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Emergency Physician Suffers a Different Kind of Moral Injury

By Carrie Vargo, MD | on July 7, 2024 | 0 Comment
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One night I found myself on the other side of the stretcher, as a patient waiting for a psychiatric assessment in an emergency department (ED). After drinking a couple of beers and texting a friend about my depression and marital issues, my friend was respectfully concerned about me. I had said that sometimes I would rather be dead than feeling this sad, so my friend convinced the police to place me under a mental hygiene arrest.

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ACEP Now: Vol 43 – No 07 – July 2024

My interview by the male emergency physician was painfully brief, but I was forthright about being from the same specialty, explained in detail the preceding events, and said that I understood that he wanted to rely on a formal psychiatric evaluation before deciding if I was safe to be discharged to home. Being stubborn, however, and nervous about a positive blood alcohol level on my record, I shared my opinion about “medical clearance labs” that we emergency physicians usually order to appease the minds of our psychiatry consultants; we should not have to wait for labs to speak with our mental health consultants.

After he left, and while I waited alone in the room for what felt like forever, I heard my husband and my three-year-old son talking in the waiting room. All I wanted was to talk to my husband and my baby boy and tell them I loved them and that I was okay. I knew it would not be until morning before I was “medically cleared” for my psychiatric evaluation, and I wanted to let them know they could head home. So I popped my head out, and, because there was no one-on-one attendant nearby, I walked out of the room to find my family. Unsurprisingly, several nurses and a sauntering security guard followed me before I could even reach the waiting room door, refusing to let me talk to my husband. After they threatened to have me dragged back by security, I walked back to my room and sat on my bed.

Several minutes later, a group of nurses and a security guard stood next to me. I knew immediately what was about to happen as they all grabbed hold of my limbs, despite my passively lying down without a hint of resistance. I knew there was no use in fighting, but I did plead, though, blabbering about giving in to the blood tests and asking why they were doing this when I had agreed to come back to the room voluntarily. But the begging and tears did not stop them from stabbing me with three intramuscular injections, later confirmed to be the notorious B-52 combo of lorazepam, haloperidol, and diphenhydramine. All I could do was submit to their power as I lost my freedom to control my body.

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Topics: agitated patientspatient perspectivepatient restraintsWellness

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