Pain Predicament


A family doctor calls to give us a heads up about a patient coming to the emergency department. He was obviously upset and sounded frustrated. He started in with the story …

I used some lidocaine a pair of tweezers, and some small scissors to remove a small lesion from a patient’s tongue. There was a little bleeding afterwards, but that seemed to stop with pressure. Then the patient said that it felt like her tongue was swelling. I thought it was from the lidocaine, so I kept her in the office and watched her for a half hour, then sent her home. They wanted some pain medication. She was allergic to codeine, so I prescribed her a few Norco pills.

The husband just called me and was screaming at me for the past 20 minutes, calling me an “asshole” and a “quack.” He said that his wife was in pain, so they went to the pharmacy to have the prescription filled. The pharmacist told them that there is a 50% likelihood of having a reaction to hydrocodone when someone has a codeine allergy. After that statement, the husband just accused me of trying to kill his wife. He wanted to know what I was going to do. I can’t give her NSAIDS because I don’t want her tongue to bleed. I’m afraid to give her any other opiates due to her allergy. Tylenol isn’t going to cut it. They called and said they’re on the way to your emergency department. What are you going to do?

His voice kept getting more and more stressed, so I tried to lighten things up a little.
“Eh, I’ll probably just give her some IV codeine and send her home.”

Dead silence.

“Did you not just hear what I explained to you?”
“Of course I heard. I was kidding.”
“Great. Now I’ve got a comedian when there’s a real problem here. Now I’M going to have to come in and manage this mess.”

And I just kept thinking to myself that Francis needs to lighten up a little.

After all that, the patient never showed up, either.

Maybe the doc referred her to another hospital whose doctors have better senses of humor.


This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.


  1. Heh. At least he didn’t send the patient to the ER with a ‘prescription’ for us to give her 4mg of IM dilaudid like one of my local practitioners likes to do.

    And perhaps the joke was in poor taste. Sometimes you have to bite your tongue and just let the poor guy rant a bit about his challenging patients.

    Or you could tell the joke and if it goes over like a lead balloon, you could suggest that if she shows up to just inject a little lido/marcaine with epi at the site and try some Tramadol.

    ER docs have a different outlook on some things. Not everyone appreciates our brilliance of wit.

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