The Reality Check

A Tragedy and Farce in One Act.

(Curtain rises to reveal a busy Resus Room setting, full of patients, families, and nurses. Occasional moans, and nurses calling out, “Can you bring me a syringe?” and “I need the doc in here stat!”)

(A patient’s husband approaches a Nurse, who is drawing up some drug or another.)

Husband: (very angry and yelling loudly) My wife is having a stroke! I have never seen her act like that? There is something seriously wrong with her! And you guys are doing absolutely nothing! I have never seen such incompetence!

Nurse: (calmly, looking at syringe) She’s receiving appropriate treatment. We have assessed her, positioned her so she maintains a patent airway, started an IV, drawn bloods, and monitoring her heart rate and rhythm. . .

Husband: (the same) I’m an RN in the ICU at Holy Somolians Hospital downtown.

Nurse: But. . .

Husband: I know when someone is neurologically impaired! You guys don’t know you ass from your elbow! She needs a CT, stat!

Nurse: (a little exasperated) If you work in an ICU, you would surely recognize an ethanol level of 83.*

Husband: What? That’s impossible! (voice trailing off) She doesn’t drink, she quit a couple of years ago. . .



*In perspective, you’re considered legally impaired with a level of 17.

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  1. #1 by Linds on Friday 30 July 2010 - 1047

    ohhh ouch :S

  2. #2 by shechem on Friday 30 July 2010 - 1111


    My snake mean MIL looked like a bloated sweet potato, had an NH4 level of 270, was hearing gospel music, didn’t know my husband’s name, needed to be flown from podunk hospital to an ICU in acute liver failure. My FIL was still swearing up and down she didn’t drink, and she wasn’t an alcoholic. After she died and we started cleaning out her bedroom, there were *7* empty 1.75 L bottles of vodka under the bed.

    I had asked several time in the previous years if she was drinking, cuz she acted like every other alcoholic I have known or seen in the ER/ICU, only to be told “naw, she is just ‘that way’.”

    Denial, it is what keeps families together!

  3. #3 by Jenn Jilks on Friday 30 July 2010 - 1113

    OMG. You have a way with words and scenes. This could be a play or a sit-com. You could write for ER!!!

    It’s the ‘calmly’ part that gets me. I spent so much time arguing with parents during non-emergencies. I cannot imagine being calm in such a situation!

    I admire you and your colleagues. “Great is your reward in heaven!”

  4. #4 by Zoe on Friday 30 July 2010 - 1714

    Bravo! *clap! clap!*

    Sadly, I’ve witnessed this farce more than once in my career.

    On my last night shift, a crazy Saturday night, a guy is brought by EHS wearing a tux, having been at his daughter’s wedding. According to paramedics, he “projectile vomited” all over half the wedding party (including the bride), and promptly collapsed unconscious. Ambulance was called. Crew states this wedding was no budget affair, it appeared as though no expense had been spared. And the place was rife with panic over the father of the bride’s “major health crisis.”

    So he comes to us, reeks of ETOH, ethanol level around 45. He was so obtunded, the doc elected to CT his head just to be safe, which of course was normal.

    Shortly after test results start coming back, I (as charge nurse) take a call from an extremely tense and demanding family member who claims to be a GP, wanting to know this patient’s status. Begins asking detailed questions about stroke assessment and treatment, and if we were preparing to transfer him to BigCity General Hospital, the local stroke center. Ummm…no, I tell him. I explained that our assessment did not reveal any stroke symptoms. GP asks (in a slightly snotty tone) what our assessments did reveal, and I, as diplomatically as I can, tell him about the elevated blood alcohol content. And point out how difficult it can be to assess neurological status on a person who is so intoxicated.

    I explain we will keep him for observation until the morning, reassess after he sobers up, and likely send him home at that time.

    GP guy says, (snotty tone diminished somewhat) “So, on a scale of 1 to 10, how concerned are you about him?”

    I answer, “Well, maybe a 2.”

    GP (sounding a bit contrite now) : “Ah…I see. Thank you for your time.”

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