Tuesday, September 30, 2008

Chest Pain, Hold the Mayo

Like any ER across the country, we have our share of regulars.  There's the cabal of the usual drunks (no sign of Jack Daniels or Jose Cuervo lately, and I'm told Jim Beam got back on the wagon), Asthma Attack Annie, Drug-Seeking Asshole, and the lovely Mrs. Hypochondriac to name a few.  They're an impressive cast, to be sure, but one of my all-time favorites has to be Chest Pain Johnny.

Johnny stops in every two months or so and every time complains of sudden onset, acute sub-sternal 10/10 crushing chest pain.  He gets brought back to the triage exam room every time for an EKG, which shows abnormalities every time.   Despite being a relatively young guy, Johnny does have a legitimate cardiac history and a pacemaker, and therefore gets the full cardiac work-up every time.  Confident that his complaint will earn him a bed for the next several hours, and if he's lucky, a few days, Johnny usually places his first food tray order at the triage desk.  

The game continues from there, with his initial demands refused while his lab work is still pending.  Those who know Johnny will usually try to wait him out, but we all eventually get worn down by his incessant whining if he doesn't manage to charm some doe-eyed volunteer or random social worker into serving him first.  On an average visit Johnny will score two or three lunches before getting discharged or admitted upstairs for further evaluation.

A couple nights ago, after several hours of dealing with nonstop chanting for food (and personally trying to buy his silence with two box lunches), I wheeled Johnny up to the cardiac floor as he salivated at the thought of room service.  Arriving on the darkened quiet floor shortly after 11pm, Johnny jumped off the stretcher, turned to the nurse, and screamed "Where's the food!?  I'm hungry, I haven't eaten all day!"

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