First of the Month

The first of the month is one of the most intense times in the ER. Everyone in the city in poverty gets their well fare checks. Drug dealers, addicts, and families all get a pay check that is suppose to last them the month. The enitre city becomes one big party, the streets are filled with people. Everyone is out front of the barber shops dealing drugs in broad day light on the cities main streets. Working the night shift we get the aftermath of the party, or as we like to call it the late night after party. The night was busy the moment I walked in the door, the place is packed with people. All beds are full and patients in beds line the halls. The corner is always packed to max capacity the first week of the month. Beds eight through thirteen are the beds that make up this corner, along with two more beds that are both called eleven, (eleven isolation and eleven observation). Needless to say that on this night the crisis patients are getting backed up all the way up to bed five. After bed eight the rest of the hospital beds become what I like to call normal functioning society beds. Beds where families are seeing their dying grandmother or someone just trying to found out why he is having chest pain, after smoking for twenty five years. When it is this backed up it starts to effect the other patients. People who are already having an issue are now scared to death. People are wondering if the patient high on PCP a bed over will break out of their restraints and start terrorizing the place. Which has happened, but thats another story.

About an hour into my shift and we get a patient who is overdosed on crack and heroin. Police found her underneath of a parked taxicab and called EMS. She was given two doeses of Narcan. Narcan is a drug that blocks the opiet receptors. She looked like she could be a mom and a family woman. But now just another junkie on the streets. I often wonder what could cause someone to get to that point in their life. We get her off of the EMS stretcher and on to our own bed, immediatly we have to restrain her to the bed. The down side of Narcan is that the patient is usually violent because we have killed their high. Because of the effects of the two different drugs, the patient would go from screaming and trying to hit everyone in sight to falling asleep in the snap of a finger. In the middle of restraining her we are getting her undressed and into a gown. In the mix of all of this chaos, while getting her pants off, I could not believe what I saw. A broken crack pipe had fallen out of her annus, I couldn't believe it!

As the night goes on the effects of the two drugs are causing this woman to scream at the top of her lungs, fall sound asleep, this is being repeated throughout the night. Across the hall is a patient who has overdosed off of Seroquel, this patient is also restrained. A male middle aged patient who is also screaming at the top of his lungs because he has just had his stomach pumped and filled with activated charcoal through an NG tube is in the other bed. The whole ER sounds like an insane assylum, normal patients are getting a little freaked out. To top it all off there is a patient who is withdrawing off of Heroin in the crisis corner, who has been sleeping all night, jumps up with a fury out of his bed and screams at the top of his lungs " EVERYONE JUST SHUT THE FUCK UP!!!!!". Sometimes this place seems more like a nut house instead of a hospital.

A Lost City

I work in one of the most dangerous cities in the United States. Its crazy actually saying something like that. The city never use to be like this, it was once a place where people from the suburbs would buy homes to spend their summers. It was once a place that you could put on the back of a post card and call it the place to be. Now the entire city is in shambles, a city full of drug dealers, gang members, rapists and killers. A city where there is not one block that doesn't have bombed out houses.  Poverty is at its worst in this city, possibly the worst it could be without calling the place a giant shanty town. The homeless set up camps all throughout the city, in parks and woods. They call them tent cities, the homeless have actually started there own community.

Last night there was a sixteen year old crisis patient. She arrived with her mother and two little sisters ages fourteen and twelve. I didn't see too much of the patient but did happen to notice the mother frantically wandering around with two daughters. The mother had to stay until her daughter was seen by the crisis unit. Angry with the situation she felt that it was her duty to let us know repeatedly that she needed to get her kids to school so that DYFS would stop calling her and leave her alone. Or as she liked to put it "so they get off my junk ". As the night goes on she continues to walk in and out of the the ER. At one point we realize that the fourteen year old daughter is missing. When we confronted the mother and asked her what had happened, she says " she mad and went home ". Completely clueless to the fact of how wrong this entire situation was. A woman let her fourteen year old daughter walk home at 3:00 o'clock in the morning through the very same streets I described to you in the first paragraph. A fourteen year old girl at that time of night in this city has a 50% chance of survival. This is a city where grown men are pistol whipped daily by children between the ages ten and fifteen. I can only hope that she made it home ok. Needless to say we contacted DYFS and hopefully Ms. Trash bag never gets to see her children again.

The Corner

There is an area in my ER called the "crisis corner", an area in the back of emergency department that holds all of the hospital's homicidal and suicidal patients. It holds the people who are drunk, dysfunctional, high on PCP, and the homeless. As sad as this sounds, which it is, it can be also very entertaining. I'll leave the sad things out, and let you in on some real true life stories about the ER. The stuff you don't hear or see on TV.
 Sometimes a man needs to decompress after a night of dealing with a woman high on PCP who spits in his co-worker and friends face, then later in the night when she is sober enough to leave... she squats down and urinates all over the floor just after we handed her discharge papers! Just another night in paradise.