In one room at the far end of the ER is a woman in her middle 30's complaining of abdominal pain. At least that’s what she told the nurse, because her actual issue, once you get past the sunglasses with the four inch lenses that make her look like a Dollar Tree version of The Fly, is that she wants her IUD removed. She needs it out today because her Legal Guardian, who has Power of Attorney for the patient because she is apparently "disabled" and getting Social Security, and who has (for the benefit of society as a whole) said the birth control device should most definitively stay in place, is out of town and this is the patient’s chance to "escape" and get it removed.
With her is a considerably older man who looks "well-seasoned,” to put it politely, and who appears exceptionally eager have this offense against nature removed so he can promote his lineage within her longing womb. The drive to spawn is overwhelming, like that of a doomed salmon fighting to get upstream, so of course an ambulance was required to get her to the ED in record time. In Star Trek terms (and are there any other worthwhile terms? I think not), it’s the Ponn Fa'ar. It's Amok Time.
When informed that I do not remove IUD’s as part of my practice, and even if I did I cannot remove her IUD against the wishes of her Legal Guardian, she says she is going to sue me, sue her Guardian, and head across the parking lot to our sister hospital in town (whose name she prefaces with a word that rhymes with “clucking”) where they will most assuredly do what she wants. She also drives us into heartfelt introspection of our behaviors us by saying she will never come to our hospital again, in what may be thought of as a successful long-term resolution to our problem.
Down the hall is another woman of similar age and weathering who is short of breath. She started gasping for air as she was running down the street to the hospital to be with her sister, who has abdominal pain and came by ambulance. She is accompanied by a teenage male who somehow is able to answer questions about her last menstrual period.
As I’m chatting with her, the older man from the first room walks in. My new patient identifies him as her father. Seeing my face as I assemble the pieces in my head, she quickly backtracks to note they’re all just “really close friends."
Where’s the Jerry Springer Show referral line when you need it?
(Afterthought: This whole episode reminded me of something we need to add to our Electronic Order Entry System. When you order an x-ray on a female patient of a certain age, you are always asked if the patient is pregnant or not. Given our clientele, there really should be another option. It would read something along the lines of, “Please, Lord, No!”)