One perk, or drawback, of working in the ER is that there are no shortages of interesting characters we see. Many of them we see over and over, and get to know very well. There was the old guy with the pacemaker who we saw >500 times for chest pain over a three year period. And the asthmatic who every doc in our group has intubated at least once. And the brittle diabetic who could somehow survive with a bicarb of five. They stick in your minds.
One guy we will never forget around here was the alcoholic we called "Boomerang Bill." As his name implied, he was in the ER pretty damned regularly. He had money, and was actually rumored to be independently wealthy. (A repellent figure, he once confided to me that he spent all his money on "booze, hookers, and taxis.") He was routinely found passed out under a bar stool somewhere, or puking on someone's lawn in the middle of the night, and the medics would routinely bring him to us to sober up. He was kind of an ass when he was drunk, and the nurses hated him because he would grope them every chance he got. But once he sobered up he was pretty polite and pleasant.
But every once in a while, he would run out of money or get too sick to drink, and then he would go into fearful DTs. I mean, his shakes and seizures and delerium were a thing to behold. We nearly used up all the ativan in the hospital chilling him out on more than one occasion. He would camp out in the ICU forever and the hospitalists hated dealing with him. But he was hard to kill, as so many of these hard-core alcoholics are, and he always rallied and made it back out to the street, where his first order of business was always, of course, to go get a drink.
Once, after dealing with him in withdrawal four times in four months, the hospitalist who was in charge of his care decided to try something new. He located Bill's brother, who was in New Orleans, and convinced him to agree to take Bill into his home and care for him. Bill was himself willing to go and try to start over. The only problem was getting him there. So a collection was taken up among the medical staff — hospitalists and ER docs alike contributed eagerly — and we bought him a plane ticket as well as some new clothes. When he was ready for discharge, the hospitalist drove him to the airport himself and actually put him on the airplane.
And that was the last we saw of "Boomerang Bill." Until (you must have known this was coming) about four months later when he showed up in our ER again, drunk but starting to go into withdrawal. I'm not sure whether we were more astonished or horrified to see him again. When the hospitalist came down to admit him (the same one who had driven him to the airport) he asked, in dismay, what had happened, why wasn't he in New Orleans with his brother? Bill replied in his gravelly voice, "Man, it's too damn hot down there. I couldn't stand it." He added, in an aggrieved tone, "And it took me forever to hitchhike all the way back up here, too."
The hospitalist's shoulders just slumped in defeat. The boomerang had come back once more.
Epilogue: We continued to see Bill on and off for the next couple of years, on his usual irregular schedule. One day he staggered out into traffic and was hit by a car and left for dead. He was brought into the ER in critical condition and died a couple of days later. Some of the nurses noted that he had seemed more despondent in his final ER visits and wondered whether this was a passive (or active) suicide attempt. And so it goes.
31 January 2012
Posted by shadowfax at 5:00 AM