Gerald O'Malley, DO: Secret myths and quiet truths of the ER

I was in the grocery store the other day and something caught my eye as I pushed the bananas and Ho-Hos through the price-check scanner. Reader’s Digest had an article about my childhood hero, Willie Mays (I know he was a Met, but even Yankee fans recognize greatness), but that wasn’t what made me buy the magazine.

It was the picture of the young woman dressed in scrubs accompanied by a headline like: “50 Secrets ER Doctors Won’t Tell You (Read This Before You Call 911).” I couldn’t resist.

The American ER (and the people that work in ERs) has always been fertile ground for urban myths and legends. I’ve heard the same outrageous stories told in ERs from Virginian Beach to Los Angeles: The violent PCP patient tossing around security guards after being tazed, the guy with the vibrator in his rectum, the “dead” patient that sits up and moans…

ERs all have similar stories and sometimes it gets hard to separate truth from fiction. Reader’s Digest actually picked some uncomfortable but undeniable truths to reveal as “secrets.”

Some of my favorites from the March issue of Reader’s Digest include:
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• Never, ever lie to your ER nurse. Their BS detectors are excellent and you lose all credibility when you lie.

• Standing in the doorway and staring at us while we work won’t help your loved one get treated more quickly. We’re pretty used to people trying to intimidate us.

• The busiest time starts around 6 p.m.; Mondays are the worst. We’re slowest from 3 a.m. to 9 a.m. If you have a choice, come in the early morning.

• If you come in with a bizarre or disgusting symptom, we’re going to talk about you. We won’t talk about you to people outside the ER, but doctors and nurses need to vent, just like everyone else.

Harsh to read, but I had to grudgingly admit that there was some truth to the “secrets.” The reality is that this can be a really crappy job a lot of the time. For every good, happy, positive outcome, there are a dozen that are heartbreaking and terrifying.

The first of the 50 secrets in the article seemed a little obnoxious and condescending. It read: “Denial kills people. Yes, you could be having a heart attack or a stroke, even if you’re only 39 or in good shape or a vegetarian.” Seemed a little self-evident to me.

Tonight I tried everything in my power to resuscitate a 43-year-old woman that I pulled out of the front seat of her boyfriend’s car. I remember smelling and seeing the burning cigarette in the car ashtray as I wrenched my back trying to untangle her feet from under the dash, lift her out of the car and drag her out onto the ER gurney. The boyfriend took the time to light and smoke a cigarette while he drove this dying woman to the ER.

I thought of the first secret as I sat to explain to her 13-year-old son why I couldn’t save his mother.