Satan runs a Hospital: Warning way TMI

Before you read further be warned there is some really nasty medical info enclosed. I mean it is gross but it is nessacary for the rant.

So I woke up on Monday(8-14) and found that a fistula I had removed a year ago was reforming. I immediately called my doc to make an appointment to have it fixed because my last one was extremely painful. I quickest I coud get an appointment was for Thursday. I figured that if I took it really easy and laid down all the time it wouldn’t get too bad by the time I got to the appointment. The last time it took about a week to get an appointment.

Well, I was wrong. By Tuesday morning it had abcessed and swelled to about the size of half a golf ball. I couldn’t sitdown, I could barely walk. In fact about all I could do was curl up in a fetal position and whimper. I called my Dad to take my to the ER because I couldn’t stand the pain. Here is where the decent into hell begins.

I show up at the local Universities ER and signed in at about 11 AM. I fill out the forms and the do the standard blood pressure-heart rate-temprature thing. I then had to explain to a nurse what the problem was. I did and when she asked me what the pain was like on a scale of 1 to 10 I replied that it was about a 9.8. She told me to go to the waiting room and would get someone for me as soon as possible.

After trying to find the least painful way to sit or stand for about 20 minutes I finally went to a fairly hidden corner in the waiting room and laid down. About 15 minutes later a security gaurd came over and told me that I couldn’t lie down. I explained to him that I was in the ER because I couldn’t sitdown or stand without extreme pain. He didn’t give a shit. I then pointed out that there was no one else within view and that I wasn’t bugging anybody. He still didn’t give a shit. I then went up to the nurse who took my information and asked her if there was somewhere I could go. She said no and didn’t seem to give a shit either. So I told my Dad to wait for them to call for me and went outside and laid down in the grass strip in front of the building and waited. And waited and waited some more. Four hours later they finally called my name. Note, during that time I counted 8 people who came in after me get called before me.

So, after four hours they took me to a curtain area with a bed, gave me a gown and told me the doctor would be right with me. So I put on the gown and curled up on the bed whimpering and waiting for the doctor to show up. It turns out that ‘the doctor will be right in’ actually means ‘the doctor will be in in about 2 hours’.

The doctor, who said he was a resident, takes a look and probes a bit which cause me basically to scream. The doctor then tells me that he is going to have a nurse take some blood, give me some pain medication, start an anti-biotic IV and get a surgical consult. The nurse shows up 15 minutes later and takes the blood and starts the IV, says “I’ll be right back” and disappears. The nurse showed up about an hour later, checks the IV and wondered aloud why the doctor didn’t give me any pain medication. I told her that he said he was going to. She look on the chart, doesn’t see anything about pain medication and tells me she will go get him so I can get some relief. Well, the wonderful doc shows up about a half hour later, looks at the chart and then says “Oh, yeah, sorry I forgot the pain medication. I’ll have the nurse get you some right away”.

What the FUCK? You forgot it? How in the fuck could it slip your mind when you had the fucking chart in your hand while examining me? You FUCKING BASTARD. But wait it gets better.

The nurse comes by and shoots some pain medication into the IV which helps some. The surgeon doing the consult, I’ll call her surgeon #1, finally shows up about an hour later. She takes a look, tells me that I need to go to the OR. She then says something about talking to her attending to get me a bed after the operation.

A little while later surgeon #1 shows up with her attending, surgeon #2. Surgeon #2 takes a look, start probing a bit and then starts squeezing and tapping the abcess which has me screaming. She then tells surgeon #1 that they will do the procedure in the curtain area. She then tells a nurse to give me ‘10 of morphine’ and that they would be back in 20 minutes. The nurse disappears and doesn’t come back.

20 minutes later the surgeons come back and start setting up the equipment. Surgeon #2 asks me if the nurse, who was supposed to give me the serious pain medication, has come back. No,I tell her, the nurse hasn’t come back or given me anything. Anyway, they fiddle around for about 5 more minutes and then Surgeon #2 tells me that they are gong to start. I told her that I neeeded something for the pain, the morphine, a local, anything before they start. She replies, “Well, a local would only be a second needle” and jams the needle in and starts sucking out some of the puss and blood. I had to bite on the pillow to keep from screaming my head off. She then makes some cuts and starts jamming something in the cut to clear out the abcess. It felt like she was jamming a rusty railroad spike wrapped in barbed wire into my scrotum. About this time the nurse shows up with the morphine I was supposed to get before they started. The nurse had a “Oh Fuck” look on her face and says “Here’s the 10 of morphine he was supposed to get”. Surgeon #2 thinks about it for a second then says “He didn’t get 10 already?”. The nurse said no. Surgeon #2 then says “Well, ok, give him 5 now”. I scream for about 5 more minutes and they finally give me enough to stop me from screaming.

Dear surgeon #2, how in the fuck could you start a procedure without checking that the proper medication had been given? You are an attending and you don’t read charts? I told you, you incompetent bitch, the nurse hadn’t given me the medication. Did you think I was yelling and writhing in pain just for the hell of it? May you rot in hell you moronic slut.

Slee

I am assuming that you were in a teaching hospital-with your mention of residents and attendings. Without insult, I ask you, do you have health insurance?

What difference does that make?

I hope you don’t have a next time, but if you do…demand that they give you something for the pain before they do anything. Don’t let them touch you.

I am so sorry you were in pain for so long. I would definitely complain to the hospital about how you were treated.

How are you feeling now?

In the US, if you have health insurance, you have more choices in where you can go for healthcare.

For example, this past summer, Aaron had a bad cold. If he’d been uninsured, we’d have had to go to the local teaching hospital and taken our chances. (Incidentally, he was born at the local teaching hospital, but that’s because they specialize in high-risk deliveries and my OB felt I’d be better off there. He was right.)

Since he had insurance, we got to go to the local Children’s Hospital, where the ER docs are also pediatricians and where the hospital knows to look for pediatric diagnoses (they found that Aaron’s cold was caused by respiratory syncytial virus, which is a particularly nasty thing in very young babies, but which doesn’t bother adults.). The outcome, having him in the hospital overnight where he could have his nose suctioned and have the MD and nurses observe him for signs of worsening, beat the outcome we’d’ve gotten at the teaching hospital (why the hell are you bothering us for a cold?!).

So, if Sleestak has health insurance, he can go to a private hospital and receive better care.

Robin

God Damnit, I hate doctors. sleestak, I feel for you, but I hope I NEVER have to feel your pain.

Recently, some friends of the family took their father to the Cardiologist. They sat in the office for about two hours, went in, he looked him up and down, gave him the once over, and fifteen minutes later, they were out of the office. It cost them several THOUSAND DOLLARS!!!

I myself, over the summer, had to visit several doctors, and I can’t name the number of hours spent just fucking waiting in the goddamn waiting room, but it was NEVER six hours. What the fuck is the point of an ER if they’re just going to make you wait around that fucking long? The “E” in ER stands for “Emergency”, am I right? What type of emergency can generally allow for a patient to wait in a fucking lobby for six hours? I understand the whole “understaffed” thing, but still, there should be a value put on each visit, and those towards the top should get immediate assistance. Your wait wouldn’t have been so bad if they would have given you a quick look over, some pain meds, and then had you wait till they could get a better look at you. But to have someone sit there in pain for that long a period of time, and then to blatantly ignore the information you’d given them and then procede with such a fucking horribly painful procedure as that without so much as a bottle of whiskey…shit!

I know it kinda trivializes things, but it reminds me of an episode of ER where in the beginning of the episode, a guy asks to see a doctor and he’s told to wait. “We’ll be right with you.” Throughout the episode, he continues to approach various doctors and nurses seeking attention, but they all tell him to go wait, never looking at him or really paying him any notice. It’s not till the end of the episode that someone finally looks up from the desk and notices that this poor bastard who’d been waiting in their lobby for hours had a fucking arrow through his head!!! Suddenly, that story doesn’t sound so far fetched.

This may depend on where you live, too - I know of at least two or three “teaching hospitals” in my area that provide superb standards of care, comparable to or better than private hospitals here. And as you pointed out, some hospitals are specialized in particular problems (high risk deliveries, trauma, etc.). For instance, if I’m not mistaken the major trauma center in Chicago is Cook County Hospital, which is also a teaching hospital and the place where a lot of people with no insurance will go.

And then there was the episode of ER where the guy with the migraine tripped the fire alarm…

One thing I DO know-it doesn’t matter if people came after you. It isn’t who got there first-it’s whoever is more in need.

However, I that really sucks. (But um, what is a fistula?)

A collegues wife recently waited in the ER on a busy Saturday with a burst appendix. She waited only 20 minutes, yet woke up in horror an hour later when her anesthesiologist mis calculated a dosage which made her wake up during her procedure. I believe they are filing suit.

I sat for three hours in the ER after a mountain bike accident with two broken ribs and a broken collarbone. Not as painful as yours, slee, but still not fun. It seems like if there’s always such a wait, maybe they’d add more doctors (I know, it’s about the money).

DeniseV, I know teaching hospitals can be good, but I’ve also had too many bad experiences to really rely on them for more than their specialities. The hospital where I had Aaron was a teaching hospital, but one of its specialties is high-risk deliveries (as I mentioned), but also, my own OB closely followed me and did not allow residents to do much of anything.

At any rate, the ER thing definitely sucks. Doctors and nurses are overworked, people go there for problems that are really better treated in minor emergency clinic or the doctor’s office, and some insurance companies balk at paying. (Note to HMOs: The reason people go to ERs is because there’s sometimes an emergency!)

Robin

Morphine? Do they still use that stuff?

The resident prescribed medicine to prepare for a procedure then performed the procedure knowing that the medicine had not been dispensed? Call your local medical association (or the state association), get the complaint form and report it. It seems to me that what happened should be reviewed by the medical community.

Unfortunately, the term “emergency” really seems to refer to life-threatening, not to acute pain.

I actually went to a very good hospital when I got a bad break in my ankle (one of those long, jaggedy breaks; it required surgery). Sadly, it was on Saturday night, which is apparently a very bad time to go to the ER. I was promised pain medications many times, but nobody actually delivered on it. It was very painful when they decided to twist around my ankle to determine what was wrong.

I understand the wait for the x-rays and everything – they did explain that it was for a cardiac patient, and that is more serious – but why promise pain medications, only to not give them out? A few times, I had to send out my mom to find nurses to find out what was going on, and got the “Oh, sorry, I forgot. I’ll call [x doctor]” run-around.

Only when I was admitted to the hospital 5 hours later was I finally allowed to get drugs. As they were no longer twisting the leg around, nor was I sitting upright in the waiting room or having it flop around unsupported on an ER bed (despite my best efforts), the pain wasn’t so bad anymore so I ended up refusing.

I do have to appreciate the orthopedic surgeon coming in. When they finally contacted him, he came in that late Saturday night in the wee hours and did surgery early the next morning.

I just wish the ER’s were better organized or staffed so that people could at least get some drugs if they’re waiting there in pain.

Slee, you should write to the hospital and explain that a resident there performed a surgical procedure on you without pain medication, after having been informed that you had not yet received your pain medication. That’s utterly inexcusable - in fact, you may want a lawyer to help you write the letter.

You may also want to call your regular doctor and tell him the story - he may be able to raise a stink at the hospital more effectively than you can.

sleestak, if I ever make it through medical school I promise to try no to let that kind of shit happen when I’m around. I think that not relieving relievable pain and not being concerned about a patient screaming in pain is as bad as anything a doctor can do wrong. If someone doesn’t think someone suffering like that is an extremely big deal, then they should quit medicine and go into used car sales or something.

I also think every hospital should have someone with enough common sense and enough authority to keep the E.R. from being a gigantic clusterfuck. It’s not that hard to do.

Fortunately, we live in a rather small town with a nice hospital. The few times we’ve gone to the ER the wait has been minimal.

Ah yes, my favorite comment from a doctor -

“Did that hurt?”

“Yes, which is why I screamed when you did it. Let’s use that as a signal, shall we?”

Your mistake was to go somewhere to suffer where you wouldn’t bother anyone. The place to curl up and moan was the middle of the emergency room floor. Make no response to those who try to argue with you. Keep moaning. You will be examined, not in a jiffy, but faster than you were, if for no other reason than not to upset the other patients.

Was this a recto-vaginal fistula? And, more importantly, are you feeling any better?

Regards,
Shodan

Also, while something may be painful enough for you to chew your arm off, if it’s not life-threatening you’ll have to wait while the guy who was trying out his new power saw goes in before he dies of blood loss (ala Tim Tayler).

Well, yes I do have insurance. I went to that hospital because it was the closest. My Dad had a problem last year, he could barely get air and was in extreme pain, and went to a local private ER and got treated about as badly as I did as far as the waiting time went. The quality of care at the private ER is probably better. At the same time an ATTENDING SURGEON was the person who caused me so much pain by being an idiot. Attendings, at least to my understanding, are supposed to be the qualified Docs in the place.

I probably should file a complaint but probably won’t because, just to be honest, I am just glad it is over.

TMI Alert

Guinastasia, an anal fistula is an abnormal track or channel from the anus that opens onto the skin surrounding the anus. Anal fistula is most commonly associated with an abscess near the anus, which gives rise to pain in or around the anus that may be dull and throbbing.

Shodan, it was a rectal-anal fistual(I am not a doc but that sounds right. It was between the rectum and scrotum) that became abcessed. Hurt like a motherfucker. I am doing better now though I have to go in everyday for the next week or so to have them clean and repack the dressing. I went in today and it didn’t hurt at all, though that may be the percocet talking. I feel a whole lot better though I have to be careful on how I sit and walk so I don’t rip anything open. It makes going to the bathroom, well, interesting. I am also still running a slight fever and I am really tired due to the pain medication.

Also, everyone, thanks for the thoughts.

Slee

Slee, I know you’ve been through a lot, but this kind of attitude is the reason that incompetent dickwads like that surgeon can continue to practice. You don’t have to sue her if you don’t want, but please at least write to the hospital.

I’m glad you’re feeling better.