#er doctors

Yes, this has to do with neurodiversity. But also about general disabilities, about sexism and racism and other things.

I spend a lot of time last week in hospital, because I had a biking accident last week and was in the ER, as well as going to two check ups, the last one earlier today. And there I once again realized how useless the painscale is.

See, the entire idea of the pain scale is that you should tell doctors the pain you are in on the scale of "no pain" to "worst pain imaginable". But... the thing is that this runs into several problems:

How bad the worst pain imaginable is varies a lot depending on what the worst pain someone has ever experienced is.

People, who have to fight chronic pain, generally have a very shifted pain scale.

A lot of neurodiverse, especially a lot of autistic people, have problem with interoception - so actually telling what they and their body feel. And this can at times include pain.

And then of course there is the issue that because of a lot of people who genuinely just at the moment are experiencing their worst pain imaginable, even though for someone else it might just be a 5 or 6, makes doctors always like "Yeah, sure" when someone arrives and tells them "yeah, I am at a 9". While also saying: "So, its not that bad," when someone arrives saying "Yeah, I am at a 4 or 5?"

Just two examples for me. Earlier last year I had done something to my back and I was in so severe pain that I barely could move. But of course I did not call the ambulance, but had my roomie bring me to the hospital. So, I hobbled into the ER there, and when they asked me about my pain, I was like "8 to 9?" And they were like: "Oh, you came here on your own, it could not have been that bad."

Another one was last week. You should know, that as a teen, I had a really, really bad internal infection, with really the most horrible pain imaginable. Like, "I was screaming until they gave me morphium" bad. So, trying to focus on how my body was feeling, I came to the conclusion: "4 or 5?" And the doctor was like: "Well, than it cannot be so bad." Welp, psych. I ended up having a fracture. And the doctor just looked at me like: "... How can you still move?" And I was just: "Well, I know much worse pain."

And it should be noted. I have had several fractures during my life and... I never considered the pain of a fracture as that extreme. I do not know whether it is because of messed up interoception or something. But yeah. I move around quite fine with a fracture.

Really, I kinda feel like even for doctors it is not really the most useful evaluation tool. Because I see a lot of doctors go "Well, it is not that bad that you need treatment" if you are telling them a number smaller than 5, but as soon as you go above 7, they basically go: "Press X to doubt".

And that is without going into the problems of sexism, racism and the like. Because when a woman talks about her pain, doctors will go like: "She is just very sensitive." Meanwhile if the person is not white they will also assume other things. And of course men in general often are made to underplay their pain, to be ruff and manly.

Mod here. I’m assuming anon’s character identifies as a Conservative Jew.

There’s quite a range of practice and belief among Conservative-identifying Jews, so respondents are encouraged to speak to that variation (e.g. plausibility, how likely to be widespread).

For this ask, Jewish folks who don’t identify as Conservative are welcome to speak to their own community’s practices vis a vis this question--as long as they specify they are not speaking about Conservative Jews. Jewish communities influence one another, especially in the case of Conservative Judaism, so you may well be onto something :)

I just smiled and went "Oh god..."

Going to the ER after SIX DAYS not holding anything down and having to repeatedly tell them you know why you can't hold anything.

"It's been six days?"

"Yes."

"Are you sure?"

"Yes. I have gastroparesis."

"Have you had these symptoms before?"

"Yes."

"Well we can do a CT, but of you have had this before I don't want to give you unnecessary radiation."

"I know what the problem is. I just don't know what to do about it."

"Oh?"

"I have gastroparesis."

They didn't write it on my chart. It wasn't in my discharge papers. But luckily they did give me zofran, reglan, phenergan, pepcid, and benadryl.

My tests clearly showed dehydration and malnutrition but they didn't seem to believe me. I even heard a doctor telling a nurse in the hall that "she is forcing herself to burp" like...

I have never been physically capable of forcing burps.

I am holding a bucket of stomach acid.

My GI works at this hospital and I have told you repeatedly that it is gastroparesis.

I don't even burp. It's weird.

Why would I try to scam you for saline and zofran? I literally just want to be able to eat food.

For a change of pace, today I am sharing a story that happened to myself, rather than to the toys who I usually observe through my camera having fun here. And today’s story is a PLOT TWIST in my own life story!

It’s ten am here now, and I spent last night in my local EMERGENCY ROOM!! I’ve been back home since about six am.

I learned in the ER that I currently have a quite painful case of…

Congress: Mandate human trafficking training for medical professionals

Originally published on Polaris.com

Last October, a doctor was examining a female patient in the emergency room, when suddenly she slipped him a note: “I have a tracker in me.”

At first, the doctor was skeptical. But the x-ray showed it clearly: a tiny metallic identifier often used for pets, implanted in her by someone who wanted to demonstrate his ownership over her. The woman was a victim of…

Please remember that while you get to go home at night, you get to detach yourself (have to some extent), your patients and the people that love them are living the things you are trying to forget. We don’t get to forget. We don’t get to detach. We don’t get to go home at night. No matter how bad your day has been, its not worse than ours and it doesn’t excuse rudeness, arrogant behavior, or any form of ignoring your patients or their loved ones.

You can turn it off but we can’t. We aren’t a conglomeration of what you’ve seen in the past or in textbooks, we aren’t here for you to show off all the complex concepts you’ve learned, we aren’t here for you to feel like a hero, we’re here for help and you signed up to be the one to give it. You are being paid for this.

That difference matters.

Sincerely,