the church entrance waiting for innocent strangers to walk in so that he can stab them and stealthily run away. 

• If you are here in the emergency department seeking narcotic pain medications, at least come here sober.  You might think you don't look high, but really, you do.  The likelihood that we will give you anything for your severe and debilitating chronic back pain is inversely proportional to the length of time it takes you to get this sentence out: "No........ seriously..........I'm........ a........... drug........... and.......... alcohol............... counselor."  Negative points for falling asleep while saying it.  

• Your primary care doctor took the time and effort to write a memo to every single emergency department across the state instructing people to never give you narcotics.  I'm sure you are misunderstood. I'm sure this is a great injustice. I'm sure your doctor is out to get you. I realize you are allergic to Tylenol, Aleve, Motrin, Toradol and every other pain medication except Dilaudid.   I'm sure you will get a lawyer and sue everyone.    Have a turkey sandwich - see you again tomorrow. 

*I will never write identifying characteristics of real patients.  If you think I'm writing about you - trust me, I'm not.  But if you read this and still think I'm writing about you, then you might want to do some soul-searching. *