By: Eric Devries, MD
It’s my constant inner monologue.
When I was a kid I hated mowing the lawn. It wasn’t the task; it was the noise. Noise has always put me on edge. My pager has to be on silent, otherwise it takes me back behind that mower 20 years ago.
I never find myself with enough time to see patients. “Hi my name is Eric DeVries. I’ll be your physician while you’re here today. I have a boss as well, they’ll come by and see you later on. What brings you in?”
By the end of that monologue I have one minute before my inner alarm starts going off.
“You’re not moving fast enough” I tell myself. I eye the constant stream of “sick” people moving past me while I interview my female patient with abdominal pain in the main hallway of our ED. My pager buzzing like an insect at my side with requests for I and D’s, laceration repairs and the continuous “did you get a chance to do that US IV yet?”
“Trauma team to trauma 1.” That’s our med resus call. Mid sentence with my current patient I have to interrupt: “I’m sorry, that call is for me. We’ll pick up with your abdominal pain when I can return.”
Not only did I not have enough time to fully interview my patient, who knows when I’ll be back. Off to trauma 1 where I find a patient who looks to be dying. She was a transfer, apparently, from an outside hospital. It appears she has ascending cholangitis. It also appears she has been severely under-resuscitated, unstable.
We give her antibiotics, we call surgery. GI isn’t going to come into the hospital—it’s late. She’s getting her 30 ml/kg of fluid. Pressors are started. She’s intubated.
It’s been 30 minutes. Was that fast enough? Does she deserve more time? Someone should call her husband. Do I really have more time to call her husband?
I make the decision to call. He picks up on the first ring. One hand on the phone, the other holding my forehead with my elbow on the table, I answer “This is Eric DeVries from Boston Medical Center. I’m one of the doctors in the Emergency Department. I’ve been taking care of your wife. You should really come back to Boston tonight.”
“But they said she’d be alright when I left. I live up in Milton. Are you sure I need to come back?” He pauses and then asks “…Did she finally stop shaking, that was scary.”
“She did stop shaking sir, yes. Please, you should come back.”
My pager goes off.
Resident Author: Eric Devries, MD
Faculty Review: Elizabeth Mitchell, MD