Creepy Love and Other Relationship Oddities of the Week: I

July 18, 2009

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From time to time in the ER, we have the unfortunate experience of seeing relationships so foul that they can only be called “creepy love” as a nurse so aptly put it one night. It is just the sheer volume of people that we interact with that necessitates, to some degree, that we see all sorts of oddities. To narrow it down to just a few is so hard that I decided this would only be one part in a mini-series. Prepare to be horrified.

Creepy Love #1  goes hands down to a mother and son team that came in last night. The son, a young man of 19 years, presents with mom because his testicles hurt. Ok, nothing weird so far. Before I go in the room, I see mom step out as he gets gowned, something totally expected. I figured she would stay in the waiting room till he got discharged. Wrong.
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As I start the exam, Mom returns. I tell her from behind the curtain that we are about to examine the private area and if she would be comfortable returning later. To my surprise, they both – almost simultaneously – say no. So, she comes back to watch me examine her boy’s family jewels.  Afterwards, we come to the a set of questions of what he was doing when his balls started to hurt.  I am totally amazed as he goes into a detailed description – again in front of Mom – of how he was making out with a girl for “a really long time” without hitting the pay-off at the end. So, I told him that most likely he was suffering from a case of  “blue balls” – or testicular vasocongestion in medical speak. 
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Mom very creepily laughed at this point and told me that this is what she had suspected as well. I thought to myself, “If she starts talking about how this kid’s Dad used to get blue balls when they were still a fledgling couple – I am outta here!”  Usually young men cross the – Mom, “this is kinda private” – line around 15 years old. 16 wouldn’t be weird. 17 is pushing it. College age is already weird. But 19 going on 20 is just creepy (this guy is about to start junior year in college).
 
Creepy Love #2: Young woman – 25 years old – presents to the ER after having a fall the night before when she was plastered. There is a gentleman (used very loosely) in the room with her who appears to be in his 50’s. I’m thinking Dad, but I learned a long time ago to not assume anything in this area (We’ve all been there before – “So, this must be your Mother right?” Patient’s wife replies in a very insulted tone, “Mother? I’m his wife“. Ohhh – can the Earth please open up and swallow me now please).
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So, I casually wait for a moment to ask the man, “And you are?”. He replies that he is a “good friend“. Another lesson that I have learned is that “good friend” can also mean any one of many things. Apparently, Mr. Good Friend was with this young lady at the bar last night and drove her home. So, I’m thinking maybe he lives on the same street – saw his neighbor trading sober for hammered and kindly offered to take her home. No, that would be too normal. This was all about the creepy.
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So, since she had fallen in her less-than-sober state, I needed to check certain areas of her that were still clothed. I told her to get gowned and that’s when the creepy-meter hit red. I walked out of the room to let her get undressed – and he didn’t.  Now I know you’re thinking, it isn’t necessarily weird for an older man to date a younger woman less than half his age, and that in some ways it can be totally socially acceptable. Believe me, this wasn’t one of those cases.  
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The last couple for this post wasn’t a creepy one at all, just a sad one. 55 year old man comes in with chest pain. There is a woman with him who looks like she fell from the ugly tree and hit every branch on the way down as well as ate bark. But I really do believe that beauty is partly from within and not only skin deep – so I really didn’t think much of it. Until I started the interview.
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Everytime this guy would try to answer a question, this woman would literally scream at him and say he was lying. Then she would tell me something else. He didn’t seem to fight it, so I could only assume she was right. It was more typical of the way an angry mother would correct her delinquint son, but this was husband-wife dynamics.
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When we got down to the social history, the guy turned out to be a regular drinker. Imagine that. I mean, who wouldn’t want to be sober to deal with a delightful woman like her everyday? To understand this dynamic better, I researched the net and found this interesting article: Top 10 Signs She’s a Bitch. Oddly enough, the first comment to that article was written by a man who called himself F@&k Me who wrote: “what happens when you’ve been married to one for 17 years, and just can’t take it anymore?”. I guess my patient was asking himself the same question everyday as he cried into his drink.

Hookin’ Up at Work (How to Get Fired)

June 20, 2009

office romance

I know I haven’t been updating the site recently, and I’m very sorry for that. I have a growing list of posts in my head, but I have been working too hard to get them down. Usually I don’t like to work this much, but I have had to pull several extra shifts because one of our docs got fired. Docs don’t get fired too much these days due to the whole supply-demand thing, but every now and again, some idiot takes it too far and becomes a statistic. This is his story.

Dr. Dumass, as I would like to call him, had a good thing going. Cush hospital, good position, great co-workers, and even a nice office. But apparently for Dr. Dumass, the nursing staff was a little too nice for him. Dr. Dumass was actually working on marriage #4 (I am not making this up) when he met Nurse S. Not only was this his fourth wife, but he had a litter of kids spread out all over the country from the last three. To quote Brad Pitt from Fight Club, “F$%#@* was setting up franchises“.

Nurse S was cute, pretty and they hit it off as friends from the start. She was having problems in her marriage and enjoyed talking to Dumass about her marital conflicts. He in turn would share with her his own marital problems with wives 1-4. They got closer and closer. 

Finally Dumass made a great suggestion, “Why not get divorced from our current spouses and get married to each other!”  I can only imagine that Nurse S was married to a drug addicted, alcoholic bridge troll with anger management issues, because I am not sure what exactly would be the attraction to a guy who has already blown through 4 wives and 10+ kids? Maybe she thought that she would be “the one“. Silly wabbit.

Things were moving along smoothly for our confused couple and they could hardly stay away from each other while at work. Either our darling little nurse would be in the docs documentation area or Dumass would be out at her nursing station whispering sweet nothings into her stethoscope. Just some advice for any of you readers involved in a similar relationship – you may think that no one notices, but in reality, everybody notices. Even the blind frequent flier behind curtain #2 knows about it because he overhears the gossip.

Before long, Dumass had already filed divorce papers and was waiting for wife #5 to-be to do the same, but that’s when trouble in ER paradise started. Nurse S comes in to work one morning and tells Dumass the hard news – she was having second thoughts. Suddenly, Dumass starts to have chest pain – you know the kind you get when you really want someone to feel sorry for you and give you that big hug you want so much and tell you everything’s going to be alright. But instead of calling in a replacement, Dumass decides to work himself up.

He goes and gets an EKG and Troponin heart enzyme done on himself. “Hmmm, looks like there might be some changes on this here EKG“, he says to himself. So he calls up the trusty cardiologist who tells him that he should get a stat echo. The echo ends up showing some wall abnormalities and is not conclusive (imagine that?). So the cardiologist tells him to high-tail it over to the cath lab. That’s when the proverbial crapola hits the fan.

Dumass tells Nurse S that he needs to get cathed … that indeed this might be their last moments together. The sappy soap opera romance is too much for her and she tells the charge nurse that she needs to clock out and take her dying beloved Dumass to the cath lab. There is no ER doc now and the chief of staff – a pathologist (autopsy doctor) – is called in to cover the ER. Must have been interesting for him to have his patients actually talk back to him.

At the end of it all, Dumass’s heart was perfectly fine – no blockages of any concern whatsoever. But folks over at admin weren’t exactly ready to throw the welcome back party for him. Instead they fired him for his Dumass behavior. He had taken this too far, and he put patient lives at risk. I actually thought he deserved an award for entertaining the hell out of the rest of us in the ER though, but decided I would keep that idea out of the suggestion box for now.

What lesson can we take from this story? I will quote a wonderful colleague of mine who once told me, “A doctor can be totally incompetent, but as long as patients like him, he will remain employed. But the moment he has sex with the wrong person or comes to work drunk or stoned, he’ll be fired in a heart-beat.” I guess Dr. Dumass can testify to this one.

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I’m Feeling a Little Anxious

May 31, 2009

A rare thing happened in my ER last week when two major traumas were brought in after what appears to have been a drug deal gone bad. I was not working when they came in, but got involved two days later when the prime attacker came into the ER for “anxiety and trouble sleeping“.

J tells me when I walk into the room, “You probably heard about what happened earlier this week right?” I had certainly heard bits and pieces from some of the nurses but never got the whole story so I told him I wasn’t sure what he meant. So he gave me his version.

Well, I was gettin together with some of my friends who were buyin some cocaine and other stuff from me when they started arguin with me and for no reason at all grabbed me and started poundin my head against the pavement. [perps always seem to be violent for no apparent reason at all don't they?] And then they pulled a shotgun and a knife on me. I tried to calm ‘em down but they were real angry [coke heads angry? nah, I don't believe you!] so I pulled out my knife and we scuffled and they ended up comin here to the ER and were flown out …”

What I knew had happened was that two people had come code three by two EMS units with “their intestines hanging out” from knife stab and cut wounds. They were stabilized rapidly and moved on via helicopter to the nearest trauma centers. The attacker, the one who was my patient presently, was unhurt and arrested. He had gone directly to jail but apparently was released on bail somehow so he could come and visit me. Police had searched his house and taken all of his drugs – an assortment of meth, cocaine, benzodiazepines, narcs and other drugs as well as weapons.  That left him in the precarious position of being unable to get high.

So I told him, “Sounds like you’re pretty skilled with a knife from what you’re saying.” He replied, Not really, it was all in self defense” [its always self defense isn't it?]. So he continues, “I just need something to help me sleep and to calm me down.”

I could understand. The guy was facing some serious jail time for attempted murder x 2, drug dealing, weapons charges and probably some other bad stuff – he couldn’t get high off of his supply and neither could his wife, who was apparently outside raising hell in the waiting room because she too was “anxious”.

And then his mom, who looked like she belonged in WWF, shows up. I guess you could say that he had some reasons to be anxious.

I didn’t buy into writing him any more drugs though and gave him a shot of Geodon to get him the hell away from our hospital. He may be anxious, but as they say, “you make the bed, you sleep in it.” I doubt he’ll be getting anything in jail to calm his nerves so might as well start getting use to it now right?

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