For Just About Everything Else

The sound of squeaking shoes and huffing ventilators filled my ears as I sat to type at the desk in the ICU. I was lucky to steal the only remaining station from a nurse who had left her chair to give report.

The nurses were dispersed in groups of two huddling around computers and signing out to each other. The ancient ritual of the changing of shift had modernized by technological necessity. Quiet voices recounted patient histories and recent lab tests. Occasionally my ears would perk up when a nurse placed special emphasis and her voice catapulted above the hum of the crowd.

A middle aged woman stood with her back to me with tattered blue scrubs and a stance of authority. She spoke melodically with occasional stops and starts. The young woman receiving her soliloquy was petite and outfitted in pink. Her scrubs were freshly pressed and free of biologic spatter or remnants of a hastily eaten meal.

I couldn't help but listen to the conversation as blue scrubs spoke.

Mr. Slip presented to his local pharmacy clinic with chest pain and shortness of breath.

I almost fell out of my chair. Who in their right mind would go to a "quickie" clinic with such complaints? I imagined the chaos as an ambulance pulled up to the local pharmacy. I craned my head to listen closely as blue scrubs continued.

An EKG was done at the clinic and was noted to be abnormal. So the patient was directed to the ER.

Again I was incredulous. They do EKG's at these places? Are they capable of interpreting them? I imagined a sign in bright colors with a beautiful, young, athletic woman smiling back at me.

We now do EKG's. Get one today at your yearly physical in the pharmacy department. By the way, did we mention we sell aspirin?

Pink scrubs looked as confused as I. Although she didn't interrupt her senior partner, her lips pursed and she flipped curls of hair out of her face in mock frustration. Blue scrubs was not finished:

After returning home to walk the dog, the patient arrived in the ER and was found to have S-T elevations in leads II, III, AVF. His blood pressure on admission was 80/50.

She went on to describe the rest of the sordid hospital stay. By the time I finished my own charting, my head was swimming. How did we get to this place?

It's like I always tell my patients:

If you have a medical problem that will go away on it's own without intervention, go to a pharmacy clinic.

For just about everything else,

see me.