The terrorism of caring.

Abstract

Myleft lung collapsed on December 6, 2001. It just dropped. I developed crushing chest pain and intensive shortness of breath. The chest pain went away and my pulse was steady so I allowed my ever-present coping mechanismof denial to take over. I did nothing about it for 2 days. Then I went to see my primary care nurse practitioner. I told her she was going to earn her money at this visit. Breath sounds could not be heard onmy left side. TheX-ray confirmedmyworse fears: pneumothorax. So I am whisked off to the emergency room where boredom and potential are the sisters that haunt the dwelling. After much fanfare, I am placed on a stretcher and the poking begins. Blood gases. Big bore IV. Foley catheter. The nurses performed these with remarkable skill and ease. Then walks in the surgeon. Let’s call himDr. Skippy. If I were a bartender I would have carded him. He was cute, goofy, and young. I finally asked him had he ever put in a chest tube before. “Yup,” he giggled as a reply. I looked over at my nurse and searched her eyes for an answer. “Iwon’t leave you for a moment,” she said as she slipped some morphine in my IV. The pain relief was joyous. She then asked Dr. Skippy how much Versed he wanted me to have. I picked up my head and informed them—once again—that I was on Sustiva and Versed was contraindicated. I was trying to formulate the words to explain induction of the CYP3A4 pathway as theVersedwas pushed intomy line. So the end result is I remember everything about the chest tube insertion since the Versed effect was reduced in the presence of Sustiva. This was my first encounter with the fact that few clinicians really listen to us dumb patients. I felt like I was there to satisfy their adrenaline needs. Twelve hours later, I hear a hissing noise in my room. I suddenly feel my left lung deflate like a balloon set free. My chest tube is half way out! I grab it and place pressure onmy chest and scream for a nurse. I quickly tell her what is wrong and she urgently pages a surgeon. I tell her, as I do my best Smurf imitation, that I want someone older this time. Experience does count. When I saw amanmy age run into the room, I actually felt relief. He promised me his chest tube would not fall out. The pain was incredible. I had to begin begging for pain medicine. As the second surgeon sliced my chest, I thought . . . this is insane! Why do I have to beg and scream?Does anyone really think I am trying to con drugs by having chest tubes inserted?