Welcome to our first Medical Monday, one day each week when we try to address the world of health, wellness and medicine. This will be a time when we hear from guest writers about their experiences in these areas, some of which will be on different ends of the spectrum medically. I may chime in occasionally as well. We’re going to do this for a while, so if you’d like to contribute your voice to the conversation in the form of a guest post, feel free to send me an email to get more details.

Some people who will write here are providers, some are recipients. The goal is to offer space to hear a new or different perspective, all with an appreciation of the subtleties of health and the intricate way the human body functions. It’s amazing, really, and a healthy body is not something to take for granted (simplistic example: until you’ve had a stuffy nose you don’t generally think to be thankful for the ability to breathe through both nostrils, right?).

One ground rule for this series: no matter how much your own opinion and experience might differ from that of the writer, please always be respectful in your comments and interactions. Some of the insights were hard earned, and we want to be a place of welcome and conversation. I know I don’t really need to tell any of you that, Dear Readers, because you know it instinctively. It’s just something we have to get on record for the court stenographer. (Don’t worry, there’s no stenographer sitting here in my kitchen with me…today.)

Let’s hear from our first guest contributor, who has chosen to remain anonymous.

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Recently I was sitting in an examination room with a nice middle aged man. He was expressing to me his feelings of anxiety. Just as he started talking about how it feels like the room closes in on him and he gets pains in his chest I hear something alarming drown out his voice. The overhead speaker blasts out, “Code Red!  Room 10!” I excuse myself rudely, because there is no other way to do it. I leave this patient and run to the next room to help assist with CPR on a patient that will likely not make it. There is no time to feel badly about the abrupt way in which I left my other patient. My mind is focused only on chest compressions and I try to keep the rate at the correct tempo. After an hour of attempting to resuscitate, the team realizes that our efforts did not pay off this time. I get a drink of water and walk back to the room with my anxious patient. I smile and apologize for the long wait.

Have you ever gone to the Emergency Room and had to wait three hours to see a clinician? Do you ever wonder why the person who came long after you did was brought back first? What is actually going on behind those curtains? We are going to get a first hand look at the inner workings of an ER.

First of all, my credentials. I have been a PA at multiple urban ERs for 7 years, including a level 1 trauma center.  What does that mean? I have seen the badest of the bad. And I love it. ER people are a strange breed. We are wild, adrenaline junky, cowgirls/boys. We are confident, and maybe a little arrogant. We work hard shifts, and we want EVERYONE to know it.  But don’t be fooled by the bravado. In the end we are softies and care about our patients deeply.

I hope that you never have to come to the ER, but statistics tell us that at some point your evening plans will include me and my team. Here are some pointers to help you get through your experience and help you understand what is going on in the ER.

First of all, if you are coming because of a life or limb threatening event, you are our number one priority. We will drop everything and literally run to keep you alive. I have walked out of a room mid sentence because I overheard a code being called. A code basically is a cardiac, respiratory, or neurological emergency. It means someone’s heart, lungs or brain aren’t working properly. We move fast because time is our biggest enemy.

I know that it is frustrating to wait, but on the other hand, it means you aren’t dying. If you are stable, there are often long wait times. If it seems like there aren’t a lot of people in the waiting room and you wonder why it is taking so long, there are ambulances coming in where you can’t see them. If someone comes in after you but they get called back first, it is because some kind of badness is going on. Please don’t harass the triage nurses. They get so much abuse from people that are annoyed with the wait time. They are stressed out and frustrated that they can’t help you more quickly. And they might bite your head off if you are sassy to them.

Please remember you are your best advocate. If you feel that something bad is going on don’t be afraid to go up and ask for help. People that work in the ER do make mistakes. I’m gonna go ahead and say it. We are not perfect and you need to follow your gut. They may think you have something simple….you may know that something is not normal or going very wrong.

Once you get into an examination room, there may be another wait. Please rest assured that we know you are there. Having a new patient on the board waiting to be seen is uncomfortable for all of us. We see that little blip on our computer screen and it drives us crazy. But if there is a sicker patient, they get evaluated first. While you are in your room, we are putting in orders, reviewing charts, going over results, putting on splints, reducing dislocated joints, suturing, putting breathing tubes in, stabilizing patients. The thing about the ER is that it is unpredictable. Sometimes there is absolutely nothing going on (we never say “slow” in the ER…bad luck). Other times we just don’t stop moving. One thing I know is that just because we aren’t in your room, it does not mean we forgot about you. We are thinking about what the next step is. We are reviewing your past medical history. We are thinking about compassionate ways to tell you bad news.

Here is my last point. No matter how awesome I think the ER is, the people in it are not perfect. We miss things. We judge situations wrongly. If you feel that something isn’t right, don’t be afraid to speak up and ask questions. If you still feel that something was missed, ask to speak to another practitioner. We may be egomaniacs, but in the end we do want the best for our patients.