We were having a nice, steady night with Brian. Brian works quickly and unfailingly manages to get all of his dictations done right after he finishes with the patient's care. This strategy assures that when 11 PM rolls around and there are no patients, he is out the door. Works for me.
We had already sent two patients with abdominal pain down to the Mother Ship for CT scans and seen three garden variety frequent flier dental paineurs who got antibiotics and Percocet (the only thing I really don't like about Brian....it's like feeding squirrels, they always come back for more). He had put Orthoglass splints on two little girls with buckle fractures and it was only 5 PM. Wham, bam, thank you ma'am. In and out.
My next triage was a plus-sized young woman with 10/10 abdominal pain that she had been having for the better part of a year. No other symptoms. No insurance. She was supposed to have followed up with her gynecologist, but apparently paying for her artificial nails, her IPhone, and her Coach bag were more important.
Me: So, what is different about your pain level today?
Pt:: I just thought it was time to do something about it.
Me: Uh huh.
The woman had with her an adorable 3 year old whom she consistently parented poorly.
"Sit down. Sit down! SIT! RIGHT NOW! What did I tell you? Do you want mommy to spank you? I told you...no, Aaron, don't do that! Get down off there! What did you...did you just put something in your mouth? Spit that out! How many times do I have to tell you to....come here....come over here right now.....AARON! GET OVER HERE! You are such a pain! I can't take you anywhere! AARON! Are you listening to mommy?"
Clearly he is not.
Aaron continued to terrorize the treatment room, and all we could hear was mom yelling at him behind closed doors. Brian ordered some of the usual tests; pregnancy test, urine, etc, but I knew the pelvic exam was coming, and I tried to mentally prepare myself. I was having some trouble with that, though.
To Brian: " I would rather have you professionally poke out both my eyes with an 18 gauge needle than chaperon you with that pelvic exam".
Brian, laughing: "I know, I'm not looking forward to it either".
When the time came, Aaron had parked himself on the stool at the business end of his mother. He could not be budged, not even with the Beanie Baby that we keep for emergencies. Brian got tired of coaxing darling Aaron, so he finally picked him up and deposited him on a chair; he immediately scrambled out and stood, again, in a posture of interest in front of his mother's crotch.
Me (to Brian): "Is he trying to crawl back into the womb?"
Brian finally just nudged him out of the way and did what was necessary.
She left with Vicodin. Yikes.
I understand that not everyone who gives birth is an ideal parent, in fact some are downright appalling as evidenced by the number of screwed up kids in the world. But this just bothered me. Having children is enough of a crap shoot as it is even with good parenting. I just couldn't help but think that this kid is doomed.