My "Smeducation" in Patient Smells
could give any future medical student advice about the ER, my three most
important words would be: Vicks Vapor Rub. When I first entered the ER, I was
prepared to be jaded, but I was not prepared for the smells: abscesses, STDs,
rotten teeth, body odor, mildewed t-shirts, alcoholics, chain smokers,
drug-addicts, and diarrhea diapers, to name a few.
worked in a nursing home, so I have smelled my fair share and this month in the
ER has added significantly to my repertoire because I've learned to expect the
unexpected. I don't mean to sound too facetious, because smells are serious.
Science shows that smells can awaken deeply buried memories and I consider my
"smeducation" essential to my future as a practitioner.
offer the perfect context to practice social justice -- every patient gets the
same level of care and concern compared to any other. If a patient walks into
the ER, they matter, odor and all, and they will get cared for. I didn't think
social justice was a reality anywhere until this month. I thought, "Surely at
the ER they won't treat everyone the same; healthcare is expensive and I'll bet
I'll see subtle discrimination."
pleased to say that I have not, which indicates to me that though the United
States healthcare system has gaping flaws, we are still the world's best. For
example, last week this precious-yet-noncompliant Jordanian patient presented
with a complication from his chronic diabetes. In his broken English he
described how in Jordan, "Doctor sends you home with a shot and doesn't fix
you. Here, I get help." It was beautiful because in the course of his stay, I
noticed a transformation of attitude towards healthcare workers and he even
smiled as he left.
time an intoxicated homeless patient who smelled remarkably like the Roanoke
River (he had apparently fallen in) received a full work-up for head trauma and
an overnight stay, a bill that probably totaled over $3,000.
there's a huge problem with this system, but I'm learning to love the patients
through their smells. The chain smoker you can smell down the hall and hear
coughing because their COPD resulted in another case of bronchitis isn't easy
to genuinely care about. But without your antibiotic therapy, that bronchitis
could literally end the patient's life. I knew I would learn a lot about
medicine in the ER, and I have, but medicine is constantly changing. The
biggest lesson I'm learning won't ever change: treat every patient as you would
want to be treated, smells and all.