The RN note read, “brothers with cold symptoms.” Oh no, the dreaded “two-fer.” When two or more family members present to the ER together, outside of the possibility of carbon monoxide poisoning, rarely is there anything seriously wrong. No serious illness? One may think that would be a good thing, right? No. The sicker folks are often the easier to take care of. The hardest thing to do is explain to a mother of toddlers that although they have a cough and a runny nose that is driving Mom to distraction; that although she has waited in the ER for three hours that antibiotics are not a good idea and that the pediatricians recommend against prescription cough meds. Often, depending on age of the child, even over-the-counter meds are not advised. What that means is a long, often painful discussion with a Mom who has waited three hours to hear that, “Yep, they have colds, wait it out, no prescriptions, sorry about your wait.”
Unfortunately, with health care now being run by business school MBA types who have turned “patients” into “customers” there is often tremendous, even to the point of job loss, pressure on physicians to write wrongful antibiotic scripts or narcotic prescriptions. Good “Press-Ganey” patient satisfaction scores can be obtained without writing unnecessary or even risky prescriptions, I do so, my scores were highest at my ER last year, but it takes a tremendous amount of time, discussion and re-assurance. Time is our scarcest resource, noting our mother and two rambunctious kids has already waited three hours. There are three things folks want out of the ER–good, fast and cheap–pick any two, you can’t have all three. I take some extra gulps of coffee, put on the game face and head to the exam room.
Timmy, age 6, and Jimmy, age 4, are both African-American and avidly crayoning in the books given to our pediatric patients. They are both smiling and jump off the exam cart they had been sprawled on and grin from ear to ear for the requisite “high five and fist bump.” It can be fun seeing kids, it can be fun seeing any patient once one learns how to easily communicate with those whose blood alcohol never goes below three times the driving limit. Moms also love it when you “high five and fist bump” the kids–remember, we are on a customer satisfaction quest here. Also, no truly ill child colors or jumps up for this kind of fun salutation. It is also fun for the Doc, and to survive the front lines in the ER year after year it is easier to love all your patients.
“What are you coloring?”
“A ambulance.” Both Timmy and Jimmy are coloring the ambulance. Timmy is a little better at staying in the lines. Timmy and Jimmy both are happy kids, a little snotty nosed but both hold up their coloring for my approval. I glance at Mom. She is smiling. Good, we are ahead on this task of explaining that Timmy and Jimmy have colds and that she has waited three hours for no magic prescription that will just make it all go away. Single Mom, either no man or likely a useless one. Useless only because he has given up–there are no jobs for him, he can’t be what men are meant to be, a breadwinner, a help and support for his wife and children. Useless because of despair that is not his fault. I am glad I can be a husband, father and grandfather.
“I worked on an ambulance before.” Looking in noses, ears and throats, listening to lungs, poking bellies.
“You was a ambulance man?”
“Yup. 30 years ago, for the City of Cleveland. Used to let kids like you play the siren a little.” True, these kids counterparts living in the projects of east 40th and Central. Urine smelling halls, broken wine bottles on the street, no hope anywhere in places no human should have to live.
“Can I do the siren now?” Timmy drops his coloring a purple ambulance. In Cleveland they were lime-green/yellow, had holes in the mufflers sometimes as loud as the siren since the city was broke, never seen a purple one, though.
“Can’t do that Timmy, Jimmy, I just work in the ER now.” Trying to imagine these titanium knees now running up four flights of stairs with EMS gear.
“What do you and your brother want to do when you grow up?”
“Not a lot of folks can do that. Be sure to work hard in school–that is really important.” Mom looks approvingly. Good! No demands for antibiotic scripts this time. “What if you can’t play basketball?”
“A ambulance man or a doctor man.” Brown-nosing can be a good life skill. “Work hard in school, you gotta’ do that, do your homework.”
What does future hold for these kids? They couldn’t be happier or smilier now. They have a good Mom. What will happen when they figure out the world is a tough place for an urban African-American male. Will they despair of being a useful man, like their father? Will they despair so much they just give up and break their mother’s heart? Drugs, criminality, early death by gunshot wound, like so many we scooped off the street in Cleveland?
This Easter let’s remember that for many it is not Sunday morning of the Resurrection. It is forever Saturday night without hope. Let’s remember that Jesus taught (as did Buddha and Mohammed) that we are our brother’s keeper. We have an Easter responsibility to those trapped without hope of a miraculous resurrection. I don’t mean self-righteous preaching hope at them, I mean faith without works is dead. I mean jobs, education, health care, drug rehab, a place at our table–where faith in practice meets reality.
This article originally appeared on The Pickaway News Journal