Another mobile post on the overnight shift. It is interesting being the first person people see when they walk in. Regardless of who they are and why they come, in principle all should be treated the same way. Sometimes, however, it's difficult to do that, mainly because the people who come are not always forthcoming with the truth. When that happens, my inner cynic wakes up, and the voices in my head become loud indeed.
Some general observations I've made:
1. The sickest people don't come on their own. And usually they don't want to come here if they can help it. Those are the ones you know will die without help.
2. Those people who could stand to wait until normal business hours to be seen inevitably show up at 3:00 in the morning. And it is usually for problems that don't need intervention then and there.
3. Those who are homeless that are seen here, if it's cold or the weather is inclement, will inevitably try to hide out in the waiting room so they don't have to go outside. That happened last night, in fact; a patient who had been seen for a couple of different issues managed to get under the radar for a couple of hours before she was discovered. Clearly she was stalling; her plan was to get admitted so she would have a place to sleep. But that didn't work out for her. And I discovered her at 6:30 yesterday morning...
4. The people who deserve misfortune the least seem to be the ones who suffer the most, no matter what the reason is.
5. Time flies when you're busy.
Some of these observations bleed over into my work in the field as well. The thoughts I have in the end don't always fit precisely into the same mold, but they are close enough. And I'm sure I'll come up with more as time goes by.