As a doctor working in a district hospital, I spend my night shifts (and a fair amount of day shifts) working in casualty. Another name for casualty is Emergency Department – so you would assume that I spend a lot of time handling emergencies right? Wrong. Casualty is just another word for “Glorified 24-hour Clinic” or at least that’s what the word on the street is. It seems like people have forgotten what “emergency” means, so to clarify I have come up with a few examples to explain the difference. When is it really necessary to visit an emergency centre?
1. When you have had back pain for the past 8 years?
No. If you have survived the pain for 8 years you probably will survive another night. Then in the morning you can go to the clinic or your GP or whomever you please – as long as it isn’t an emergency centre. Seriously, unless you can’t move your legs or were involved in a car accident, your back pain is not an emergency.
2. Speaking of car accidents – When you are involved in a fender bender that didn’t even leave a mark on your body?
Not an emergency. The other day 91 school kids who were involved in a very minor bus accident (if you can even call it that) were brought to EC to be “check out”. Ninety one! Ninety one walking, talking, playing, children with not a single scratch or bruise on their little bodies had to be seen by two doctors in casualty. For what?
3. When you get your arm caught on palisade fencing while running from the pigs, leaving your elbow gaping open?
Although unnecessary and avoidable, this is an emergency and you may present to the emergency centre for me to suture your wound – even if it is at 4am and I can’t really see straight anymore – I’ll do my best. But I will also take multiple photos of my handy work and you will be featured on my Insta story, or at least your elbow will.
4. When you have cataracts?
Are you kidding me? The other day a patient was referred from his GP to the EMERGENCY centre to sort out his cataracts. In this case the patient was entirely faultless and his GP was the one who had forgotten what emergency means. I’m really not sure what he expected from me? To remove the cataracts right there in casualty? Note to GP’s – there is a thing called an outpatient department. This is the place you can refer patients with non-emergent cataracts to.
5. When you’ve had a seizure for the first time?
Seizures are scary AF – I’ve seen plenty and they still instill a slight panic in me. You should definitely get to an emergency centre. The rule of thumb is that everybody is allowed to have one unexplained seizure in their lifetime, but all the dangerous causes still need to be excluded, so by all means, you are welcome in casualty.
6. When you’ve had a seizure but you are a known epileptic and instead of drinking your tablets you drank two liters of soetwyn?
I really want to say no because you are just wasting my time, but technically this is still an emergency. There’s not much I can do for you though, except make sure you stop fitting (which you probably already have), tell you to stop drinking (which you won’t do) and put you back on your antiepileptic medication (which you won’t take), so I’m not really sure what the point is.
7. When your son has behavioral issues and is generally acting like a incorrigible teenager?
No my friend. If I wanted to deal with things like that, I’d have my own children, thanks.
8. When you are just drunk?
Also no. A lady literally presented to EC the other day with the complaint that she felt “dronk in haar kop”, but she smelt like she had drunk sixteen liters of brandy. I (politely) told her that she felt that way because she was, in fact, “dronk in haar kop” and showed her the door. This was at 11am by the way, and to be honest I was kind of jealous (day drinking is always fun).
9. When you are drunk and then fall off your ‘stoep’ and break your leg?
While annoying, I suppose a trip to casualty is necessary. Please just refrain from cursing your doctor while she tries to help you. She didn’t push you off the stoep. And her mother has nothing to do with this.
10. When you are kicked by an ostrich?
I’ll allow it.
11. When you have menstrual pain?
Nooooo! I know it can be bad but have you ever died from having your period? Seriously, just be grateful you are not pregnant and take a Myprodol – you will survive and you will be a stronger woman for it.
12. And finally, one that you will gather I am very passionate about: When you have a cold?
This is for all the Panda’s out there: A headache and snotty nose does not equal imminent death and you do not need an antibiotic. And if you really think that an emergency department visit is necessary then you will be triaged green. And you will wait for multiple hours. And the drunken fools with stab chests who arrived after you will be seen before you. And while you wait, you will be forced to sit on the ‘dirty’ seats and walk on the ‘dirty’ pavement and use the ‘dirty’ toilets (none of which are really that dirty). And then, when you eventually get to the doctor and waste another five minutes of “your precious time” shouting at her about “the state of the hospital”, she will listen quietly. And when you give her a chance to speak she will explain to you that your snotty nose is not an emergency and defer you to the clinic – and it would have all been for nothing anyway, so you might as well have stayed at home. The End.