MONEY Magazine: How to survive the ER

MONEY Magazine: How to survive the ER – Nov. 21, 2005: keeping notes

NEW YORK (MONEY Magazine) – Funny thing about emergencies: you don’t see them coming.

So when my 84-year-old stepfather Jim quietly slumped out of his chair late last year, my mother and I were stunned.

Ten years of helping him manage Parkinson’s disease hadn’t prepared us for this. Barely conscious and unresponsive, Jim needed an emergency room—like, stat. You know the image: overcrowded halls filled with doctors who don’t know you, overwhelmed with people unable to afford care elsewhere.


This article has a good list of things to do, before, during and after a trip to the ED.

I have one (really minor) quibble, and then a comment/question. Quibble: the author states the ambulance is compelled to take a patient to the closest facility. This is very EMS system dependent, and probably geographically / legally variable as well. In my fair city, patients meeting trauma criteria bypass nearer hospitals for designated trauma centers. This is protocol driven, and seems to work pretty well. Stroke diversions are coming, though I have some reservations.

My comment/question: Patients, and specifically families who keep written accounts of their interactions in the ED always get my attention (I’m usually concerned they’re angry and are making a list of things to speak to their lawyer about). Now, were I a laymen in that circumstance, I’d keep records like crazy, if only to be able to tell family what happened, so I understand there are a lot of perfectly benign reasons to keep a contemporaneous log of goings-on. But it always raises my Attention-Meter.

Any patients do this, and what’s your reception been like?

I read this link on someone elses’ blog, but I don’t know where. Sorry for not giving you attribution).


  1. I get a little amused by the scribe types just like I am amused by the people that bring in the diary of complaints.

    0901 bp 140/70
    0902 bp 150/80
    0903 bp 160/90 feel a little dizzy
    0904 daughter calls from jail
    0905 bp 170/90, heart starts to flutter
    0906 feel faint after going to bathroom

    once in the ER
    1005 nurse x takes vs
    1015 doctor x examines me
    1020 nurse y gives me an aspirin.

    On and on, it is all usually just nonsense. The CNN article is good.

    Bring a list of medicines and know why you take them, and know your primary doctor name for Pete sake!!!!!

  2. I actually told my mother to do this only because she is clueless about anything medical and can call me later or during if possible to give me the details. When my stepdad ended up in the ED for passing out and possibly(?) having a seizure, they left the ED without still really knowing the whys and whats. If I had been there I would have asked a million questions they couldn’t think to ask because they were not medical savvy.
    (Turned out to be the combination of a tumor and a low electrolyte balance)

  3. A patient taking copious notes is almost always a harbinger of doom, in my experience… particularly when all they want is everybody’s name.

    Prepare for that nasty, five-page, single-spaced-typed letter to your administrator.

  4. Maybe I’m too mellow for my own good, but I go out of my way to make sure they get all the information, including the spellings. Oddly, they often quit writing! LOL! I remind them that they can get an entire copy of the medical record within a few days.

    I find that the “scribes” I’ve had usually have a running log of the patient’s health care so it isn’t like they just started documenting the ER visit.

  5. I just read the article. How sad,she never mentioned the nurses once. We don’t have case managers running around our ER – apparently they didn’t see the nurses are resources for anything. I’d have been happy to write the author, but unlike a blog, there is no room for comment!