One of the saddest commentaries on my city that I see on an all too regular basis is the absolute lack of coping skills in the growing generation. We had generation X and then Y, and I guess they’ll need to call this generation W for whiners. Too pampered while growing up that they have no idea how to manage their own problems after they very effectively create them.
I had the unfortunate experience of seeing A teenager who came to ER on three separate occasions seen by three separate ER physicians for what he described as chest pain.
I had no desire to see him again in what remained of my ridiculously long shift .
Day 1. Chest pain , Palpitations.
ECG and all normal. Some anxiolytic and discharge.
Day 2 . Chest pain , palpitations.
ECG and all normal. Some anxiolytic and discharge. Patient insists on admission. Counseling and CIAO!
Day 3 . Palpitations. ( My day)
I heard Nurse while checking his vitals reassuring , you’re fine . Nothing is wrong.
She told me that the boy had appeared twice earlier to the same centre with chest pain . And yes a dozen attendants with him.
You have exams ahead ?
-Yes, I have one scheduled tomorrow. I don’t care. My health is more important... you know I have missed all my exams . That’s not a concern. Please do the needful.
So, I listened patiently to him as he told his sob story. Afterward, I explained to him once again that he was not crazy but that he had several issues that he would need to address one at a time (just like the rest of us mere mortals). He didn’t seem to like my suggestion as that entailed actual effort on his part.
The next day he showed up yet again, this time saying that he felt chest pain with giddiness . I was obligated to do more of a work-up this time – which was completely negative 80 minutes and ₹ 5000 later.
Second occasion:
This was times when I was having a good time in ER when a bunch of what I call HULKS walked in with a girl on stretcher .
We were assuming it to be a drug overdose or brought dead case.
Vitals were fine . She was unresponsive to pain stimulus. She held her breath for a while . Her mother rushes to me .
Put those drops in her nose and she’ll wake up.Every time she does this. We get her to this hospital. Put those drops and she becomes conscious.
I look at my staff try to hold my laugh and find them looking at the fan , floor anywhere else but me. I order. Sister please get the drops. She holds her giggle , gets spirit . Puts in her nose . The girl sits down.
After requesting for privacy I ask the girl various questions which she ignores trying to act as if she is in stupor. Once again spirit therapy and she sits back.
Now comes the worst part . Counseling. Explain Attendants your kid is fine and malingering.
There are possibly two outcomes of such revelations in Hyderabad,
1. They’ll believe you. Take the teen home . Bash them red and blue.
2. They won’t believe you. Bash you red and blue.
This is when what we call “Safe Medicine” comes into picture.
You have to act sympathetic and smart. I explained them that there is no emergency as such where I can take a medicine and intervene.
Madam , those drops . They work like magic. CT scan ,MRI . Nothing could help . How do I take my baby home in this condition.
While I notice the nasty teenager open one eye and see the drama going on.
I explained the kid is WORRIED about something, that she is possibly scared to share with her family. She does not need a psychiatrist neither a neuro physician but a psychotherapist. She needs support and counselling more than medicines.
They stared at me in surprise. They had not heard of that field. After reassuring them , I send them away .
The lady comes back after a while. Can you please write the drops name please! What if she faints again?
So far so much.
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