I was assigned to Mean Doc for my rotation this week in the ER. He was nice to me, but he really did earn his title of Mean Doc with regards to how he treated everyone else. There were two patients that he yelled at. Yes, yelled at. It was all I could do to keep from laughing. Now, he did have a few good points. He was extremely good (shockingly good) with the patients that were not (1) teenagers or (2) Old Feisty European Man. He was happy to teach me things and explain things when I didn't understand and he was happy when I caught a minor (very minor) error he made. He was mean to the nurses and ER techs. In fact, I can see why they all dislike them. None of the other ER docs are as rough when them as he is.
There was one teenager, who was in the hospital with psychiatric problems. This teenager changed the answers to questions being asked. I don't think the teenager did it intentionally or to trick Mean Doc, but he just blew up at her. He started raising his voice (not quite yelling) and it was all I could do not to start laughing. The look on both of their faces. She was still completely confused and he was so frustrated. I don't think anything was accomplished with their interaction. It may have been one of the few times that I might have been able to get more information from a patient than an attending. He wasn't patient enough.
Oh, and the Old Feisty European Man! He was my favorite patient of the night. He is a sort of regular at this ER. He comes in so often that when fire and rescue brought him in, the entire staff started saying, "Hey Old Feisty European Man, how are you doing? You haven't been here in days." It reminded me of an episode of Cheers. I don't know the whole past medical history, but I know he has chronic pain and he presented to the ER with chest pain. Mean Doc wrote orders for pain medication for his chronic pain because they knew that they were going to have to do some things that would probably make the pain worse. The only problem: Mean Doc didn't write the dose high enough for Old Feisty European Man (he has been taking this pain killer for a long time and needs more than most people would). To make a long story short, Old Feisty European Man was yelling in his room for about an hour. When the test results came back, he did have some problems and they needed to keep him in the hospital. But by that point, Old Feisty European Man was so angry that his pain wasn't being controlled that he decided to go home and give himself the dose of pain medication (which was higher than the dose the ER gave him). I volunteered to go talk to him and beg him to stay. I let him know that Mean Doc ordered more pain medicine and that he would get it immediately if he just returned to his room and that he really did have some concerning health problems. He said to me, "You are such a sweet girl, but if I have to die I'd rather go home and do it alone. At least there won't be any morons there to bother me." He then told me he wanted to sign the papers so he could leave. Mean Doc came out and tried to get him to go back to his room, but Old Feisty European Man refused. Mean Doc started talking as loud as Old Feisty European Man (which is loud because he is hard of hearing). This continued to escalate until they were screaming at each other. Finally, Mean Doc said that he didn't care anymore and would be getting the papers Old Feisty European Man sign out AMA (against medical advice). I wish you could have heard them discussing how Old Feisty European Man was ill and that by leaving the hospital he could die. It was like watching a poorly written comedy. I think it was so humorous to me because it was so absurd. I know that sometime things can get out of control (quickly), but this just seemed a bit crazy and I think Mean Doc added to the situation rather than being a calming force. Oh well, no one is perfect and the rest of his 20+ patients were treated very well. Shockingly well in fact.
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