I have asked myself many times why some people wait till the moment before the break of dawn to have their most pressing issues resolved in the emergency department.
A 52-year-old male had come in by ambulance with difficulties breathing. The paramedic had also noted that, ‘the patient is known to have asthma and is on inhalers. All observations are fine’.
Yes, I admit there are also many times I wonder why paramedics decide to bring non-emergency cases to the emergency department for “assessment”. What more can be assessed if someone is fine?
When I ushered the patient into the cubicle I remembered how he gestured to his wife not to come in with him. But she ignored it and just walked right in.
‘What can I do for you?’ I asked the husband as he sat down on the chair.
‘I was having difficulties breathing tonight’
‘Yes, I read the ambulance triage sheet. How do you feel now?’
‘Better, I am not having breathing difficulties anymore. But doctor, can you please tell me why I am feeling this way?’
But instead he sat there, staring at the floor as if he would find the answers to the breathing difficulties he no longer had and where they came from.
I rolled my eyes. Yes! I rolled them way up to the ceiling and back at him again because he was not even looking at me, and neither was his wife. She sat practically facing the door, ready to leap out. I proceeded with more questions. The more I asked open ended question the longer it would take for him to give me a straight response, so I quickly reverted to questions that required a simple ‘yes’ or ‘no’ answer. It took me almost 6 minutes to get to the simple conclusion that he smoked despite his asthmatic condition. I felt the need to explain the effects of smoking. As I proceeded to elaborate on how smoking can exacerbate an asthma attack, he felt the need to remain silent, and, to my amazement, he had fallen asleep.
‘Why are you sleeping? Am I boring you’ I said in a raised tone. Even his wife startled and turned towards him.
‘Oh, sorry doctor. You see I have not slept in days.’
‘Yes, doctor, that is true,’ His wife confirmed. Speaking of sleep, I was so desperate to get out of the department and get some of it myself.
‘It is my wife….’ Long pause. Very long pause. ‘She is having an affair’
Well, I sure as hell did not see that coming. Daytime soap opera in the emergency department.
Soon a bickering match between husband and wife ensued. To my amazement, he had found his voice and started relaying all the events that led to the affair. He depicted in detail how when he was in the basement he could here her with her lover making love in the bed he brought. Her lover was a nobody in India, and since he had lost his shop she had made it very clear how she despised him. She would not even look at him, and that is why he found himself hiding away in the basement, abandoned by his own wife. The shame he had felt was incredible. He could not talk to family and friends about this because he would be laughed at. He had already lost his shop and now his wife was having an affair with a poor boy from India.
She turned on him, repeating and confirming everything he said and looked at me as if I would take her side.
I just sat there and listened as both husband and wife conversed with each other. I think something good did come out of this. There was some form of communication established between the two and for that second they must have felt like a married couple again. And I unintentionally became a marriage counselor
Sabine Fonderson MD is an emergency medicine doctor in Scotland. She is passionate about writing and is a freelance editor and content author for blogs and medical startups. Sabine is author of Unbelievable stories from the emergency department, published in May 2016. She writes about her experiences as an ER doctor on her website www.sabinefonderson.com There you can also read how she has found creativity and flexibility in her professional life.