Shockingly, at about 4am, it appeared my wish was coming true.  No patients had registered to the ER in about an hour, and I had gotten all my work done.  I allowed myself the thought that had been floating around my subconscious since I had gotten to work, “Maybe I could lie down for a little while. . .”

Almost guiltily, I snuck off to the doctors room to close my eyes.  In about 1 minute I was soundly asleep, dreaming vividly.  In about 2 minutes, the phone was ringing.  “Dr. Evans, you have a new patient.”

Like some kind of zombie, I lurched back to the ER.  My skin blotchy, my hair at all kinds of crazy angles, and my brain on some other planet, I found the exam room and chart.

It was a man about 50, who reported that he was having trouble sleeping that night.  He went into excruciating detail about his uncomfortable bed, his strange dreams, and how tired he was.  I tried to be sympathetic, but in my mind, I was hitting him over the head with an oversized frying pan.

I ended up prescribing him some sleeping pills, and thought I might lay down again.  It never happened.  Another patient came in with a very bad heart attack.  That woke me up faster than 3 cups of coffee.

Oh If We Were Only Senators

Re:  Recent Bailout – a medical perspective and analogy, from a colleague.

To my fellow emergency physicians,

         Watching all the senators pat themselves on the back last night for coming together on this bailout gave me a little dyspepsia, so I had to throw together this medical analogy – one which I’m sure your medical side will appreciate:

          A middle aged male comes to the ER for increasing chest pains, has his cursory evaluation, following which he is sent home on stomach medicine.  This occurs several times over the course of many months.  He then comes back in with crushing chest pain and an obvious Heart Attack.  The physician now treats him with thousands of dollars worth of medications and he is flown to a nearby heart center for emergency bypass surgery, following which he survives – with many complications and a $300K bill.

          The physician’s partners congratulate him on a job well done and another life saved, but he should have been sued, had his medical license revoked and certainly should not have been paid for the visit. 

                Oh if we were only senators

The stock market stresses the heart and more

Q:

 

 

 

Can anxiety from the economic meltdown cause a heart attack?

A:

The fact that we are not seeing 1000 heart attacks per day probably means that this economic meltdown is not actually causing heart attacks directly. But are we seeing more anxiety problems and panic attacks? You bet! Any ER doctor will tell you that anxiety is a big component of our work, mostly because people get concerning symptoms with anxiety such as chest pain, trouble breathing, numbness, tingling, palpitations, and the like. It can actually be difficult sorting out which patients are just anxious and which ones have a true medical problem going on, and often times, some tests are in order.

I remember working in Los Angeles after the Northridge earthquake, and many people came in with severe anxiety, trouble sleeping, chest pain, etc. The financial problems going on right now are absolutely causing people stress, and we are seeing them in the ER regularly. I’m always happy when I can tell patients that their symptoms are not due to a major medical problem, but unfortunately it doesn’t do much for their financial woes.  I also feel that stress, in general, can cause long term health problems, if not managed appropriately.