Emergency Service

Before telling about these events, I must tell another story which will help you better figure out the character of the people of Trabzon. A colleague of me, who comes to Trabzon to work as an assistant during the same period as mine, arrives at Trabzon around six o'clock in the morning. He parks his car by the road to buy some drink from a snack bar. As soon as he gets out of the car, he hears a man, whom he found out to be a taxi driver, calling out to him;

- Look here, young man!

- Yes?

- First of all, welcome to our city.

- Thank you.

- Your car blocked my way, so how will I get out of here if a fare comes up?

- Sir, I’m just about to buy a drink from the snack bar over there, it won't take even 10 seconds.

- I understand what you are talking about, but how on earth will I take my cab out of here if a fare calls me?

- Just 10 seconds, sir!

- I understand what you are talking about but how on earth will I take my cab out of here if a fare calls me?

- Alright, alright, he says and parks his car one meter away, buys his drink and comes back to his car, a little frustrated, asking the taxi driver;

- So was there any fare when I was away, sir?

Unmoved, the taxi driver replies with a permanent smile on his face:

- Oh my boy, no fare shows up at this hour of the day...

Now that you have an idea about the people of Trabzon, it won’t be hard for you to believe in what I'm going to tell you now. Around 11.00 p.m., we were sitting as a large group in the intern room right at the entrance of the emergency service. A man in his forties rushed into the room, seemingly in panic, with the index finger of his right hand stuck into his right ear; he goggled his eyes and spoke with a shaky voice;

- I have a fly in my ear!

- Why don't you take your finger out of your ear so it will go out?, said one of the interns.

After a moment of hesitation, he took his finger out of his hear. A little later, the fly flew out of the ear. Naturally, everybody burst into laughter, including the patient himself. We soon learned that the patient had come all the way from his village at a three-hour distance to the hospital, just for this simple issue, with his ear blocked by his finger...

The season when figs ripen is also the season when people of my hometown start to fall off fig trees. This is the issue for everybody in the town, no matter what gender or age. I even had an 83-year old female patient who fell off the tree. One day, as I was about to take over the night shift, I saw four patients in the trauma room. My colleague said:

- Altuğ, this one fell of the fig tree, he has a pelvic fracture; this one fell of the fig tree, too, and he's going to have a leg cast; and this one also fell of the fig tree, now under observation for internal bleeding. And this last one fell of the pear tree.

When I heard this, I couldn't help myself asking the last patient:

- I'm sorry to hear that, but I really wonder why you fell off the pear tree while everyone else fell of the fig trees.

- Well, doctor, we have a pear tree near the fig in our garden; I knew that climbing up the fig tree is dangerous, so I climbed up the pear tree to reach the fig from there, but I found myself falling of the tree.

- I think it's clear to me now...

For those who do not know, I can briefly say that the pain in acute appendicitis usually starts in the stomach, though not necessarily, and it then spreads down the side to the lower right abdomen. Once I had an old patient having pain in the lower right-hand side of the abdomen and the examination revealed results similar to acute appendicitis.

- Sir, you say you have much pain when I press here (I press the lower right corner), now can you tell me if you have pain when I press the left part?

- No. Not as much as on the other part.

- So you say you have pain only on this part? (I point at the lower right corner)

- It gives me too much pain when you press down there.

- Well, was the pain always on the lower right corner?

- ???

- Sir, I am asking about the pain, where did it start?

- It started when i was in Akçaabat town, my son...

A doctor can fully enjoy his profession in the city of Trabzon where people always love and respect physicians. One day, I was telling a patient about the prescription I wrote out when he interrupted me, saying:

- Doctor, I swear to God I will find and take whatever drug you prescribe, even if I know that it's a poison. Don't waste time telling me about the drugs, after all the pharmacist will write them down on the drugs for me. Can I do anything for you?

- Okay, get well soon.

- Thank you very much.

DID YOU KNOW?

The correct medical approach at Polyclinics is to get the most probable diagnosis in the first examination, whereas an Attending Physician of Emergency Medicine asks for the diagnosis with the highest risk in the first examination. For example, when a patient visits the hospital with pain in stomach and nausea, the most probable diagnosis involves diseases caused by intraabdominal organ pathologies, but the first examination is to diagnose any possible heart attack, though less frequently encountered compared to other possible diagnoses. Although patients sometimes find such examinations unnecessary, it must be noted that the first objective at the emergency service is patient health, not patient satisfaction.