It's Not About You

When you’re with someone in the ER, good for you. I see plenty of patients with no one. Through life circumstances and personal choices—i.e., the two things that all humans are victims of—they are alone. This doesn’t bode well for an ER visit with no one helping you navigate all the information and details that an ER visit entails. It doesn’t bode well for your long-term health either, as having community is a crucial piece of overall health.

However, this is vitally important: the visit is not about you. (As a general rule for life, “It’s not about you” should be in the top 10.)

Be supportive, ask pertinent questions, help clarify what the options are, ask what the doc is worried about. Offer to get water or a blanket. Go move their car to a better parking spot before they get a ticket because it’s parked in temporary parking. Make some phone calls to other friends or family if needed. Be useful and functional.

Don’t bring up your own issues or medical problems. When doctors ask about disease in the patient’s family, they mean first-degree relatives only. As a friend, your medical history is at best non-contributory and at worst distracting from the issue at hand. Being that pretty much every patient has relatives with chronic diseases, this is often less pertinent in the ER anyway.

Off the top of my head, clotting disorders, conditions that cause deep vein thrombosis (DVT), and pulmonary embolism (PE) are often useful to know. They are not common, and they are pertinent to assessing risk and the subsequent workup for those conditions. But if the patient is 70 years old, has features of metabolic syndrome, and smokes cigarettes, I don’t also need to factor in that someone in the family had a heart attack. The patient has enough risk factors already, and that little tidbit of information doesn’t change anything.

Avoid retelling a story about your “N of 1.” In a medical study, “N” refers to the number of patients studied. An N of 1 refers to a single patient experience. An N of 1 can be valuable when it comes to experimenting on yourself. For example, you can do an N of 1 study on yourself and stop eating Fruit Loops and OJ for breakfast and instead eat bacon and sausage and see what your continuous glucose monitor (CGM) tells you about your blood sugar. It doesn’t require any formal study or a medical degree to figure that out.

N of 1 stories often distract from the issue at hand when retold in the ER about someone the patient knows. Such as, “Aunt Judy had stomach pain and died.” Although that’s true, and I’m sorry for Aunt Judy, the chances that the patient in front of me with stomach pain has the exact same condition as Aunt Judy is low.

In one of Jordan Peterson’s books, he talks about being the kind of person who holds up and supports the family when someone dies. Strive to live a life such that that person is you. The same applies in the ER. Whether the visit turns out to be a false alarm, a new diagnosis of cancer, or a fatal heart attack, be the support needed. Be the person that keeps it together.

I’m not saying you can’t express emotion, but keep it in check. Crying is okay. Even brief episodes of yelling sometimes fit the situation. But excessive wailing, yelling, slamming your fists on the counter, flailing around the family waiting room, destroying property, or making accusations against medical providers are not acceptable. And yes, I’ve seen all those behaviors. It often seems more performative than authentic. It focuses the attention on the person acting out when the person who is sick or dead should be the center of attention.

Don’t distract and steal the show. There are no Academy Awards given out in the ER.

It’s not about you.