The Surprising Reason I Love Being an ER Doctor With Tattoos
Appropriateness of tattoos for physicians or other professionals is a heated debate.
“Doctors are people too and have a right to express themselves.”
“It’s unprofessional (big time statement of inquisition in academia), you might offend patients and hinder your ability to care for them.”
I tend towards “all things in moderation,” but have noticed that on the gritty front lines of the Emergency Room my tattoos seem to be well received and can actually help patients relate to me and establish trust.
The short falls of the American health care system is a topic far beyond this article, or quite frankly my ability as a writer, so please allow me grace to speak in the generalities that brevity requires. The ER currently serves as a catchment area for those lost to Blue Cross and Blue Shield. I have no data on this, but from personal experience there seems a correlation between individuals with substantial ink and a wry suspicion of physicians. People who have dealt with some shit on the way up; young African American and Hispanic males, ex military, ex convicts, pretty much anyone who fell outside the protection of the typical middle class American dream. These individuals constitute a large portion of my ER patients, and I have found my tattoos to be especially helpful in letting them know there is a relatable side of me a little less formal than the white coat.
“Mr. Jones. 34-year-old male chief complaint not feeling well,” states my resident (a learner in their specialty training who has graduated medical school, but works under a fully trained doctors license) pulling my attention from multitasking. He continues on.
“Vitals are normal, his physical exam is benign, no past medical history, not on any meds, says he just doesn’t feel right, I think we can let him go home. “
“Huh… think we need any labs or imaging?”
“I really don’t Sir, I think Mr. Jones is fine.’
This does happen in the ER, healthy people endure our sometimes horrendous wait times for things like a work excuse, trying to gain sympathy from a lover or family member, inadequate housing and it’s raining outside, or they simply have no better place to be etc. With a few more years and thousands of patient encounters under my belt though, I am much less quick to chalk up the patients visit to being nothing.
“OK, sounds good, I’ll go see him and let you know if we need to order anything.”
I go through my well-rehearsed routine of introducing myself and start gaining the history; the information needed to build a case for the cause of disharmony that worried this patient enough to come to the ER. My detective work won’t end here. Before the trial of treatment I will strengthen the case through objective supporting evidence gained by the physical exam, and possibly more advanced studies including blood work or medical imaging. Any experienced physician will tell you however, the history is where the money is at, that’s where 90% of the diagnoses should be made. Language is what separates physician from veterinarian, though in medicine we think we are hilarious and are quick to remind pediatricians that the gap is minimal. Language however is only as helpful as the information it provides and the level of trust and comfort I can establish in a few minutes at the bedside impacts this greatly.
In Emergency Medicine, gestalt, or gut feeling, plays an important role—it’s the art of medicine if you will. I digress, back to Mr. Jones. 1st step: Is he sick, could he die in the next few days to weeks if I miss something? No. 2nd step: Is something off? Yes.
This is not uncommon, it’s the ER; people come to me on their worst days, and each and every one of us has plenty we would prefer not to share with a stranger. My investigation has produced the same outcome as my resident’s, before leaving I turn and look at him in a final attempt.
“Are you sure there is nothing else, Sir?”
He holds strong “No, I just feel off, I probably shouldn’t have come.”
I change gears “Nice ink by the way” referring to his multiple tattoos.
He cocks his head a little “Doctors are into tattoos?
I smile, “Careful with stereotypes my friend” as I pull the left sleeve of my scrubs up to unveil the detailed wolf that encompasses my left shoulder girdle.
Why a wolf? Glad you asked. My upbringing was somewhat non traditional amongst my Med School classmates. As the Hebrew proverb states “Better a meal of vegetables where there is love than a feast with strife,” such was my childhood. Moving around shacks, forests, farms and a barn for a year in the Northwest, I always had a pet Wolf. Wincey, Big Foot, and Bandit. They were strong and fiercely loyal, yet intelligent and independent. I love and relate to them and my tattoo feels a natural expression of who I am and where I came from. I digress… back to our patient.
He looks surprised and impressed; in all humility my wolf took five hours of fine detailing and is pretty sweet.
“I have a dildo in my ass.” Mr. Jones blurts without warning.
Even as an ER doc this catches me off guard a touch, but I recover quickly, now satisfied that I’ve gotten to the bottom of the issue.
Rectal foreign body removal technique ranges from being able to extract it with your hand using a lightly sedating medication to calm the nerves to a full on trip to the Operating Room. But you can guarantee that most have tried pretty thoroughly on their own before coming to the ER. Thankfully the former was true for our patient. Exercising my privilege of working at a teaching hospital, I did my best to reassure and normalize the situation with Mr. Jones and then stepped out to find my senior resident. With a slap on the shoulder and smile I told him “Don’t fail me” and sent him back in the room armed with an anti-anxiety pill, topical numbing cream, some lube, and a latex gloved pinch grip using a thumb and three fingers. A couple of long minutes later it was out and only pride at risk for a longer recovery when Mr. Jones went home that evening.
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