Tag Archives: Trauma

Know Your Rights in the Hospital: Urgent vs. Emergent Care

There are basically two types of scenarios when you have to go to the emergency room for trauma: 1) Emergent- where you are in some kind of danger and need an immediate procedure to be stabilized or 2) Urgent-you are going to need to do something relatively soon but you are not in immediate danger.

This is what I want you to always remember:  If it is urgent, not emergent, you can leave and get another opinion if you don’t feel comfortable.

When I was taken to the emergency room a month ago, I went in as a trauma patient.  I was admitted because they thought there might be something wrong with my spine and couldn’t get an MRI until the following Monday (the fall happened on a Saturday.)  Still serious, but not emergent, were the injuries to my mouth.  My jaw was fractured, a tooth was lost and several others were chipped or had moved, my nose was fractured.  (My wrist was also in a lot of pain but nobody was paying much attention to that at the time.)

From the second the oral maxillofacial surgery resident started talking to me, I got a bad vibe.  He wasn’t talking to me, so much as talking at me.  He was much more interested in explaining my injuries to a pretty intern than helping me figure out what needed to be done.  From the second he looked at the scan before he even looked in my mouth, he was talking about surgery.  He also refused to put my tooth back in that had been saved at the scene and stated coldly that he doubted that three of my other upper front teeth could be saved.  He started talking about incisions and plates but he had to send the photos to his chief who was off for the night and who would see me the next day.

Thankfully for me, the plastics team came to see me first the next morning.  They explained that they had looked at my scan and that while my jaw was fractured, it was still in position and could very well heal on its’ own without surgery.  This was very good news for an all-natural chick who would only have surgery if it was ABSOLUTLEY NECESSARY.  Then the oral surgery team came in headed by the chief (a four year resident) and the “charming” two-year resident I met the night before.  He painted a much different picture than the plastics team had just given me including dire predictions of future problems if he did not cut the insides of mouth open and install several plates and screws.   These scary warnings were directed mostly to my exhausted parents.

I asked who would perform the surgery, he said he would.  I asked if the attending surgeon (a seasoned and well-respected oral maxillofacial surgeon) could perform it.  He said, “No” and explained that the attending would only be in the room since this was a teaching hospital.  I asked if I could meet the attending.  He said not until after I consented to the surgery.  BIG Red Flag!

When I explained what Plastics had told me, he got pissed off and went to find them.  They all returned together and encircled my bed in the Trauma Unit taking turns pulling on my upper jaw.  The Oral Surgery Chief Resident would say he felt it moving.  Then the Plastics resident would say he didn’t.  Finally, I said I had enough and only one more doctor would get a pull on my jaw.  That’s when the Oral Surgery Chief Resident snapped at me, “Stop being demanding.   We are trying to help you.  You shouldn’t make any demands!”  I looked at him and said through my mangled teeth, “it’s my face.  I will make any demands I want.”  I had remembered something Dr. Christiane Northrup said on her radio show.  I am paraphrasing but it was something like, doctors work for you.  You are their boss and to remind them of that if necessary.

It’s hard to remember that when you have been through a trauma.  You are tired, scared, in pain and in my case mourning a lost tooth.  I was fortunate in my situation because shortly after the doctors left, my best friend, a medical malpractice attorney, came to visit me.   Once I told her what they said; she said we’ve got to get you out of here.  She said it was absolute bullshit that they told me that I couldn’t talk to the attending until after I gave consent.  Furthermore, a resident was not the optimal choice to operate on me if surgery was even necessary.  She explained the hospital I was in was good for trauma but that was about it and if the situation was no longer emergent then I needed to get out of there.

I was sure after I talked to her that I wanted to be released without the surgery but I was stuck until my spine was cleared.  Would you believe they made six different attempts in one day to get me to consent to surgery?  Even the anesthesiologist came in to get consent after I said no to three different people (twice to the guy who would have performed the surgery!)  It got to the point where I was afraid to sleep or take any pain medication because I feared they were trying to break me down.   I finally complained to the Nurse Manager and Hospital Administrator to get them to stop harassing me.

Thankfully, the next day the MRI was done.  My spine was fine and I was cleared to check out.  I was able to go home to finally sleep (and see my dog!)  Then a couple of days later, I met my current, excellent oral maxillofacial surgeon (vetted by my friend’s boss.)  He was shocked that they had done nothing in the hospital to stabilize my teeth.  He explained all the different ways to approach the situation.  Since my bones were in alignment despite the fracture, I opted to have my jaw braced and wired shut.  While he was doing that, he managed to save the three other teeth that were in question because “the blood flow was still good.”

I am so grateful to have had enough knowledge to realize that I didn’t need to stay in a situation that felt wrong.  I am also thankful to have a friend who backed me up and translated my suspicions into facts and helped me get to a better place.   Please know that you have options when it comes to your health.  Avoid making rash decisions.  Quiet down and listen to your heart if something doesn’t feel right and it is not emergent, move on!!

Love and blessings to all,


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