I found myself in the Emergency Room today. I am not sure it was entirely indicated but then again I would not spend three hours in the ER if I knew it to be unnecessary, or would I? I have diagnosed myself (not really appropriate; doctors cannot heal themselves) these past weeks with incredible stress- related anxiety, and have until today decided that my heavy chest pain was directly associated with the many difficulties I have been faced with. Perhaps I went to the ER today to avoid arguing with my daughter, or not to face the house or my departure or leaving my practice, or whatever I may not want to deal with. Hazard of hte profession; I find myself questioning what may appear to be perfectly reasonable decisions.
Once I announced to my family that I was going to the ER, I delayed my departure. I played violin with Maya, I waited for Eric to come home and cook dinner (bloody steaks which both Tara and I did not eat). Once I really had no more excuses about leaving, I got into my car and started driving toward a 'doc in the box' called Patient First but drove into GBMC when it appeared to my right. Chest pain got me past the electronic double doors immediately for an EKG which was normal. Another hour passed during which I read travel magazines from last year and and started to get antsy. Finally I spoke to a triage nurse and started to feel ridiculous. Was I making this all up or was this presentation legitimate? Bloodwork was next and then it was out to the waiting room again where I did not want to read old magazines anymore and began fiddling with my iphone. I called my offices and got messages and returned them. I looked at my email and then erased messages and realized that I was really just fine and there were far more ill people waiting for care and what was I doing wasting the doctors' time?
I walked out to the clerk at the front and said I was leaving I thought I had been there three hours and it was in fact only two and the nurse brought me to the inner sanctum, so after explaining that I did not think my symptoms were serious and that I really wanted to leave, she suggested that at least I wait for a doctor. I read last Sunday's New York Times but it did not engage me ( I have lost interest in politics and that has ruined the Times for me!). I began texting Eric furiously and then tried to text anyone else I could think of. Finally a very sweet and serious doctor came in to tell me I needed to be admitted to stay in CCU and get a stress test in the morning. I tried to convince him that I was fine, and in the end I had to sign a paper that I refused a stress test, but I assured him that I would contact a cardiologist the next day.
He asked me about stress, and I realized when I told him a tiny smidgeon of the enormous events that were occurring in my life, that there is simply too much going on. The renting and emptying of the house, the closing of two practices, the difficulty terminating patients, the disagreements with my daughter and my worries about her, the finalization of all our plans for our year away, the illness of my mother, the strain on Eric and I; there is just too much to manage and limited resources to do so.
When I finally signed the papers to absolve the hospital of responsibility, I walked our of the emergency area and found myself feeling lighter in the pouring rain and the lightning strikes. Was it because no obvious pathology was discovered? That I had three hours of rest? I was held hostage in the ER and could not accomplish anything; I could only sit and think and wait.
I came home to Maya and Tara sleeping together in the guest room on Maya's mattress on the floor and Eric working on the computer. I do not feel terrible about my visit to the ER. It was three hours of my life, and not all that reassuring. I wonder if it is just one more thing on my list that I have taken care of, that I can strike of my list of 'things to do'. I could not stay in the hospital and indulge myself for the whole night and part of tomorrow. I cannot imagine keeling over in the next few days, and perhaps once again this is anxiety manifesting itself ( not that it is not manifested regularly anyway).
Karma is odd. I sent a patient to the ER yesterday (and avoided the same ER today) and then I find myself in the ER for my own issues. I wonder f it means anything (what goes around comes around) or is just coincidental and meaningless. For a minute or two (especially when the doctor was trying to convince me to stay) I wanted to tell him it did not matter if I did fall over with an MI, but that would sound negative and I amended my words and reassured him. I am home and safe for now.