A fine line indeed

It's hard not to see things from your own point of view after you've been constantly drilled to approach things from a specific perspective...the relationship between doctors and patients is often a fine line between love and hate.

Perspective. So a guy came in this morning to the ER. His history.
40 something year old man with a 4 day history of right sided flank pain and nausea. He was seen in the ER 4 days ago when the pain began and was found to have a kidney stone. He was sent home with pain medications and an appointment was made for further workup in the outpatient setting. Anyhow, it appears this morning the pain was no longer controlled by his vicodin. He starts yelling at me saying he wants immediate treatment. We offered to place stents as a temporary measure to alleviate his symptoms. The OR is booked, so a definitive treatment cannot be offered at this time, but stents can be placed as a temporary measure until we book his case in the OR. He went off about how he works in the health industry and that I'm full of shit. He demanded definitive treatment and would not sign a consent for stent placement. I had 5 minutes until I had to meet up with my team for morning rounds. Sorry buddy. No stents for you.

Patient's perspective. He has had excruciating pain for the last few days. Every time he comes to the ER, he has to wait 6-9 hours until he is seen. Even then, nothing is done and he is sent home until his pain and nausea gets out of control and he has to return to the ER. The doctors don't care enough to stay a little later to fit his case in because they need to go off and play golf.

I talked him down, but I don't think I'm going to have time to do that later in my career. There are many patients to be seen, none who are more important than any other person. It all depends on how you look at things. Patients can be really annoying. A lot of them have psych issues and have personality disorders, which make them hard to treat and require lots of time to work with. Some are downright stupid and do things that get them back into the hospital...things that people within reason would not do. Each patient on your list means 15-20 minutes of less sleep each night. After a month of sleeping 3-4 hours every night, some times I wish these patients would just piss off. Some patients just never get better and are stuck in the hospital. It sucks for them and for us.