The Emergency Department Fails a Woman With Life-Threatening Internal Bleeding

Where things went wrong


A big “wrong way” sign.
Photo by Kind and Curious on Unsplash

It was not the kind of Emergency Medicine I ever wanted to practice.

Pale on arrival, with a blood pressure of about 90/60 and a heart rate of 110 — three factors denoting borderline shock — she was a woman with a medical history strongly suggesting active internal bleeding, specifically from the stomach.

Days earlier she’d noticed dark, tarry, extremely foul-smelling stool, melena in medical terminology, the result of blood mixing with gastric acid and transiting the gastrointestinal tract being metabolized before exiting.

Like many patients, she’d hoped this unpleasant problem would resolve on its own. She’d stayed at home toughing it out.

Then a boring, burning pain in the upper central abdomen had ensued. This too she endured, self treating with over-the-counter pain relievers, which may well have worsened her predicament.

Finally, after vomiting an alarming volume of blood vaguely resembling used coffee grounds, my patient came to the Emergency Department (ED).

She drove herself in. This was one hardy individual.



Michael Burg, MD (Satire Sommelier) 😬

The “MD” & “um” in Medium, and the “er” in wisenheimer | Doctor Funny editor/czar | Sultan of satire | disgraced former parking lot attendant