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Tales from the Trenches – A Late Night in the ED

True Tales of Medicine - Late Night in the ER
Cheryl Lafond/123RF.com

Tonight began like any other night. I sleepily entered the back door near the trauma bay and was greeted by a man sprinting down the hallway wearing one shoe, tighty-whities, and sporting handcuffs attached to one wrist.

He has just liberated himself from the ambulance stretcher while being transferred to the hospital cot. Strung out on the latest cocktail of street drugs and less than able react to my presence, we collided with a sickening thud and fell to the ground. Staff and a frustrated police officer piled on to restrain this agitated soul.

One can never be sure what a shift in the emergency department will bring. That’s part of the allure, and night shifts deliver on another level.

The department settled down to the usual hum after the gentleman was sedated and admitted for monitoring and detox. My partner and I managed the routine cases of belly pain, headaches, coughs, and lacerations – the so-called bread and butter of emergency medicine. It’s not like in the movies, and there is no theme music playing – ever.

The radio crackled to life as a police officer relayed he was coming in with a suspect with minor injuries during an arrest. Abruptly, the officer blurted out a few expletives followed by the wail of his sirens.

“He’s seizing in the back of my squad!”

The charge nurse and I jumped at the chance to escape treating another earache. We quickly assembled our team and waited outside the ambulance bay with a cot. The young officer and his partner were surprisingly calm as they screeched to a stop and got out. The physician assistant and I each got in a back door, supported the patient’s airway and began to extract his twitching body from the back seat.

Abruptly, my helper was gone, the nurse started screaming, and I saw the officer jump onto the trunk of his car while drawing his weapon. As I popped my head up to look out the car door, I saw the problem.

Later I learned that a “residence of suspicion” was located across the street from the ambulance entrance. The occupants had been outside taking in the evening’s festivities and thought their dog could spice up our evening.

It took me about a millisecond to react. I jettisoned my body backward from the squad car and pivoted to sprint towards the hospital entrance. My shoulder planted into the hip of a rather large gentleman who quickly went down. A bright yellow object skittered to the ground. Hospital security, I would later learn, and he was none too happy about the situation. I guess a brand new taser was now permanently scuffed from tonight’s adventure.

Yelling “Dog!” and relying on a last minute burst of speed, I slid safely past the trauma bay doors with little time to spare. My physician colleague, a wise and jaded veteran, sat at the desk and laughed hysterically. He reminded me why he NEVER goes outside while on shift.

Point taken. I began to seriously question my desire to work at this facility.

We ambled back towards the glass doors and noted the owners had graciously restrained their pit bull. He looked at us with a smirk, “No blood -no foul. Guess he just got off the leash somehow.”

Our team finished and extricated the patient, who now was also grinning. It turns out he was just faking the seizure in hopes of avoiding another arrest.

Apparently, I’m a slow learner as I worked as a locums physician at that facility for another year. A career in medicine is full of surprises and at times, danger. Choose your specialty and assignments wisely – and be ready to sprint on occasion.

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About Mitchel Schwindt, MD

Dr. Mitchel Schwindt is a board-certified emergency medicine physician who practices in a variety of clinical settings. He completed his residency at Butterworth Hospital in Grand Rapids, Michigan. As part of Michigan State University, Butterworth was renamed Spectrum Health, and is one of the busiest level 1 emergency and trauma centers in the United States. He served as chief resident his final year. While there he was inducted into Alpha Omega Alpha, a prestigious medical honor society. He also devoted a significant amount of time working as a flight physician (helicopter) for an aeromedical company.

Dr. Schwindt has served on many committees and steering groups related to health care, quality and process improvement and was a former trauma program medical director. He serves as a volunteer physician for local sporting and martial arts events. He is a consultant and medical advisor to several dental groups and has developed protocols and policies related to medical issues in the dental practice.

Wellness and nutrition are a passionate interest for Dr. Schwindt. He writes extensively on the subject and has published several related books. He is a member of the A4M – The American Academy of Anti-Aging Medicine and is currently pursing a functional and sports medicine fellowship.

In his free time, he enjoys competing in triathlons, skiing, water sports, time with family, foreign travel and pursuing entrepreneurial activities.

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