Undistinguished guests: An emergency room story | Daily Clinics

Undistinguished guests: An emergency room story 
I was taking my duty at casualty (emergency room) and it was during the lockdown period. As police patrolling was happening in the city most stringently, people were afraid to step out of their homes for trivial reasons, and consequently, we had only minimal patient load at the emergency room (ER). You may be wondering why there is a decrease in patient turn over at the emergency room during the lockdown. The logical explanation of it is that people of my country don’t want to understand the purpose of the emergency wing and they bring their patients even for a trivial illness which can be dealt with during outpatient clinic hours. Running nose and occasional cough can be managed at a local health center and such children shouldn’t be taken to tertiary care centers. Tertiary care hospitals are the fertile ground for antibiotic-resistant strains of pathogens and visiting the hospital itself can land you in acquiring an infection. There are even clever people who come to casualty because they don’t want to stand in the queue in front of the out-patient clinic. 
During that night shift, I stepped outside the ER, and then I saw a mother and infant accompanied by 3 other people (grandmother, father, and uncle). I anticipated that the child might be having some severe illness and that is the reason why there are 4 bystanders along with him. The mother brought the infant and surprisingly, in my primary assessment, there was nothing life-threatening for that baby. He was sleeping well, and there was no abnormal pattern of breathing or signs of dehydration. However, there is a rule in pediatrics that; if the mother says the baby is sick, then the baby is sick unless you prove otherwise, and hence I decided to examine the baby. I started probing about the illness and the mother told me that the child hadn’t passed stool for 24 hours. 

Then the conversation progressed in this way: 
Me: Is he is playful while awake? Is he feeding well?
Mother: Yes 
Me: Is he sleeping for about 2 hours after feeding?
Mother: Yes 
Me: Any episode of incessant cry or blood in stool?
Mother: No 

In that way, I ruled out major complications by these questions, which can happen in infants and I could comprehend that the mother is not exceedingly anxious even though they brought the baby at midnight. 

Me: Do you think that your baby is sick?
Mother: No. I think he is fine. 
Me: Then why did you come here in the emergency room, that too at midnight? 
She didn’t answer immediately and after almost a minute she replied. 
Mother: We couldn’t get out of the house for the past 7 days due to lockdown and a hospital visit is the only excuse by which we can escape the police patrolling.

Even though I smiled at her, inside my mind, I was yelling like the famous Pakistani cricket fan who gave the renowned reaction after Pakistan’s defeat against India in 2019 cricket world cup (O.... Bhai.... Maro.. Maro Mujhe Maro)

Me: Do you know that the COVID isolation ward is a few footsteps away from this emergency room and your child as well as your mother is at higher risk of acquiring serious COVID complications? 

She didn’t reply but she appeared apologetic. Even though staying at home is difficult for many, especially for the people who travel every day for their jobs; the purpose of lockdown will not be met unless the people adhere to the government instructions. I told her not to repeat it and made her understand the risk they were taking in the name of some relaxation during the lockdown. 
This wasn’t an isolated incident and we encounter similar people every day at ER. Even before the COVID pandemic, people used to come to emergency room for trivial illness and it is frustrating for the doctors as they lose time that can be spent for assessing sick children who need immediate intervention. In short, what I want to convey is that, please avoid consultations at the emergency department unless it is an emergency. 

Daily Clinics is a series of short blogs in which the author describes anecdotes told to him or experienced by him during his medical career. 
Please give your valuable feedback as comments in the comments section. 

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