Saturday, September 26, 2009

A Chief Complaint with no Easy Fix

Chief complaint - back pain. In fast track it’s a fairly common, slightly irritating (if the person is a known drug seeker) but mostly benign chief complaint. Not last night. I picked up a chart from triage and read that the patient was a 27 year old woman presenting with back pain. On first look she appeared to be quite well – there weren’t any exaggerated displays of agony, her gait was steady and unremarkable and she denied any parasthesias.

“So what is it that we can do for you?” I eventually asked.

“I need a referral to a plastic surgeon for breast reduction surgery because my back hurts. And if I can get it done this week, it’ll give me enough recovery time to wear a strapless gown on my wedding”.

Shocked and mildly amused at having to ‘work up’ this patient, I just had to ask why she chose 0400 to come into an ER to ask for a plastic surgeon for an obvious non-emergency.

“Umm hello, wedding” she told me in a tone that suggested that I was not only an idiot for asking something so obvious, but that I should lose my license for failing to grasp a fundamental truth about the importance of being able to fashionably wear a strapless gown on one’s wedding day.
In the end, things took their expected course. She was sent away because we could not provide the care she was seeking. She was visibly upset at not being referred to a plastic surgeon right away (they like to sleep at 0400) and left with well vocalized thoughts of malice for us all.

Notwithstanding the behemoth that is the wedding industrial complex or the frenzied feelings of insecurity about one’s looks in a world where one’s every movement can be photographed (from every imaginable and unflattering angle) and be posted on facebook within minutes, I still think trekking it out on a cold night to go to an ER in a hospital whose specialty is oncology and cardiology to ask for a plastic surgeon is bordering on downright irrational.

Despite the fact that she was a complete bitch to me, a part of me sympathizes with her. I know I’ve spent an entire day getting my hair and nails done for a casual get together and bought an insanely expensive item of clothing to try to silence my own inner critic. She too is trying to achieve her vision of perfection but I do hope she wakes up out of her wedding induced fog and pursues breast reduction surgery to enhance the quality of her life as opposed to quality of her photographs.


Anonymous said...

Not to sound sexist (OK, it is sexist), but I would hope she gets her surgery, then finds out her new hubby just LOVES big boobies, and married her for same.....

S3XinthePantry said...

She had no clue - 4am assessment by specialist (non emergency) - and reduction surgery with in the week?

Sorry you had to deal with the verbal abuse!

LivingDeadNurse said...

wow...she must have just come up with that idea...lying in bed sits up..hmm lets rush to the ER to get my boobs reduced so that i look great in a 911

good grief

baxter said...

Yeah - like anything is going to change as long as the media prioritizes looks and spending mega millions...and altho we all laugh at Bridezilla....apparently there is no lack of idiots that want to be on that program!!!

CxJvak said...

But wait, this breast surgery for a wedding IS an emergency!

William said...

You could have suggested that she see a neurologist for a cerebral augmentation...

PS- Check out your fellow Canadian at "Asystole Is The Most Stable Rhythm".

You two remind me of each other.