An ED Physician's Confession: No Winners...And the source of my disillusionment.

In the emergency department we see a smorgasbord of human offerings.  There are the sick, the almost sick, the well but think their sick, and the well but want to get high so act like their sick.  This covers just about everyone.  The trick is to pick out who's who.  As ones ED career careens forward it is easier to label people in the last category.  This is the jaded, hardened perspective and society has only itself to blame. Over the last few hundred years the constitution of the average human has softened to the point of practical putrescence. Current humanity, a loosely referral, expects to be wealthy or at least for some sort of free ride; we expect to be pain free or at least a drug to ease the way; we expect us to immediately stop doing CPR on a dying 30-something cancer researcher to deal with the stomach pain that they've had x 6 months...and they won't leave until it's figured out. And when no narcotics are offered they leave threatening to sue.  It's no wonder after years of enduring this crucible of florid entitlement, that those of us in the trenches may become a nit jaded...a bit fuckin' stupefied at what the festering cross-section of humanity that stagger daily to my ER tells me about the road we're are currently traveling.  In the end we will have become so soft that our flabby constitutions will barely offer us the fortitude to get up and piss in a toilet, while silently weighing the option of just pissing the bed.. The path of least resistance is alway there for us to use as a foil for of what we should be, of the path we should endeavor to ravel.  I fully blame western medicine.  "Do what ever the fuck you want and when you are start to get sick...we'll pump you  full of toxic drugs, pound on your chest and in the best case you may live the rest of your vegetative days in a wheel chair with a tracheostomy and a feeding tube and  your poor family waiting with baited breath to wipe your soiled ass.  Did I mention I was jaded?  Did I sign up for this?  Is this what all ED docs are doomed to conclude at some point in their career or and I just more intolerant than most.  The more I work...the more I see....the more I think that a National Darwin policy should be implemented and let those who choose to ruin their health wallow in their self actuated aftermath.  Why should I spend out limited resources to save these people when  in fact they clearly know the risks of their actions... let them reap what they sow.  And save the true medical care for those unfortunate souls who are struck down by no fault of their own. Hard truth... Life is pain and we all die.  The best we can do is suck it up while alive an die a with shred if dignity.  This latter comment to be sure is more for your family' benefit than yours.  Offering them a relatively calm transition in to death with a show of strength is the best of all gifts.. I sincerely doubt you saw too many Arapaho indians crying at the prospect of their imminent death.  A contrast showing just how soft we've become.  And in the end it will be our undoing. Grow a spine America...before it's too late.