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Tales from the ER

By Dr. Spencer Price They’re called the Darwin Awards ‘“ annual recognition bestowed upon those among us who perform acts of supreme stupidity and who, in so doing, often pay the ultimate price. An example of a classic Darwin Award winner is the crook who, during a robbery, aimed a gun at an innocent person and pulled the trigger. When the gun failed to discharge, the would-be robber turned the gun around, looked down the barrel, and pulled the trigger again. Unfortunately for him, this time the gun fired, sending the criminal to an early grave and earning him a Darwin Award. Recently, I had the misfortune of witnessing truly Darwin Award worthy behavior while at work in the emergency room (truth is, witnessing such behavior is commonplace in the ER). It was 3:00AM. The ambulance had just brought in a young woman, 23, who had been involved in a single-vehicle automobile accident. When the emergency medical personnel arrived on the scene, they discovered something unusual ‘“ the young woman was lying in the grass beside her car, asleep. Of course, they didn’t know she was asleep at the moment and thought, rather, that she was unconscious or worse, but a quick examination revealed that the victim was, in fact, asleep. The EMS guys managed to rouse her from sleep long enough to obtain a brief medical history and an explanation of the events preceding the accident before she fell asleep again. As it turned out, the young woman had been experiencing insomnia for several days after starting a new job. She had visited the emergency room (note: insomnia is not an emergency) and received a prescription for the popular sleep aid, Ambien. She had taken the medicine several nights after arriving home from work and discovered that it took about an hour for her to feel sleepy. Disappointed that the medicine didn’t work instantly, she came up with a plan. She worked an odd shift ‘“ 6:00PM until 2:00AM ‘“ and she lived about an hour’s drive time from her job (you can probably guess by now where this is going). So, she decided to take the Ambien as soon as she got off work ‘“ her theory being that since the medicine took an hour to work and since she lived an hour away, she would be sleepy and ready for bed as soon as she arrive home. It just so happened that on this particular night, the medicine worked a little faster than usual ‘“ most likely because she had not eaten prior to taking the medicine after work as opposed to having taken the medicine after she had eaten upon arriving home the previous nights. So, about 15 minutes before she reached home, she fell asleep at the wheel, crossed the centerline, drove down an embankment, and struck a tree, all while fast asleep. She had no recollection of the accident whatsoever. Luckily for her, she only suffered minor bruising. Now, with regard to her situation, the operative word is ‘luckily.’ The physical impairment under which she was operating a motor vehicle could have resulted in her own death and, worse, some other completely innocent person had she struck another vehicle while crossing the center line. Of course, although the young woman had a job, she had opted out of the employer-provided insurance plan which meant the bill for her emergency room visit, including lab work and a CT scan, will be paid by you and me. Astoundingly, a review of her medical record demonstrated she had visited the ER on 27 separate occasions during the previous year ‘“ all for minor complaints that could have been handled by a primary care physician. And who got the bill for those ER visits ‘“ you guessed it ‘“ the taxpayers. It’s frustrating enough to witness the abuse of the medical system occurring on a daily basis. It’s downright infuriating to witness abuse that comes as a result of unthinking and even overtly stupid acts. The complete lack of judgment demonstrated by the young woman is, regrettably, not an uncommon occurrence in the ER. However, the rest of us who try our best to exercise good judgment in our daily activities shouldn’t have to pay for it.

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