What I saw in the Emergency Room

Published: November 3, 2011

When I was told that my next 12-hour shift is going to be in the Accident and Emergency department, I was a little too excited.

I have grown up watching “ER” and later “House MD” because medicine in every form has never failed to captivate me. George Clooney looked like a Greek god in blue scrubs while running for surgeries in ER. So when I, a doctor was told that my next 12-hour shift is going to be in the Accident and Emergency department, I was a little too excited and scared.

Patting myself on the back, I reassured myself that it was extremely wise to be trained in major and minor emergencies because we live in an emergency hub. I told myself it was nothing to worry about – I would do just fine.

On my way to Lady Reading Hospital’s casualty ward my heart did a weird flip-flop when I reached a dilapidated building that seemed to howl:

“I am about to die, rescue me.”

Since it was my first time, I was asked to observe and that I did. Sure ‘medical casualty’ is all about serious patients but it has it’s perks too and these are the five kinds of patients that you will usually find in that busy “A and E” department.

The functional patients

Unconscious but vitally stable, this patient is usually a mentally disturbed young boy or a girl craving for some good old attention. We examine them properly, exclude any serious cause and then stuff a cotton soaked in ammonia up their noses after which they promptly regain consciousness, sit straight and cry for mommy dearest. Their hospital note usually reads “referred to psychiatry for further evaluation.” If you ever hear a doctor say, “you are functional”, be warned. In all probability they mean you are a “psych case.”

The meat-eaters

Overweight and most probably food connoisseurs, they are fond of meat at Namak Mandi so they eat as much as they can, get heartburn and epigastric pain the next day and come to the ER for rescue. If you don’t give them instant attention, all hell breaks loose and the advice to eat less, walk more and keep their weight in check goes in one ear and out the other – lost for good until the next episode of heartburn.

The hypochondriacs 

They are young, google-educated, nervous and extremely conscious about their health. They know about more diseases than a doctor and can put them to shame easily with their knowledge. You will find them rushing to the ER as soon as they feel a flicker of pain in their chest thinking it’s a heart attack. They want full work-up, even the laboratory tests that have not yet made it to Pakistan, round the clock attention and a heavy dose of counselling and the next time you see them, they will have researched another disease and presented with the symptoms of that.

The drug addicts

Lonely, miserable, haggard, and malnourished they come to the ER when they have no money for drugs and are in withdrawal. A painkiller injection – one or too many is all they want.

The perverts

They are hunters and roam around in the A and E department in search of a lady doctor just so she can check their pulse, temperature and blood-pressure. When I came across one, my experienced senior doctor told him to wait outside and that he is coming to check him after which the pervert immediately left the hospital premises complaining that he only wanted a lady doctor. Amazing, I know.

Bushra Maheen Rahman

Bushra Maheen Rahman

A doctor from Peshawar who writes, blogs at www.pistaye.wordpress and tweets @MaheenRahman

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Bushra Rahman

    Wed Editors:

    Thank you for publishing this. There is one minor correction, however. I am not a med-student now. I work as a doctor in LRH.Recommend

  • http://www.salmanlatif.wordpress.com Salman Latif

    Lol! Awesome one.
    During my mobile camps to south-punjab some time ago, I also realized that a large number of rural women would fall in the same category that you defined as hypochondrias – only, they don’t have any medical knowledge yet they can tell a hundred health issues that they have at any given time :DRecommend

  • http://iblees.wordpress.com/ Haseeb Asif

    mister express sir i would like uncover this womans deception she is only low nurse not doctor in reading lady hospital and nobody ask her to check there pulse becaus she threats all patientRecommend

  • marium

    I totally agree with you .. i worked for 3 months in emergency and i have to say more than 50% of patients are either functional or pervs … They are the ones (and their families ) who take most of your time and energy …. its actually more important to learn how to deal with this sort than dealing real emergencies at least for a female doctor Recommend

  • troll

    Oh so you are trying to tell us you are a doctorRecommend

  • Dr.jobless

    A and E has all of them, sure. But it also has serious patients. those who have met RTAs, just had an MI or maybe a stroke. Pulmonary embolism, DKA, opiod poisoning and more than any of all you or I have mentioned, you have gastro. No, Seriously.
    You write well. And that’s about it. For a place as happening as deptt of A and E, this is just an average piece. Recommend

  • http://shahidrizvi.wordpress.com Arcane

    Dear writer… I still dont understand that what is the purpose of this article?? totaly uselessRecommend

  • faraz

    I wonder who comes to a hospital to ogle at a female, because good looking doctor is a rarity Recommend

  • A bit confused…Malik

    I disagree with these observations. Yes, there are quite a few fever, sore throat, I hurt my thumb while playing ball kind of patients in the ER. But, the majority of the patients come with serious, life threatening complaints like MI, hematemesis, stroke, pancreatitis, peritonitis, hypertensive emergency, and gunshot injury to name a few. Well at least they did in the ER I rotated in. But then again, mine was a proper ER!Recommend

  • Bushra Rahman

    @ A bit confused…Malik;

    If you had read it properly, you would have noticed something about “serious patients” in the ER but then again, I think you just read the headings and hit the comment box. No wonder you are confused. Recommend

  • Pagall

    Hey Doc
    what’s up?
    chk my pulse and bp
    All the best :)>-Recommend

  • Saad

    whats with all the ‘felt-up-women’ writing at ET. Recommend

  • http://www.tanzeel.wordpress.com Tanzeel

    The encouraging part of this article is that hunter did not appear to be a gay, else we would have been reading an entirely different account from your senior male doctor.Recommend

  • Akhrot

    LRH needs to assess her MBBS degree again seems its fake that’s why she avoids critical patients of hospital and leave them to die.Recommend

  • Sadaf

    That note is great! One has made strong observations around the ER. But somewhere I would like to ask if there is no patient with serious illness or complication? The one who may need real attention and medication??Recommend

  • sars

    well the way to avoid that is get a good medical training and youll be assigned actually sick patients and not just time wasters.Recommend

  • Imad

    Would never forget the days I spent in the casualty unit of Lrh during my housejob,it was one heck of a tough job.Recommend

  • Imad

    PS,agree with most of your points as have had first hand experience of all this and its quite annoying as these functional patients divert one’s attention from the serious ones.Recommend

  • http://lonepkliberal.wordpress.com Loneliberal PK

    What I saw in the emergency room was a man’s phallus trapped in a bottleneck. After that, my fascination with this post rapidly declined.Recommend

  • Dr F

    @Bushra Rahman:
    Good 1Recommend