Saturday, July 19, 2008

Cantankerous Old Goat

I’m a nice guy. I really am. I may be foul mouthed but absolutely never with patients and even in the face of verbal assault and an insult to my mamma I remain the epitome of composure. When a patient gets mean with me I have a tendency to be so sickeningly sweet and nice to them that it makes my partner want to vomit while if the patient could hear the voice in my head they would hear a string of cuss words that would make a sailor cringe.

The other day I was called out for a male in his 60s with abdominal pain, after a five minute response we roll up to the house and see a man, wearing no shirt, standing by a car in the driveway. I grab some gloves and make my way to him to find the man is not wearing pants either. He is just standing there in his once-white tighey-whities, diaphoretic and looking like crap. My partner retrieves the stretcher and we place the patient on it and lay a sheet over him up to his chest to offer him some level of decency while we move him to the ambulance. I’m assessing the patient while my partner gets a set of vitals and I start an IV. This is when the fun begins. The patient lets out a disgusted sigh and says “.let’s just go already” and I explain that we aren’t going to spend more than 10 minutes on scene and that as soon as my partner gets up front that we will start moving toward the hospital. I had already asked the patient for his permission to start an IV and he granted it but when the needle penetrated his skin and he yanked his arm back while barking at me “Ow, that f*cking hurt!” I decided that given his rock solid level of stability and that my assessment leans toward thinking that this is more a case of lonely old man than an acute illness I again ask him if he would like me to start the IV or if he would like to defer it. He opts to defer by saying “well you obviously don’t know what the f*ck you’re doing.” I took a deep breath and thought of shiny, happy things and continued my assessment. When I got down to asking about recent bowel activity and dietary changes he looked up at me and informed me that I ask too many questions and that I should just do my job and drive him to the hospital. That blew it.

“Pull over and hand me the phone” I said to my partner.

“What are you doing? Why are we stopping?”

“Well sir, you’ve obviously made a mistake. It seems to me that you want a taxi and not an ambulance and given the great cost difference between the two and for the level of service that you demand I would think that a taxicab would be much more economical.”

“You’d better fucking learn to treat people with some respect young man! I’m the patient, you do what I say!”

“You sir, are the one who needs to learn some respect and understand that I have a job to do and that if you call 911 seeking my services I am going to do my job and that includes a whole hell of a lot more than just driving your miserable ass to the hospital. Now do you want my services or not?”

“Fine.” He grudgingly says as he thrusts his arm at me to start an IV.

Upon arrival at the ED I meet his daughter who asks me if he was difficult and proceeds to explain to me that he’s been a “cantankerous old goat” for the past few months.

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