I picked up a young man in turnover. That means his care had been started buy my partner on the evening shift but he was still in need of care when I arrived so he became my patient.
He was in his thirties and came in saying he had been hit by a car. There was no witness and the police who took the report called his story into question.
When I arrived, he was getting his CAT scans and x-rays. After reviewing them, I determined they were all normal. I then went to check on him and get him discharged where I found him to be most disagreeable. I don’t think he was drunk but he was the kind of antisocial person that was just horribly obnoxious even when sober.
One example of this obnoxiousness was that he swore constantly. When I asked him why, he said he was a skateboarder so when he gets upset, he just has to swear.
After many efforts, I was unable to get him up and walking, though he didn’t seem to be injured. Since I can’t really discharge someone who can’t walk, I called the trauma surgeon with the bad news that they were going to have to admit him to the hospital.
When I went in to tell the patient we were gong to keep him, he said he was not going to stay. I asked him how he was going to leave if he couldn’t walk. He demanded a wheelchair and got mad and called me nasty things when I told him we didn’t have wheelchairs. “What the fuck kinda hospital is this if you don’t have wheelchairs?”
I told him we had wheelchairs but they were for hospital use and not for people to take home. “I’ll bring it back” was his promise.
When he finally understood there was no wheelchair for him to take home, he went down onto the floor in his underwear and said, “Then I’ll crawl out!”
I pointed out he was free to crawl out if he wanted to but he couldn’t leave with the IV catheter the trauma surgeons had placed under his collar bone. Hearing this, he reached up and tried to yank it out. I politely pointed out it was sewn in and I would be happy to take it out before he left. I then promised to take him in a wheelchair out to the waiting room and he could crawl from there.
At first he refused to let me take the catheter out because I was “a quack” and he didn’t trust me. I pointed out I had been nothing but nice to him and was trying to get him to stay so we could keep him comfortable and make sure he was OK. “I can’t fuckin’ stay in the hospital!” he bawled at me.
Eventually, he let me take his IV out. He took some clothes the staff found for him, then let himself be wheeled to the waiting room with no clear plan of where is was going or how he was going to get there. I have no idea what happened to him though I imagine he probably walked away.
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