Gunfight at the Crouse E.D.

By Mark David Blum, Esq.

Recently a man pulled a gun and pointed it at the head of a security guard at the Crouse Memorial Hospital Emergency Department. According to news reports, the gun came out in frustration at the man’s sister waiting for medical help. The end result was the man himself needing treatment after apparently falling down and hurting himself while in the custody of hospital security and Syracuse police.

No justification exists for pulling a gun on another human being unless you intend to shoot. Moreover, you don’t shoot a security guard because hospital staff wont make your sister a priority in their triage. In our country, you are just as guilty for stealing a loaf of bread to feed your starving family as you are if you steal to feed your drug habit. At sentencing it is then that the matter of degree comes into play. But both cases are theft.

Often I discuss how our nation’s relationship with drugs and medicine as an industry collapsed with the passage of the Harrison Act. I wont go into the details or reasoning. Summarized at its best, the Harrison Act changed the relationship between the doctor and patient and pharmacist. Before the Act, the patient was in charge and made decisions based on his information provided by the professionals. Subsequent to the Act, the entire medical industry has placed itself in a role as super parent and behaves without explanation.

Personally, I have nothing against those who work in medicine. It cannot be easy to be around pain and suffering all the time. These are the cherished souls who end suffering and bring comfort. Respected they should be as healers.

At the same time however, an institutionalized arrogance has grown to the point that the patient is no longer the object. It has become a world focused more and more and specializations such that the same nurse that takes blood out of one vein said she could not fix a backed up IV in another arm. A “phlebotomist is a phlebotomist” goes the old saying. Once each finds his or her specialized niche, they do not come out there from.

The same phenomena is part of the patient experience. No longer in control of our treatment, now we are denied information because no one person you deal with has been involved at every step. Doctors come and go and manage to forget to communicate one to another. We become the disease or injury that brings us before them. Their interest in us is limited by where we fall on the triage scale. “The gunshot wound in 11 needs …”

Well for the record, this past summer, I was the gallbladder inflammation at the Crouse emergency department. Apologies go out to my treatment providers that my ailment was not very sexy and easily diagnosed. Because blood was not spurting from a gaping wound and because a diagnostician and not just a patch it guy would be required, it felt as though I was the patient of least interest.

Who can blame them? Constant heavy vomiting and intense wretching, crying and writhing in pain are not issues these macho driven ER docs prefer to deal with. I did everything by the book. When it started, I waited a few hours to see if it would stop. The pain got worse. Then I called my family doc and made an appointment. Apparently I must have passed out because I remember someone telling the lady behind the glass, “you know there is a guy out cold on the floor out here.”

I never got five words out of my mouth before the doctor said, “why did you come here instead of going to the Emergency Room?” Well aside from being TOLD to come in and having to endure the pain and symptoms for several more hours, 911 was called and I was whisked away in an ambulance to Crouse.

Mind you that I still had not received any pain medication and have not been seen by a doctor.

Arriving in the Emergency Room, I am dumped from the gurney into a wheel chair and abandoned in the waiting room. It was then ten hours into this intense pain and my ability to “cope” was at its limit. At the speed of a herd of turtles stampeding through peanut butter, I was finally seen, stabbed, poked, prodded, drained, and after sixteen hours, I got pain relief. The doctor said that he had good news and bad news … in that the good news is that they cant find anything wrong, and the bad news being that they couldn’t find anything wrong. He gave me a prescription and sent me on my way.

I wasn’t even home before the pain came back. The Mrs. called the ER for advice and they said to come right back. In less than 30 minutes, I was back in the ER waiting room being treated by the staff as through I just landed from Mars and nobody seemed to remember I had just left there an hour or so ago. Nice thing that change of staff and nobody says nothing. Again suffering horribly in the ER, vomiting nicely everywhere, one doctor who was inside earlier and knew I had been treated came out to schmooze with the security guard. When I went up to him and reminded him I had been there earlier and can he please go tell them I am back. His response was to slide the computer monitor over so as to avoid making eye contact.

Back inside I went and again, nurses, phlebotomists, CAT scans, sonogram (is it a boy or a girl?), EKG, ad naseum all came to my rescue. Everybody that is, except a doctor. Meanwhile the pain is worsening and they feel the solution is to send in a social worker. Perhaps she was there to make sure I didn’t grab the guard’s gun and shoot myself in the face for pain relief.

Eventually the great educated minds of the invisible faces I never saw decided I needed a night or two for observation. Admitted to the hospital proper and finally in a room with plenty of pain medication, help, and comfort only took 19 hours from first symptom. A night of morphine and other medications and I woke up a new man.

Once inside the main machine, a hospital is a warm and receptive place. The ER stands as the gatekeeper and if you cannot appease their need to see priority, you are just dumped onto the pile of human refuse littering any emergency room in any hospital anywhere in the country.

Doctor, Heal Thyself. Get off your lazy ass and check on your patient. Don’t let a clerk be the first person an injured or suffering person sees. Step up and do the job for which you trained. Most times you have the luxury of waiting for tests and data before determining a course of action. But when a patient comes to you in pain, it is time to remember we are human beings and not widgets to be processed through a factory. Step up. A hospital is not a prison and doctors are not my parents. It is time perhaps they consider that lesson.

I can understand the frustration that comes with watching a loved one suffer. This man with the gun reflects the feelings I believe are shared by thousands who pass through hospital emergency departments. While most of us realize the futility and foolishness of making an overt threat, I bet my savings that many have had murder in their heart. A person in pain and needing medical attention needs help and there must be a response. When the hospital won’t respond because of triage protocols, when employees hide their faces and information, and when people are left ignored and untreated, loved ones can snap. I don’t justify what the man did. At the same time, I can certainly understand where he was coming from.

Back to the MarkBlum Report

It is always a far better thing
to have peace than to be right.
But, when it is not,
or when all else fails

P.O. Box 82
Manlius, New York 13104
Telephone: 315.420.9989
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