A Night in the Emergency Department

Within minutes of my arrival at the Emergency Department a call comes in that an ambulance will arrive shortly transporting a man in cardiac arrest.  Orientation can wait.  Over the next 20 minutes he is given a regiment of drugs.  I follow him to a unit that will try to locate and destroy the clot in his heart.  In the next hour his heart stops four times while technicians put two femoral catheters in his legs and follow a dye through his blood stream.  Eventually they finish what they can do and ship him to the Cardiac Care Unit.  No one knows about permanent damage.  On my way back to the Emergency Department I pass a frantic looking woman with a cell phone.  She's just spied her teenage daughter running in and cries, "they say it's his heart and it's serious."  I don't make eye contact.

An older couple accompanies a woman on a stretcher with hematemesis and a severely distended abdomen into room 9.  She's legally blind and keeps asking if they are in the room.  The old man continually assures her with a soft "I'm here, mom."  I consider the overflowing landfills briefly as my non-latex glove count hits double digits in an hour.  Another bout of black vomit snaps me back to reality.  Mother Earth can take the hit tonight.  The nurse readies an NG tube while I wipe off the patient's chin with a warm wash cloth and tell her she looks pretty again.  She smiles.

Every time I walk past room 20 I hear a woman sobbing into the phone.  She was out celebrating tonight and a dozen margaritas later she woke up on a stretcher with a fractured tibia and fibula from tripping over a curb in a parking lot.  Somewhere between the bar and the hospital she's lost her purse, her clothes, and her self respect.  All she can do is apologize to her mother on the phone through sobbing breaths, over and over.

The hours pass by.  A 22 year old woman has an abscess under her eye; the doctor decides to drain it with a needle instead of a knife because he doesn't want to cut up a young girl's face.  A 27 year old male has a seizure because he stopped taking his medicine; he says his doctor never gave it to him.  A woman in room 10 watches hospital security put restraints on her husband so he doesn't roll off his stretcher or hurt someone.  An 84 year old man with dysphasia (he can't speak) watches in silent pain as a nurse tries to get an IV started for the third time.  An old man tells jokes to his wife and the assistant who is setting up for an EKG; the only interruption of his smile is every few minutes when he's curled up and clutching his chest in pain.

The Emergency Department showcases the extremes of the emotional spectrum - the best and the worst of human nature.  In one bed is a 27 year old female with cuts on her wrists who washed down all the pills in her medicine cabinet with a bottle of vodka - 20 hours later she wakes up long enough to ask to go to the bathroom and then passes back out.  Two rooms down is a man with Alzheimer's, cursing at the nurses for trying to remove his shirt.  His wife tells me that half the time he doesn't remember his name, but he always remembers how to swear.  She tells him she loves him as she calms him down.  They'll be together forever.

When I drive away from the ER that night Loveline is on the radio.  It's some girl complaining that her boyfriend doesn't try hard enough in bed.  The world's problems seem trivial.


I became an EMT last year and as a part of the course I had to work a twelve hour shift in the emergency department. I wrote this essay for the class, but it seemed like something to share here also. Read out of context it may sound like I didn't enjoy the night, but that was definitely not the case - I had a great time and learned a lot. I would definitely volunteer to work there again if they had the room.

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