Crozet Annals of Medicine: A Night in The Life

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The damp streets of Charlottesville are quiet at 11 pm as I drive in to begin my ER shift. Lightning splits the dark sky and illuminates ominous thunderheads.

Three cop cars are parked in front of the ER. I walk in through a waiting room full of the tired, the poor, the huddled masses yearning for free medical care. As I put on my white coat, an overhead page calls for security to bed 34 “Stat.” A show of force quiets the unruly patient and I settle in to take sign-out from my colleague.

It is Saturday night in the ER.

I inherit a typical patient load, a GSW (gun shot wound) to the face, multiple MVA’s (motor vehicle accidents), a peds vs auto (pedestrian stuck by a car), chronic abdominal pains, intoxicated regulars, suicidal regulars, sick kids, sick adults.

I have a great team on with me tonight. Experienced nurses, bright residents, willing medical students. By virtue of training and inclination, we are happiest in the ED in the midst of trauma, chaos and illness, and Saturday night is a distillation of all of that.

An eager but inexperienced intern presents the first new patient of the night, a sad and moving case of domestic abuse with multiple facial bruises evident. The case quickly turns bizarre when I see the patient and gently wipe off her “bruises” with a damp piece of gauze. Call psych. It is Saturday night in the ER.

We move on. Noses bleed, gums bleed, brains bleed. Toothaches throb, houses catch on fire, little old ladies fall down and can’t get up. Little old men get confused when the sun goes down. Widows get lonely. Kids wake up in the middle of the night crying. Outside hospitals call to transfer problem patients. It is Saturday night in the ER.

A young man is stabbed in the back at a party. He doesn’t know who did it or why, but he is supremely unconcerned. Call trauma. I spend an hour catching up with the happenings of the night as seen through the eyes of the cops.

And finally my night is complete. A 27-year-old male arrives at 0500 to report difficulty sleeping.

I walk outside to see the warm dawn coming, the sky overhead clearing. It is Sunday morning and I am going home to bed. Sleep well, Charlottesville.

Have a question for Doctor Reiser? Email [email protected] and we’ll send it his way.

Dear Dr. Reiser,

I remember your article of several months ago cautioning that a little learning is a dangerous thing, and that information from the Internet does not always serve patients well. Is the same reasoning behind doctors’ not letting patients see their own charts? Noticing how careful doctors and staff are about removing the folders from examining rooms these days, I wonder, does it take a Freedom of Information action to have access to one’s records, or is a request enough?

Your devoted reader,

Cecilia Chandler
Crozet

Well CeCe, it is a fine line. Patients have the right to request the information in their own medical records, but you might find that your doctor describes you in strictly medical terms as morbidly obese and appearing older than your stated age. These may be accurate (not in your case, I am sure) and important observations regarding your health status, but they may not foster the most therapeutic doctor-patient bond. So doctors are habitually a little circumspect about allowing lay access to medical records. But if you really want to know what is in there, go ahead and ask to see your records. It is allowed, if not recommended.