The Defenseless Ones

Something I thought about today that isn't usually discussed is the problem of Elder Abuse. Now, while most people think about physical violence when they hear abuse, you don't often think of other ways in which the elderly are taken advantage of. I had a case today that kept me late and which turned into a very disturbing story.

Again, while I cannot discuss the particulars of the case because this will now be a criminal investigation, I can say that a moment of kindness offered by a stranger turned into a break-in and physical abuse on the elder person. To add insult to injury, the attacker portrayed a health care worker "acting concerned" about the elder when they somehow managed to call 911 and police arrived.

The elder was then transported as having Altered Mental Status and ended up in the ED. Meanwhile, the stranger and their accomplices ransacked and stole from this elder person. Luckily, a concerned neighbor was able to get a license plate, and the suspects are being tracked. But this poor person had to suffer some humiliation with no one believing them, not to mention the losses suffered in their home, and probably some loss of faith in humanity. I was in shock as I was told the story. If I get an update I will post it.

Unfortunately, we often see some form or other of elder abuse. Usually neglect, sometimes by families that mean well, but are just not prepared to handle the demands of a frail aging person with multiple medical problems. Or by the hands of those in the nursing homes to which they are entrusted. I haven't written about some of the more horrific stories I've heard and seen. I've had a patient I've called Adult Protective Services for due to concern their fracture was inflicted by a staff member.

As for the rest of the day...

I spent the morning cleaning up from a multivehicle accident that resulted in the death of a Buffalo police officer.

I then had a patient come in with a steak knife sticking out of their belly. The driver and passenger of a motorcycle crash who both needed trauma work-ups. An overdose who needed to be intubated upon arrival. And assorted other crazy patients that each took up their own space of time.

Tomorrow it's back to the fun at the County. What a way to spend the weekend!

p.s. you can link to the National Council on Elder Abuse by clicking on the purple ribbon.

Another Month Did and Done

Well, it's Sunday. Officially, the last day of the module, and the last day of the medical year. Tomorrow morning I start as a senior resident in the Emergency Department. Fifteen more months and I will be done. I am going to put a counter on the sideline to count down the days.

After the excitement and interesting tales from this last rotation and the two months of Orthopedics before this, my husband was telling me that I was going back to the usual "boring stuff." I reminded him that I would be doing this "boring stuff" for the rest of my career; unless, of course, he lets me return to surgery and be a resident for another three years. By the groans and threats of moving to live in an RV on a beach in Florida I take it he is about ready for this to be over too.

My last case at the ME's office on Friday was a sad tale of a massive thunderstorm and downpour, a car out of control and hitting the curb at about 75 mph, jumping the curb and over a about a 3 foot wall and slamming into a church. The driver had major trauma to his head and lower legs. His passenger died.

Again, while I can't discuss the specific findings, I can say that this was the most trauma I had ever seen on one person. That the driver survived at all is incredible. I was in amazement throughout the entire post-mortem exam. I couldn't even begin to think of what I would do had this patient come into the emergency department. Where to even start. But, this is one of the reasons I did this rotation. To make you think about the traumas. To make you understand more fully the traumas. And, to realize that there are some things that can't be fixed.

What I'll be missing tomorrow: a second child has died of the H1N1 flu virus. We had been following her condition very closely throughout the last week. And, a victim of a train accident has died. I heard the radio call out when he was first injured and was amazed that he survived to make it to ECMC. I heard about his progress in the ICU. They will probably be posted tomorrow. With tongue in cheek, this just goes to show that even at the ME's office, life goes on.