Not Only a River in Egypt

My patient was a thirty-something-year-old woman complaining of sudden onset of crampy abdominal pain—a condition for which the lengthy differential diagnosis runs from “nothing-burger” to life-threatening. Often a challenge, even for a seasoned ER doc. On entering the cubicle, I found the patient supine with the head of the bed raised about 20 degrees; she felt most comfortable in that posture. Although not in severe distress, she appeared anxious; worse when a wave of pain traversed her lower abdomen. She …

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Of Cadillacs and Throwing Stars

Once upon a time, in the mid-eighties, luxury automobiles sported fancy hood ornaments at the crown of their long front ends. (I’ll leave the interpretation of that custom to my psychology friends.) Here’s an example from the hood of a 1983-ish Cadillac: These ornaments were not fixed to the hood, but attached via a wire thingy that allowed them to flop flat when needed, for instance in an automated car wash. Sometimes they suffered damage from general use or vandalism: …

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“Time Is Life”

Eight hours into a hectic 12-hour solo-coverage day shift in our community hospital ER, I finally got the chance for a lunch break. I hustled to the hospital’s food court, bought two slices of pepperoni pizza to go, and hurried back to the ER lounge where I popped open a Diet Coke, took a big swig, then dove into the pizza. The head nurse appeared at the door just as I finished the first slice. “Chest pain in One.” I …

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Reflections on “St. Elsewhere”

This Emergency Department scene from the early 1980s’ TV show, “St. Elsewhere” recalls similar scenes from the Phoenix hospital where I practiced emergency medicine. Although we had nobody the stature of Denzel Washington or Ed Begley, Jr., we experienced similar dramas and challenges as depicted in that iconic TV drama. Back then, I had neither the time nor interest to watch more than a partial episode. I was a full-time emergency physician and spent my leisure time in non-work-related activities. …

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