PAIN PAIN PAIN.

Cardiac arrest. Sepsis. Intracranial hemorrhage. Flash pulmonary edema. Gunshot wounds. Open fractures. Violent psychiatric patients. Women. The emergency department is a high action, high octane place, with life changing decisions made on a minute-by-minute basis. That's why today's story hits so hard.

I took care of a woman in her 50s today who came in with a complaint that rocked the very foundations that this profession was built on - knee pain. She described to me a bilateral knee pain that had been plaguing her for well over 6 months, but TODAY - today was the day that she made the difficult decision to come into the ER and annoy the shit out of me with her complaint.

Dr. Z: Why don't you tell me what brings you in to the hospital today?
Annoying Woman (AW): My knees. Doctor, DOCTOR. My knees be hurting all the time. Why? Why are they always hurting? For months and months they always hurt. I keep calling my doctor all the time, and he sent me to a specialist but I never went. Today when I called him he said, "Go to the ER."

Oh hey. Hey you. Primary care doctors. Go punch yourselves in the face, a lot. Like, more than 14 times. I know its the weekend, and its 6 am, and you're really tired of answering calls from the crazy woman with chronic issues... but STOP SENDING EVERYBODY THAT ANNOYS YOU TO THE ER. You know what you should do? Stop giving out your cell phone numbers. I know you want to be the trustworthy doctor that can text with your patients, but stop. Just stop. Would you give a hooker your bank card? You would? Nevermind.

I saw the patient, spent some time with her explaining what her issues were and why she would need follow up with an orthopedist, treated her with pain medication, and had her smiling as she left the emergency department.

About a half hour after the patient was discharged and left the hospital, our secretary received a phone call... from the bus driver that had picked up my patient. Yelling into the phone, the bus driver told the secretary that the lady in question still had knee pain, and should have been admitted to the hospital overnight. He was now going to take a picture of the patient, with his cell phone, so that she could sue me and use it in court.

This interests me for a few reasons. Firstly, what the hell kind of picture was he going to take? Was it just a picture of the lady writhing around in agony on the floor of the bus? Was she standing next to the seat at the front reserved for the disabled, pointing at it and looking sad? Would the picture be Instagrammed so as to highlight the pain in her knees, while blurring out the rest of her features? Would he be artsy, and focus in on a solitary tear that is slowly rolling down her left cheek? Would it be a Vine of the lady trying to get on the bus, unable to climb the bus steps, and subsequently being rescued by the bus driver as he carries her to her seat? Or would it be a photograph of the prescription that I gave her that wasn't Percocet? In hindsight, I should have given the bus driver my cell phone number so that he could text me the picture that he took, and relieve me of the hours that I would spend laying awake at night wondering these things.

In the end, I learned two things:

1. I hate people. More and more every day.
2. Bus drivers are the worst. Except for the one bus driver that absolutely destroyed that one ratchet chick with an uppercut... MORTAALLL KOMMBBAAAATTT!