I strode down to the ER, trying not to get lost in the catacombs of hallways, despite having been in this hospital for months. Lack of spatial skills ruled out radiology as a specialty for me pretty damned quickly. Being the middle of the night, the patient had the sheet pulled over her head trying to shut out all the noise and intrusions of a busy ER. Gently as I could, I awoke the patient and was greeted by the equivalent of this lady in the video below, only instead of an African Americam lady, mine was a rural Caucasian lady. In all honesty, when people are sick, I tend to find the commonalities of what it means to be human be far more important than cultural differences.
Her raw honesty and spunky character perked me up from lack of sleep right away. Small and bent over with skin the texture of leather, she had a toughness that bespoke a very, very hard life. I began with the simple questions of a full history. It got interesting about time for the social history.
"You married, single, divorced?"
"Heh-heh, there be a good story if I wasn't in such bad pain."
"So let me guess, divorced then?"
"Yup," she said still chuckling.
"How much alcohol do you drink?"
"Oh just one now and then."
"Come on Miss Smith, do I look like a young and naïve doc to you? Now how about the real amount?"
She laughed despite her abdominal pain and answered, "You funny. About a six pack a day. And that's the truth." I noted it and she interjected, "don't be writing that down, honey! Lord, Jesus, you gonna be thinking me an al-key-holic."
"Now come on ma'am. Does it look like I'm gonna judge you? I'm here to help you."
"Well, doc, then you gotta do sumpthin' about this pain. Lord, Jesus, I'm about to go down to the gift store and get me some Tylenol! Sweet baby Jesus, I got the flu and it hurts" Nevermind it was 3 am and the gift shop had long been closed, but I believed her. She really would climb out of that bed and start wandering around looking for the gift store to get some Tylenol. I did not doubt her for a minute. She had a gritty determination that I could not help but admire.
"Well, ma'am, your flu test came back negative and according to the CT, the reason you're in such bad pain is you have a pretty bad case of divertilitis."
"What? Nah, you're test be wrong. I ain't got no whatchamacallit, that whatever-itis. Baby, let me tell you, it's the flu. I've had the flu before and it's the flu."
Round and round we went, with me trying to explain diverticulitis and her trying to convince me it was the flu. So rather than argue, I asked her to trust me, which she reluctantly but finally did. I think that simply by listening to her, truly listening, I had earned her trust, which was not a quick thing for her to give out given her past incidences in life. And I validated her trust by getting her some pain meds ASAP. And after she got her pain meds, she was the sweetest, most appreciative patient in the world.
As I write this, I think of my own pain. Of when it hurts so bad, all you want to do is to make it stop. You don't care what anyone else thinks. You want it to stop and when determined, you'll do anything to make it stop. She also reminds me that, when lost in your own pain, it's easy to forget that everyone has their demons. Granted, some people may experience less than others, but to the individual, that doesn't matter. Pain is pain. And as a both a doctor and human being, it's best to honor that person's pain.