No Sedation, No Pain

10 03 2010

Alchemist is up late blogging in the name of Alchemist threadworks when he should be sleeping, but that was a heinously busy ER shift, and I need to decompress.

Had a guy come in from deep in the Canyon with a bad ankle.  He looked like an uglier, dirtier version of Jon Bon Jovi.  He had apparently kicked the wall out of anger, and the wall won.  My first thought was that he was a drunk a**hole with a potty mouth and a bad attitude.  He blew a .07, which qualified him to legally drive a motorized vehicle.  Okay, so he was a reasonably sober a**hole with a potty mouth and a bad attitude.  After I had to yell at him to stay in bed a few times, we got security to keep a closer watch on him.  He still insisted on trying to get up and walk.  The x-ray showed that he had a bad fracture/dislocation of his ankle, and it gave me no small pleasure tell him it was time to turn off his lights and yank that baby back into place.   He declined an IV.  In fact, he declined any medications.

“Just tug on it.”
“Seriously?”
“Yeah, just do it.”
“No way. You have no idea how bad this is gonna hurt.”
“I ain’t afraid.  Just put it back.”
“You don’t want me to give you anything?”
“Nope, get on with it.”
“Well . . . okay, but don’t kick me.”
“I’m okay, I got my teeth in.”
So I tugged.  And he adjusted his dentures and bit on his shirt.  I tugged some more.  I got my foot up on the stretcher and pulled til my veins popped in my head. It still wouldn’t go in.
“I don’t think it’s going back in.”
“You aren’t pulling hard enough.”
“I’m pulling as hard as I can.
“Don’t be a p*ssy.”
“Dude, I’m not being a p*ssy.”
“Then pull on it.”
“Okay, but you are tensing up.  You need to relax.”
So he took the shirt out of his mouth and gave me a big grin.  I pulled.  He grinned.  I pulled harder.  He grinned wider.  Finally, I felt a little movement and then, CLUNK.  It was in.
“Atta boy.”
I told him he was one tough hombre.  And he was.
In the end, I couldn’t help but like the guy a bit.  I liked him more than many of my other patients.  He told me he had to go to his construction job on Thursday.  I told him no way.  I know he won’t listen, but I imagine he’ll figure it out after this ankle crumbles under him.  Kudos to him for actually having a job.  Maybe he was a more upstanding citizen than I gave him credit for.  But I still was kinda stingy on the narcs.  I had a suspicion he would either use them for recreation or sell them.  Yet, he was alright by me.  Saved a hell of a lot of sedation paperwork too.
Moral of the story:  Never judge a hillbilly by his pseudo-drunkenness.
Still waiting for product to come in.  If it’s not too much trouble, become a follower of this blog, and tell all your friends too.  As always, you can check out the Alchemist Threadworks website at http://www.AlchemistThreadworks.com.
Thanks.
-jeff
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3 responses

10 03 2010
KK

That dude with the dislocated ankle was too funny. I LOL'd when I read the part about "Don't be a p*ssy" "Dude, I'm not being a p*ssy" — I can totally see that conversation going down.I was removing a mass on someone's eyelid last week and he didn't want anesthesia either. So I said, "Don't move because you may end up with a blade in your eye. OK, are you ready? One… two… [then I snipped and removed the mass] OK, you are done." "But you never got to three.""Oh, yeah, an ER doc taught me that trick.""Thank the ER doctor for me.""OK, I will."So thanks Wu.alchemistthreadworks.com

11 03 2010
DPJakes

Loving this blog! Glad to see I'm not the only one to pre-judge dirty rednecks (or the whole gamut of unwashed masses that {sometimes} pay our wages).

28 03 2010
Vivienne

Forget t-shirts, Jeff. You need to write a book. Seriously. You need to blitz the internet and get a billion followers and then sign a book deal. Your writing is awesome!




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