Are ER’s Bad for Staying Alive? Maybe!

Right after reading about The Pitt – here’s link to the Trailer – I received a note from a friend who told me about her recent visit to the ER with her elderly sister. She writes: “It is interesting to see how the ER is now the place where illnesses are diagnosed. The doctors seem to have quick access to the tests along with technicians and doctors to read the tests. On one hand, there is excellent fast care available, but from my experience this care is too often provided by employees that need less burdensome work loads.”

With the help of her primary care doctor, I finally convinced my sister who was suffering with extreme fatigue, shortness of breath, and dizziness, to go to the hospital ER. The doctors examined her and thought she probably had an internal bleed but the diagnosis could not be confirmed until after a full GI series – both top and bottom.

What struck me most about this experience was that four young doctors (residents wearing 3 different colors of uniforms) came to visit me and my sister – two old, exhausted ladies (one in a hospital gown) – to get permission for treatment. I also noted that the other team – the cardiac/thoracic team – the guys that actually make the final decision about treatment were not there to weigh in. So why weren’t they there at figuring this all out instead of the 4 young doctors from the gastro team?

There were at least 3-4 blood tests, two ultra sounds of her chest, an EKG, cat scans, and x-rays to locate the cause of the symptoms. The symptoms were developed suddenly: breathlessness (having to stop to catch her breath every few steps). She was finally diagnosed with anemia and not the everyday anemia but serious stuff that could result in dizziness, extreme fatigue, falling, etc. So they dug further. They asked the same questions about blood in the stool, color of the stool, hemorrhoids and any supplements she might take. The doctors finally agreed it was internal bleeding but the diagnosis could not be confirmed without an endoscopy and a colonoscopy and that would take a couple of days.

We entered the ER at 3:30 PM. I finally left at 11 PM. My sister had agreed to a blood transfusion and that began once they found a room about 2 AM. So within 12-18 hours she was in a room and beginning treatment of the symptoms.

Another odd thing I noticed is that when the doctors reach a diagnosis and they need your consent for treatment, they turn on the charm and list all the positive outcomes. We, the patient and/or caregiver, become convinced because it all seems plausible and we want a good outcome. Some of this behavior may be rooted in the fact that for some odd reason we are looking for the doctor’s approval. But be aware that it’s really important to ask for information about the risks and the bad things that might happen so you can make a better decision.