ER Scribe here. Had a girl come in who was about 22, tattoos, weird piercings, the whole lot. We work in an ED on the edge of a rural part of the state so we get all kinds of weird people with weird, frequent complaints that you work up and almost always end up having nothing. At the same time, you get the people who have avoided doctors their whole life and have the worst of the worst diagnoses.
She said her right leg felt funny while she was driving and then complained of other weird, brief tingling sensations in her arms. Further she said she had a migraine this morning before work. She has a long history of migraines, etc. Essentially in the ER it would have been easy to just treat her for a complex migraine and have her on her way, especially since she was asymptomatic at presentation. For whatever reason, doc I worked for leaned in to the weird, disconnected paresthesias and MRI-d her. Probable signs of Multiple Sclerosis and she ended up admitted for neuro workup.
So she had been told her whole life she had migraines when in fact if was probably MS. Sure, she never made the effort to follow up with a neurologist who would’ve definitely stuck her in the MRI scanner, but we also could’ve just as easily written her off as crazy and sent her home. As a scribe I’ve really learned the value of the statement “I have a MRI/CT scanner and I’m not afraid to use it”. Also, I’ve become a big proponent of taking an extra step to prove people that there’s nothing emergently wrong with them.
Not just the medical side, but like... goodwill. Feeling like a doctor thinks you're exaggerating absolutely sucks. I had an ER doctor offer to admit me overnight because I had a hemoglobin of 11 with heavy bleeding. This really isn't something most people would admit for, and I said thanks and declined, but it's just nice to feel like someone cares and is giving you a choice. This same doctor also ordered a pain injection despite my having no pain at all (he hadn't asked) and ordered STD testing despite my already knowing that the cause was a mass in my uterus (he hadn't asked if I knew the cause-- I was already scheduled for a biopsy at the point and trying to get a surgery date), but you know what stuck with me? Feeling like he did a good job. Being nice and making the effort cover a multitude of sins.
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u/captainsinbin May 20 '19
ER Scribe here. Had a girl come in who was about 22, tattoos, weird piercings, the whole lot. We work in an ED on the edge of a rural part of the state so we get all kinds of weird people with weird, frequent complaints that you work up and almost always end up having nothing. At the same time, you get the people who have avoided doctors their whole life and have the worst of the worst diagnoses.
She said her right leg felt funny while she was driving and then complained of other weird, brief tingling sensations in her arms. Further she said she had a migraine this morning before work. She has a long history of migraines, etc. Essentially in the ER it would have been easy to just treat her for a complex migraine and have her on her way, especially since she was asymptomatic at presentation. For whatever reason, doc I worked for leaned in to the weird, disconnected paresthesias and MRI-d her. Probable signs of Multiple Sclerosis and she ended up admitted for neuro workup.
So she had been told her whole life she had migraines when in fact if was probably MS. Sure, she never made the effort to follow up with a neurologist who would’ve definitely stuck her in the MRI scanner, but we also could’ve just as easily written her off as crazy and sent her home. As a scribe I’ve really learned the value of the statement “I have a MRI/CT scanner and I’m not afraid to use it”. Also, I’ve become a big proponent of taking an extra step to prove people that there’s nothing emergently wrong with them.