You know when something hits you and you say to yourself: Of course...duh. I had a thought about work. From now on, just about everybody is going to be either a train wreck or a nut case. The days of getting normal people into an inner city ER are over. Bye bye. Never coming back.
People have too many other options these days. They have shiny new suburban ERs. There are more and more urgent cares. There are orthopedic urgent cares. Any kind of normal person is going to them first.
I kept thinking, okay, yes the train wrecks and nuts are increasing, but eventually it will balance out again. It won't though. Here's a sampling of a typical shift:
drunk woman who was beat up a few days ago and her whole face is bruised over
ex con guy convicted of attempted murder
16 year old who was stabbed in the back
chronically ill 300 lb woman who is now having another problem
women who is shouting baaabaaaa like a sheep
confused grandpa who lives alone with no family
16 year old heroin overdose
The days of ankle sprains, lacerations, strep throat are over. Those people went to Bob's urgent care emporium. Why would they want to sit in the lobby with the hood rats and junkies and STDs and moaning back pains? It scary and gross out there. I don't blame them. Bob's is clean, new, has a fish tank in the lobby.
So welcome to the modern inner city/ghetto ER....where there is a constant stream of train wrecks. nuts, ineffective copers, junkies, drunks, neurotics. This is our life now. Reality is a bitch.