Why are you here?

I'm sure I'm a pleasure to be with, but it still doesn't explain why some people choose to visit the Emergency Department. I find myself listening to patients' chief complaints and asking questions, eventually asking the biggie: But why are you here? Case in point- a man with end-stage AIDS came in to the ED by ambulance at 4am. Fever? No. Weakness? No. Vomiting? No. He couldn't sleep. He took a sleeping pill, but still couldn't sleep. And I found myself asking the question that I try to avoid, "But why are you here?" And when I say "here", I mean the Emergency Department. What is it that you want me to do? This is not an emergency. Most nights, I don't sleep. An inconvenience, yes. An annoyance, again yes. But an emergency? Most definitely not. I offered to hit him on the head with a frying pan.

Another patient came to the ED recently with two years of abdominal pain. TWO YEARS! She'd seen multiple specialists, had invasive procedures and surgery and still had pain. Nothing had changed. So why are you here???? She told me she "couldn't take it any more". Again, what did she want me to do? Amputate her...abdomen? Not something I'm credentialled for. But I offered any way.

There is no life-fixer-upper magic pill or injection in the emergency department, folks.