Sometimes what patients really need can be surprising

“I give up! I can’t help these people.” Emily was completing the final month of her emergency medicine residency and flopped into her chair with exasperation.

“What’s up?” I asked. We were on the final two hours of our shift together. And I, as her attending, was already feeling apprehensive about the patient encounter that awaited me.

“They want so much from me, and I can’t fix them!” She began to tell me about the patient in room 24 she had just met: a young woman with a benign-appearing neck mass that was diagnosed last week. We had found it two weeks ago on CT in our emergency department, and she had since seen her primary care doctor and a head and neck surgeon, received a fiberoptic evaluation, and was scheduled to have an operation to remove it the next day.

“What’s she doing here?” I could feel my own irritation brewing.

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