more from the bad doctor files

I sent a student who had been in a car accident this weekend to see her doctor yesterday.  She had been rear ended hard enough to take the rear fender off her car and to misalign her trunk.  She’d been complaining of a headache and nausea and one of her eyes looks like it’s dark, like a mild black eye.

She writes to me later:  My doctor told me to take some advil and that the headache should go away in a few days.

Ok, so maybe she doesn’t have a concussion.  Maybe it’s from having been married to an ER doc and the child of an ER nurse that I think someone who has a car accident should get some damned films.  And maybe that’s not a sound basis for judgement.  But you know, in the 7 years I was with him, the ER doc husband had two patients with badness that he missed or nearly missed.  One was a patient with a dissecting thoracic aneurysm who collapsed in the parking lot after being discharged from the ER.  The other was a lady who had hit the steering wheel with her face and torn her nose…essentially lifted it right up off her face.  Husband MD didn’t notice this until he had already signed her discharge papers and was about to let her go when he thought “Hmmm, that little cut on the side of her nose that I thought was from a torn out nose ring seems to be on both sides of her nose…I wonder what happens if I push on her nose – OH HOLY SHIT!”

I sort of assume that if wanting to be sure you don’t miss the hidden trauma isn’t motivation enough, the fear of lawsuits should help you along the rest of the way to investigate and not send your patient out into the world with something that could be alarmingly bad.

But then that’s just me apparently.

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