Some People Have Nine Lives Too

July 12, 2009
Medical Cynicism 101

Medical Cynicism 101

I remember someone giving me a book to read called The House of God when I was in medical school. I imagine that a lot of you have read this book as well. I thought that it would have been a better book had it not digressed so much into sex and I never really finished it for that reason. Looking back now at the some of the book’s ideas, especially that of the GOMER, a lot of it really rings true.

There are certain people that come to the ER that seem to command little to no empathy from all ER staff. They go by different names but they seem to make their way to all ER’s irregardless. They just don’t die, no matter what they – or someone else – does to them. They survive such extreme conditions that would kill even the most hardened average person a long time ago. And they just keep on ticking away.

I saw one such person in the ER this weekend. A staffer at the ED told me that he knew him well as he used to see him regularly when he owned a liquor store. The guy apparently had 6 kids with 6 different women (another f#^&er setting up franchises I noted), and was clearly proud of it when I asked him. This time, he was driving his motorcycle at about 100 MPH down the highway, weaving in and out of traffic, until he lost control. His bike slammed into the median strip ditch at this insane speed and he went flying into a field where he landed on his back. Of course, he wasn’t wearing a helmet. Would you or I have survived an accident like this? No. We would have died when the bike hit the ditch or even before that maybe. Did it kill him though? Not even close. He ended up with a broken collar-bone and first rib. He went home after a short observation period in the hospital.

Or not so long ago, when I saw a raging @$$hole in the ER demanding that I give him a prescription for ritalin. I had already looked into this guy’s long list of abuse (cocaine, meth, alcohol, narcotics, benzos, etc.) as well as the previous notes describing his charmingly prickish personality and habit of physically attacking those who disagree with him.  So, I explained to him as politely as I could (while maintaining a safe distance) that this was not something that we ever did and that he needed to speak to his doctor if he felt he should be on it. He threatened me and used enough profanity to make someone from the Sopranos blush, and then left the ER.

He was so angry at so many people that he decided that enough was enough and he was going to die. He took an overdose of someone else’s Vicodin and Xanax and locked himself in his room at the house he was staying at.

An hour later, one of his house mates came to check on him because he was “unusually quiet”.  No answer and so he broke down the door only to find his “friend” lying facedown on the floor with two empty pill bottles near-by. He tried to wake him up and then called EMS. They arrived within 5 minutes – 5 minutes where no one was doing any CPR on this 37 year old man. He had to have been dead for at least 30 minutes before EMS even layed hands on him. They worked him for 15 minutes with nothing and brought him back to me.

In the ER, we worked him for another 20 minutes and just before I called time of death, wouldn’t you know it – his heart started beating again. I really don’t know what happened to him eventually, but how could a man who has been totally dead for at least 30 solid minutes to one hour get anything back is beyond me.

If it was some kid who had drowned in a pool and was given CPR by mom and then brought to us he would have been dead of course. Its the people that seem to be the most vile that survive. The ones that you hope make it are never the ones that do make it. Their stories are tragic. As for these people, I honestly believe that they are anaerobes like bacteria.

They seem to actually thrive when they don’t have oxygen or other elements essential to life for the rest of us. They fall off a building and the next day they are walking out of the hospital after they have drained the life out of everyone they have come into contact with – which may in fact be their secret. Maybe there is some truth to Vampires after all?

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