Hump Day

The main qualifications for working in the Emergency Department in our current day and age include splitting your time and attention between people who are unfathomably intoxicated and people who are convinced they have Coronavirus. Sprinkle in a handful of heroin OD’s and the occasional victim of gang violence and it all comes together to produce quite a stressful Wednesday afternoon. On one such hump day, I found myself leaving the time clock and coming face to face with an interesting patient load, the first of whom was a chronic alcoholic who looked roughly thirty years older than his alleged age of 48. He reeked of stale cigars and Keystone Light and his long, unkempt beard looked like it was full of regrets. He had checked in for “witnessed seizure” but was refusing to corroborate the full story. Upon further questioning, he admitted that the seizure had been “witnessed” by his dog. Excellent. On to my next patient, an obese, middle-aged black lady whose family had called 911 for “altered mental status” when they were unable to arouse her for dinner. The medics dropped her off in my empty room as EMS handed us roughly six different bottles of prescription medications… evidently the patient had a history of chasing her Percocet with Moscato every afternoon during Family Feud. As we rolled her on her side, I noticed the resident pull an object out from underneath her. Evidently her remote control had been wedged between her ass cheeks. He handed it to me and casually said “we should give this back to her when she leaves. I hate it when I lose my remote control”. I rolled my eyes and placed it with the rest of her belongings but was quickly interrupted by a 65-year old “CPR in progress” being rolled into my last open room by paramedics. Numerous medical staff assembled at the bedside, preparing all of the essentials for a “code blue”. The two procedural intubation medications were drawn up, Etomidate for sedation and Succinylcholine for paralysis. A young nurse who was newly off orientation had each medication in hand and was standing off to the side, looking puzzled. She finally called out the mnemonic phrase utilized for remembering the order in which to give the intubation meds. An entire room full of medical staff looked on in horror as she yelled “DATE BEFORE YOU SUCK” (Etomidate before Sux). The attending physician cringed as Lisa the Loudmouth pushed the medications and the patient’s airway was taken. After eight rounds of CPR and various attempts at interventions, the ED doc made the decision to call the code. We all stood for a moment of silence (even the novice nurse with the underdeveloped social skills) and then prepared the body for the morgue. As my partner and I removed the patient’s clothing in preparation for the body bag, we noticed something cold in between his legs. Upon removing his layers, we discovered that his family had shoved an entire frozen Cornish game hen in his pants in a misguided attempt at “cooling him off” after he had “fallen out”. Evidently he had a well-established history of heroin use and would frequently overdose, which resulted in many a cold shower by proxy and apparently the occasional foray into frozen poultry. I made a mental note to tell our community nursing program to educate our drug-abusing patients about the majesty of Narcan in lieu of holiday dinner entrees as I was interrupted by my intoxicated hallbed patient handing me a microwaveable deep dish pizza that he had evidently brought with him. As he asked me to heat it up for him, I realized I probably should have known from the moment he walked in with three full suitcases that the hospital was his home now. Onto my final patient, a man in his early thirties who had checked in for groin pain after having sex earlier in the day. I walked in just as the surgical resident was explaining that his imaging showed a “penile fracture” and he would need to go urgently to the Operating Room. His girlfriend started bawling dramatically as if she had just realized he unsuccessfully dodged the 1940 draft into World War II. I rolled my eyes and thought to myself that if I were this chick, I would be running up and down the halls, high-fiving strangers and bragging about my dick-shattering sexual prowess. As I wheeled my patient up to the OR and attempted to make small talk (turns out the weather forecast isn’t all that interesting when your manhood is literally shattered) I decided to keep it light and wisely remarked “congratulations on a Hump Day to remember”. The anesthesiologist glared at me as I made my way back downstairs to the ED, reiterating our unit’s reputation as a bunch of slovenly medical rule-breakers, and proud of the fact that despite my best efforts I still hadn’t made the most inappropriate comment of the day. That gold medal went to Lisa for her reminder to all of us to always date before you suck.