Your Brain on Drugs

The following is the shift report I gave to the oncoming nurse who took over for me tonight in my esteemed and ever-classy place of employment… first patient: a kid in his twenties who came in because the pain medication his primary doctor prescribed him after surgery was “insufficient” by his standards. He tells me he is allergic to Tylenol and is therefore unable to take it for his post-operative pain lest he break out in a full-body rash and experience complete, unadulterated anaphylaxis. He is instead requesting a prescription for Percocet (which is a combination painkiller comprised of Oxycodone and yep you guessed it, Tylenol). According to the young pharmacology neophyte, Tylenol will literally kill him, yet Percocet apparently causes neither his skin nor his throat any adverse reactions… defying both science and logic. Second patient: a gentleman who came in after an episode of severe mid-sternal chest pain radiating to his jaw and left arm. Upon arrival, his coronary arteries are literally becoming more occluded by the minute while he experiences what we call a “heart attack”. I inform the physician of his EKG, which looks like the most ominous combination of squiggly lines. The plan is to transport him promptly to the cardiac catheterization lab, where he will undergo an invasive diagnostic procedure. While we await transport, I explain to him the risks of the procedure and read him a written consent full of fine print and legal minutiae. He responds by looking me dead in the eye and asking why the hospital no longer carries Coke cans since his last visit. I explain to him that we’ve discontinued Coca-Cola in a hospital-wide health initiative to combat “sugar attacks” (which for some reason is an inner-city term for diabetes exacerbations). I briefly contemplate rolling my eyes and hand him the consent. He sneezes on my pen, drops the consent on the ground, and asks if he can have a cheeseburger while he’s waiting to go to his “heart attack operation”. I walk out of the room, speechless. Third patient: an extravagantly intoxicated gentleman who was found and brought in by the city police after suffering a large laceration to his forehead. He obtained this wound by falling face-first in a parking lot while trying to eat an old container of Chinese food out of a dumpster. He is wearing two different shoes and admits to drinking “12 beers”. One of the cops, in an effort to be helpful, asks the man his name which elicits a response of “Fraggle Rock”. The officer walks out of the room, muttering something about “no pension is worth this nonsense”. Fourth patient: a large man who was wheeled into the room by county cops, already handcuffed to the stretcher, who had been fleeing the law and in a brief and shining moment of brilliance, had decided to eat the evidence (a crack rock) so as not to be implicated on drug possession charges. He ate a fucking crack rock. The cops arrest him anyway on the grounds that possession is still nine-tenths of the law, even in your intestines. He is arraigned at the bedside with a heart rate just a few beats shy of 200 per minute, pumping blood through a body that looks like it has never set foot on a treadmill. Fifth patient: a pleasantly confused gentleman who had been brought in by city police after he was found smoking PCP in a local park and arguing incessantly with a tree. He becomes singularly focused on leaving the Emergency Department around 5:45pm, appealing to anyone within earshot that he needs to leave promptly at 6pm in order to be on time for his “poetry meeting”. Within five minutes, our very pregnant and disgruntled ED doctor approaches him and states that if he can recite 3 original poems for her, then he can be discharged. He finally admits that he is many things, none of which comes close to a poet, and that he needs to make it home before his wife arrives so he can “start cooking so she won’t know I was in the park smoking wet”. Brilliant plan. For clarification purposes for those who function at a normal level in society, “wet” is essentially a marijuana cigarette dipped in PCP and/or embalming fluids, which escalates your level of intoxication from “I really want to dip a Crunchwrap Supreme in some peanut butter and chase it with a milkshake right now” to “there are tree-people watching my house while I sleep and I believe the only solution is to light the entire city on fire and then run naked through the streets while singing the National Anthem”. And that, my friends, is your brain on drugs.