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    Tuesday's Thoughts: Are You Absolutely Certain?

    I believe it was Benjamin Franklin who said, "Nothing can be certain, except death and taxes." I suppose you could fall off the grid and for the most part elude taxes. However, death, while I'm not one to dwell on the topic, is something that can't be avoided.

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    And while death, and more or less taxes, can be considered absolutes, most things in life, especially medicine, can't be defined in this way. In essence there's a lot of gray. If you're a linear thinker, or someone who sees the world in black and white, then you're bound to find this statement bothersome. I hate to shatter your bubble, but there's one thing I've learned in my years working in emergency medicine and that's the absolutes are not routine, rather the grays seem to rule the roost.

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    It's not to say that absolutes don't exist. A broken bone can be realigned and mended. A deep cut can be sutured. A UTI can be treated with antibiotics. Then again, there are situations that develop that even make these routine treatments ineffective.

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    As medicine and medical conditions become more complicated, the road to a solution winds through a landscape filled with a complexity of grays. A failing heart can be treated with medications, pacemakers, state of the art pumps like an LVAD (left ventricular assist device) and surgeries, yet these solutions come with their own inherent sets of problems. Medicines have side effects or sometimes they just don't work for a particular individual. Medical devices are machines and like all machines they have a shelf life. And we humans are made of organic material and, simply put, aren’t made to last forever.

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    So why am I bringing this up? It’s November and men's health awareness month. And with this acknowledgement comes the notion that the best medicine is preventative medicine.

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    I'm sure most, if not all of you, understand the basics to preventative medicine. Things like regular doctor check-ups, undergoing screenings for testicular, prostate, breast or colon cancer, eating a balanced and healthy diet, getting involved in an exercise regimen and finally something that's often overlooked is our mental health and ability to maintain a positive outlook.

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    Doing these things in no way guarantees you perfect health and the avoidance of any medical issues. Like I said things aren't absolutes. However, it will provide you a better quality of life and quite possibility avoidance of the emergency room.

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    As you're aware covid infections are on the rise. Well, I should clarify and say they've exploded. I'm often asked if I see an increase in the number of pandemic patients coming into the emergency department; and the answer is a resounding yes. Not only have the amount of people with covid-like symptoms multiplied, so too have those who have already been diagnosed with it. These patients represent a fraction of what we deal with because there remains a wide array of other health issues that continue to present themselves as well.

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    The emergency department is available to anyone, anytime, day or night. No matter the issue, no one gets turned away. Couple this with the pandemic numbers and you begin to understand that the department quickly fills to capacity, and like a clogged drain, this backs up into the waiting room. Just because you come into the department doesn't necessarily mean you'll be treated right away. I’m in no way implying that it won't happen. Yet, it must be remembered that a finite number of exam rooms are available, it takes time to provide good medical care and based on the severity of the medical issue it might take a while for it all to come together.

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    Unfortunately, patients and their families have specific expectations and if these aren't readily met then anger, frustration and anxiety blossom. More often than not, this frustration is taken out on the medical staff. I'd like to say that I, nor my colleagues, were made to be punching bags, the recipients of endless insults or the beneficiaries of excessive profanity.

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    I don't know if a solution for waiting exists. To be honest, it's a problem in all emergency departments throughout the nation and dare I say the world. No doctor, nurse and tech that I know has gone into medicine with the desire to not care for people. If you give respect, trust me when I say this, it will be reciprocated. Then again, a little preparation, prevention and adherence to the pandemic mandates can provide you a much better chance of staying healthy and avoiding the emergency department all together.

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    I still believe the majority wants to be in this together, let’s not be too close together while we’re all in it.

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