Thursday, February 7, 2008

A letter to a frequent flyer with actual medical problems

Dear Obese Woman with Poorly Controlled DM, HTN and COPD;

We would like to take this opportunity to thank you for allowing us to be your Emergency Room of choice for your thrice-weekly 'medical events'. The chance to serve you has never lost its appeal. The fact that you have always been horrendously rude to all of the staff involved in your care, from tech to RN to MD, as well as to the family members who dragged their asses out of bed at 0300 to sit by your bedside and have abuse heaped upon them is completely understandable. After all, you are a very sick woman.

Of course, the fact that you have repeatedly refused to put down the beer, the cigarette, or the bacon cheeseburger has greatly increased the level of 'sickness' that you have achieved. But I digress.

We appreciate the chance you have provided for us to brush up on our IV skills. I must say, the one who gets the 22g in your pinky finger is highly regarded at the nurses' station for at least 10 minutes.

And the fact that inserting your Foley catheter has always been a two-person task (one to hold panus traction, the other to go diving in the depths of the unwashed kootch), allowing us to tie up an additional person that could be doing something else, indicates that you must be Somebody Important; somebody that it has always been our pleasure to serve.

We are aware that you could have greatly reduced, or even eliminated, your trips to the ER by simply being compliant with your medications, (most of which can be purchased at Wal-Mart for $4.00), and we have always seen that as a vote of confidence in our excellent care.

And the fact that everything from the ambulance rides to the Cardene drips to the Bi-Pap to the insulin to the serial EKGs and cardiac enzymes have always been paid for by our local, state and federal government medical aid programs means that reimbursement for your care has always been prompt and accurate. Except when it wasn't. But that's ok. As long as you could afford your Budweiser and Marlboros, we've always been happy to serve you.

So you can understand how sad we are tonight, having seen you for the last time in our ER. We worked so very hard to make sure you could come back and see us another day. Your visits mean so much to us, after all. But alas, asystole is not a rhythm oft recovered from, and though the medics did their best, as did we, your family will just have to spend the 0300 hour in bed from now on, as they won't need to be here, by your bedside in the ER.

Though the tube in your throat isn't helping your COPD much anymore, and the 20 g in your thumb won't be used for Cardene or Insulin tonight, and well, we didn't bother with the catheter, since there's no such thing as a stat Foley, we can tell you with utter certainty that you are in no way hypertensive.

And we consider that a success.

Thank you again for choosing us for your medical care-
The ER Staff


scalpel said...


The Platypus said...

Like my friend Richard used to say, there's plenty more where she came from.

ndenunz said...

Kinda like saying "I told you so."

Ambulance Driver said...

You are my hero. How I've wanted to write a letter like that, but you beat me to it.

Babs said...


Oh. I'm sorry. Should I wipe away a tear for the dearly departed? Kleenex, anyone?

MY OWN WOMAN... said...

I guess I better tell you before someone else does. While I agree with you MOSTLY there is something about your post that did bother me. I've written a little post of my own about your letter. If you'd like you can read it over at my site.

It was too long to leave in the comment portion.

Evil Lunch Lady said...

I understand "my own woman's" point with her blog entry and I understand yours. Here's mine, as a mother with a daughter with chronic conditions ER visits where frequent. And I'm sorry this lady died, BUT my kid who needs to be seen, because of no fault of her own, has to wait in a hall way, with everybody eyeballing her, while some person decides to kill themselves slowly kinda sucks.

I also know what the above posters feel like, I'm also watching my brother and mother do the same, except with boose.

Sorry for the long's been a bad day at my house.

911DOC said...

i know this lady and her multiple clones. she is lovely.

ERnursey said...

'unwashed kootch' Ewww, yuck. Unfortunately we have to go there all too often.

girlvet said...

...and the thing about this is that no doubt this woman was on either medicaid or medicare and disabled from her freely chosen lifestyle...meanwhile I'm paying hundreds every month for health insurance...

Anony said...


DixieLaurel said...

I'm pretty sure I've taken care of her once she was admitted to the floor. Nothing about her made me happier than getting dinged for late medication administration because she spent 2 hours downstairs smoking.

Nurse K said...

Anyone sprain their wrists from the chest compressions? Wrist sprains from obese-person CPR: That's my specialty.

"I can't compress the chest, there's too much soft tissue!"

Tex said...

You reap what you sow....
You chose the life you lead...
No deed, good or bad, goes unpunished...

Buy a carton, Drink a case, Pass the Doritos


the anonymous therapist said...

I probably shouldn't be as amused by this as I am. But there is some sort of satisfaction in this kind of situation.

Nicely written. :)

GuitarGirlRN said...

We all see this person. And yes, myownwoman, that person was special to someone. And I'm sure they are sad and upset about that person's death.

But when are people accountable for their own health?

Anonymous said...

I pay my own insurance. I do not drink,smoke, or take drugs,although I have other vices. I would never want to be treated by someone with your attitude. What if someone made these comments about someone you loved. You would not like it even if it were true. What goes around comes around.

I hear the brightest kids are choosing fields other than medicine. Wonder why? Maybe they met someone like you. Then again maybe you were an inpiration to Michael Moore when he decided Fidel Castro had a better medical system than ours.

by the way did I see you on the Late movie, hanging out with Johnny Weissmuller.

Anonymous said...

I read your profile. I can believe you don't have the attention span of a gnat. Can't tolerate stupidity? I would rethink that one.

I just saw a report on Natalee Hollaway, the American girl, who disappeared in Aruba. Your attitude mimics Joran Van Der Sloot.

Anonymous said...

Just curious: How do you feel about treating people who drive motorcycles, jump from planes, jet ski, etc.?

If people need to be accountable for their health, then I think ALL people need to be accountable and I should think you'd be equally disgusted by a thrill-seeking person's frequent trips to the hospital due to other dumb decisions.

I agree that obesity is a burden on health systems; I just don't think it deserves the wrath -- or the prejudice -- it often incurs.

But nobody deserves rudeness, especially those trying to help you. That is one aspect of your job that I do not envy.

I liked your letter because it very effectively communicated the frustration that healthcare professionals must experience.

HollyB said...

Well, I'm NOT a health care Pro, but I USED to be a Social Worker. And for what it's worth, based on your thumbnail sketch about the way this woman treated the people around her, including her family, I'd say she was a Malignant narcisscist [I hate trying to spell that]
As the Adult daughter of a Morbidly Obese, Alcoholic, I'm bettin' her children, the ones who aren't co-dependent anyway, are doing a happy dance now that demanding, self-centered,martyr-Mama is off their backs now.
I doubt that theirs a single soul who really misses her.
REalistically, what was her contribution to the quality of life for anyone on this planet? She couldn't even be an organ donor due to the diabetes! Don't let the metaphorical door hit you in the ass on the way out, Bitch!

MonkeyGirl said...

Dawn, sweetie, perhaps you should find someone to vent your vitriole on that you actually know. You're going to have a stroke if you let anonymous people on the internet talking about fictitious patients get you so riled up.

Go take a Xanax and drink an Appletini. You're way too uptight.

Anonymous said...

Monkey sweetie, I am perfectly calm. never took a xanax, never had to. I descend from a long line of people who lived long healthy happy lives. To top it off I made a bundle last year winning lawsuits against smart butts. And I can top that. My husband has the looks of a rock star. He's the only thing that might give me a stroke. If that should happen you can bet I will die with a SMILE on my face. If I were you I would leave the fiction to Nora Roberts.

And Holly Darling get a life. I hear they are remaking the wizard of oz. Why dont you audition for the Margaret Hamiliton
role.better yet consider 'the Bride of Chucky'

oops look at the time I knew I shouldn't have left my rolex in the bathroom.

Travis Tritt could tell the both of you. Here's a cell phone call someone who cares.

MonkeyGirl said...

Riiiight. You have a Rolex, you're married to Mick Jagger, the sex is great, you're rich and you're happy?

Bullshit. You're an insecure, fat, celibate, crappy lawyer with nothing better to do than try to make yourself seem important by trolling medblogs.

Face it, sweetie, if you really were what you claim to be, you wouldn't have to tell people about it, and especially not in the comments section of some stranger's blog.

But if you want to continue heaping unoriginal insults upon me, feel free. Obviously you have nothing better to do on a Friday night. What's wrong, rock-star hubby out with his girlfriend?

Anonymous said...

My my we are fiesty aren't we. Mick Jagger? You must be kidding. Maybe you are confusing me with yourself. Then again Mick wouldn't look at you even if he is older than Robert Byrd.

Fat? I weigh 115 pounds. I think you should take a xanax and top it off with a valium.

Strange that one so full of venom should have such thin skin.
I know- watch a video of Jeff Corwin. He ain't Steve Irwin, but he does have an affinity for snakes.

My rock star hubby is right here safe sound and looking good. Any girl who tries to be his friend will go the way of the passenger pigeon

I feel geniunely sorry for any patient of yours. Unless of course they are fiction.

911DOC said...


M-G, UROCK even if you like the stupid cat pictures.

911DOC said...

dawn, you are too funny. i do believe you may be an attorney.

MonkeyGirl said...

Ok, you're gonna have to help me out here. What do Jeff Whoever and the dead Australian dumbass have to do with anything? Forgive me for not understanding what you're referring to- I don't spend a lot of time sitting on the couch watching TV. I have this thing called a J-O-B.

And I don't have thin skin, nor am I feeling particularly venomous. In fact, I'm quite enjoying your delusion. Have you met The Speaker, by chance?

Anonymous said...

I read your blog 911doc and I like it. There is a difference in frustration and just plain being mean.
By the way I am an attorney and I love it.

Anonymous said...

Venom, snakes, Jeff Corwin. You got the venom and he's got the snakes. Bet Alan Jackson wishes he had thought of that. I got a job too, but I only work 4 days a week.

As for Steve, rest his soul he did love those crocs.Even a Fat Woman with a bad attitude would have been an appetizer for them.

Why are you on the computer trading barbs with strangers.

I love the way you say bullshit. It reminds me of Michael Gaffney scoring a 96 on the back of 'Little Yellow Jacket'.

911DOC said...

dear dawn,
thank you for the kind comments. just for fun can you tell me what the word (phonetically now so there's no cheating) "teh - raa - sof" means to you as an attorney?

MonkeyGirl said...

Holy crap, you don't know The Speaker, you are The Speaker!

Welcome Back, Crayzee!

I can't argue with you anymore. I have patients to abuse, and frankly, I really just can't figure out what the hell you're talking about.

You hurt my brain.

SUV MAMA said...

MG, if there is an actual fist fight, I want you on my side. :)

I think it's fantastic that you brought to life an issue that needs to be debated about- but instead comments are focused on your "attitude" and missing the point.

When ARE these people responsible for their health?

And yes, it's different than those who "jet ski" or "sky dive" and are injured. But let's talk about that.

And not talk to the lawyers.

They don't deserve the attention.

Anonymous said...

Seems to me if DAWN wants to "prove" how kind and considerate she opposed to how unkind and unconsiderate MONKEYGIRL is...then DAWN should get a job in a hospital...preferably an inner city hospital.
I would think that in her pursuit of a "career" and the $$$ that she claims to have earned...then she should have enough money to tide her she should be able to afford to work in a hospital for a bit.
I mean if she is sooooo all knowing about the human condition (and how OTHER people should understand the human condition), then she could really get an education by working on the "other" side. Maybe she would then understand the frustration and utter dislike we health professionals have for fascits like DAWN. Fascits that demand we believe as they do even when we can see the truth. And the truth NEVER squares up with their vision of humanity.
So how about it DAWN?!?! Care to walk in our shoes for a year????

Anonymous said...

I do not work in a hospital. My mom and other relatives do. Personally I have never had a bad experience with either an E.R. or a doctor. What I have done is sit beside a high school friend who died at age 32 from Lou Gehrig's disease and yes I know the medical term for it. Try that one out for size.

I was also there when a relative who had been a golden girl in both high school and college died after a drug overdose. Did she die alone? No. Was her family devastated? Yes. Did they get over it? Are they happy that the self absorbed, little bitch who stole from them, embarrassed them, cost them thousands of dollars is dead? NO! They would give everything they own or ever will own for one more chance to wipe up her vomit, bail her out of jail at four in the morning, or most of all bring her home alive to the little girl she left behind. Buster,Steve, Mr, Anonymous, whoever the hell you are, don't talk to me about a vision of humanity. You might be surprized at how fragile humanity really is. I couldn't care any less whether you like me or not. It's clear you are neither Albert Einstein nor Albert Schweitzer.
Try reading Sigmund Freud.

And Suv Mama if you should ever need an attorney and you might, you had better hope he or she is on YOUR side and competent. People have been rescued from death row by attorneys. The Declaration of Independence, The Constitution, and The Monroe Doctrine were penned mostly by lawyers.

Human rights, Abortion,and all other issues that shaped this nation were decided by a panel of guess who.

I guess if there wasn't a great need for lawyers, then John Edwards wouldn't have to defend living in a six million dollar home.

My dad is a defense attorney and a good one. He has defended many people for free. Get over it.

Anonymous said...

Sorry Doc I am still calm though madder than a junkyard dog. Are you referring to Tarasoff as in Tarasoff v. Regents of the University of California?

MonkeyGirl said...

Enough, Crayzee. I'm done with you. You may consider this a victory if you want. I will delete anything else you say. I refuse to let your bizarre anger take over my comments section.

Go away.

Anonymous said...

I am crazy like the late great Waylon Jennings. You on the other hand are insane. Delete anything you want. Come on over to my blog next week. I might mention you.

Happy Birthday, Merry Christmas, Happy New Year,and ADIOS

Nurse K said...

I would like to point out that lawyers are God's gift to mankind and doctors and nurses who save peoples' lives day in and day out like you pick up Starbucks on the way to your office are just assholes.

In honor of Dawn, we should drop celebrity references in all of our comments from here on out.

Me? I just got home from work and I'm tired like Health Ledger before a massage.

911DOC said...

yes! you are a lawyer or a good googler.

scalpel said...

Weirdest comment thread ever.

RealisticRN said...

I find it hard to believe you had a mother...being a lawyer and fact, you and your ilk are part of the reason we hate our jobs so much! Just because you have the talent to go in front of a jury and cause people's hearts to bleed thereby forking over bunches of money to people who never earned it does not make it right. One day someone is going to stand up to you and the rest of the scumbag trial lawyers (Edwards)...for now, go ahead and be smug. Just like cheap oil, it won't last...

scalpel said...

My dad is an astronaut, and he looks like John Travolta.

My wife looks like Penelope Cruz, only with bigger boobs. Any man tries to horn in on that action will be as endangered as a sea turtle.

I'm more of a Brad Pitt type, but not the scruffy version like in Kalifornia.

And I just wanted to mention Robert Heinlein, because I'm special like that.

Nurse K said...

Your dad's an astronaut? Big f'n' deal, my dad is the President of the Universe and he owns a really bitchin' Cadillac.

So that makes me the daughter of the President of the Universe. Top that, lowly trial peon.

Oh, and my dad looks like a bloated Bill Clinton, but, lucky for me, I look like a flatter-chested version of Scarlett Johansen. Big boobs are so 1990.

MY OWN WOMAN... said...

Monkey Girl... I'm sorry... I didn't mean to get anyone wound up so tight. left a nice post on my blog, but I don't think you understand what Monkey Girl NOR I was trying to say. In fact, if you would just calm down and re-read both posts, you'd see that we (MG and I) agree on most everything...we just have a different opinion on ONE thing. And yes, adults can differ and discuss and still remain civil.

If you've never worked the ER, you have NO way of knowing the frustration that Monkey Girl, nor I, nor any other person that works ER goes through on a daily basis.

Yeah, I still love the ER, and yeah, it can make me crazy...but then, I didn't have far to go.

Dawn...relax....chill....have sex with your rock star....It's all good in the hood! (ok, I smirked just a little when I typed that)

MonkeyGirl said...

Heh. It's like a SNL skit in here now.

My dad IS the Universe, or at least Mr. Universe , (same-same, right?) and my boobs are so great that I insured them for $7 million like Tom Jones' chest hair.

My Own Woman- no harm done. The opinion of people that don't know me doesn't bother me in the least. Your responses, both to my post, and to the Crayzee, are right on. We don't all have to agree about everything! Well, except that dropping celebrity names for no apparent reason is a bit crayzee. But fun...

Mom In Scrubs said...
This comment has been removed by the author.
Mom In Scrubs said...

OK I can't NOT chime in here...

Setting foot in a hospital, sitting at a bedside, or knowing someone who knows someone who was in a hospital does NOT qualify "The Dawn" (yes, folks, that's what she calls herself, and invites you to call her too!*gag*) to judge any healthcare employee based on a rant. Walk a mile in the shoes of another, and THEN you may offer your educated opinion.

Rants are necessary. They keep us sane (whether written, spoken, or just run round and round in our heads). I am sure, The Dawn, that you have ranted in some form, written or not, despite your lofty position in life. That MonkeyGirl chooses to write her rants is a non-issue. You, The Dawn, can choose to read or not to read...just as you can choose where you shop.

Being a LAWYER, owning a ROLEX, being married to an INSANELY attractive man, and not HAVING to shop at Wal-Mart does not make you any more qualified to comment on the attitude of MonkeyGirl than your much-disparaged BURGER-FLIPPER who likely wears a TIMEX, and whose tattoo-to-tooth-ratio is 4:1. The FACT is that neither you nor the burger-flipper have worked even 1 shift in an ER, or in any healthcare profession.

Can you argue that you have, in fact, endured repeated verbal abuse and borne pained witness to willful medical noncompliance of a patient who has no interest in maintaining her own health...all while smiling and biting your tongue simply because it is the professional thing to do?

The fact that MonkeyGirl posted her frustrations on her blog does not prove that she treated her patient any less than professionally. There is no evidence to prove that she sent this "letter" to the patient or the patient's family.

I submit, therefore, that there is no evidence to support your case, The Dawn, and I respectfully move that your accusations be dismissed as unfounded.

And on a snipey note: I have visited your blog, all 3 posts of it. I do not have the capacity to respect anyone who refers to herself using "The (insert name here)." Illeism is not attractive on any level. Maybe you should go hang out with "The Donald." I bet he wears a Rolex too.

Nurse K said...

I instantly pictured shaving Tom Jones' chest hair to attach cardiac leads.

"Please don't sue me..."

ERP said...

Wowsers. I just spent 25 minutes after the end of my shift reading this thread!

Sara said...

I was gonna ask Dawn why she's, ahem, "on the computer trading barbs with strangers", when she could be busy with rockstarman... Then I realized I don't wanna leave my blogger ID and have her whining on my blog. Ew.
Since it's golden oldies name dropping time, I bet her husband looks like Bonzo.

SUV MAMA said...


Sweetie, honey, darling,

My father is an attorney.

If you will READ my comments (you know, the great guys that penned the Constitution and the Monroe Doctorine were LITERATE) you would see that I merely said "they don't deserve the attention" in reference to lawyers.

Now, if I'm reading your comments correctly, you are saying that we should pay MORE attention to lawyers, because, you know, if I ever need an attorney my comments here will be on the record.

You missed the point (which is the understatement of the year).

This post wasn't about lawyers. It was about a patient.

But then again, if the fucking lawyers could figure that one out, we'd spend a hell of a lot more time on actual health care and a lot less time defending needless lawsuits from petty, small minded assholes like you.

Of course, written with all due respect for someone who thinks their blog comments are in the same category as the writers of the Declaration of Independence.

Excuse me, I feel an enormous guffaw coming out of me, and I might require medical attention. MG, you free?

MonkeyGirl said...


Nope, never free.

But I am cheap and easy... ;-)

DrShroom said...

Sorry, I got kinda sucked in to this one. So: I thought the original post was a good 'un. I guess you can tell that from the response it generates.
Secondly, and I apologise if this is me being a bit too English, but isn't bragging about your rolex and rockstar-a-like husband just a bit vulgar..?

Slainte MG


Anonymous said...

SUV Mama:
You are my hero. If you were single I would ask you out.

Jaded doc.

Angry Nurse said...

I'm trying to decide what was more enjoyable here the post or the comments! Either way, I'm laughing so hard I'm squirting milk out my nose!

License Pending said...

Drshroom asks "Secondly, and I apologise if this is me being a bit too English, but isn't bragging about your rolex and rockstar-a-like husband just a bit vulgar..?"

Nice pick-up!

Yes. It is every bit like being in high school - which I'm guessing Dawn is the at very least in high school or, as MG suggested, home schooled, in which case our tax dollars have been spared.

People who have Rolexes don't brag about them. People who are lawyers make arguments based on evidence instead of shrieking "I'm a lawyer, scumbag!"

Or, at least where I went to school that's how it is. And I haven't seen anybody do that since I graduated.

angry male nurse said...

I bet the WHOLE ER could smell that kooch. But that probably wasn't her biggest concern.