The one who was preoccupied about her toothpain at 4 a.m..

Accidents and Emergencies - Short-term care - Any hospital
Any training year

"- Good evening !
Er, Good morning !
Er, Good night !
Anyway, excuse me for that, what can i do for you ?"
"- Good Night. I am here because I have this horrible toothpain. Here."
"- Here ?"
"- Here."
"- Since... ?"
"- Since yesterday night. The problem was that it was saturday, so no dentist could have me in. So, i took painkillers.
And... Well, it doesn't work, i am in pain. So, here i am."
"- Mm."
"- Mm ?"
"- Mm.
Well, we are going to give you some painkillers.
And then, since it is sunday, monday actually, and it is four in the morning, well, i guess you won't immediately find some dentist to take care of you. Even here, in the university hospital.
Because, you see, i am not a training dentist.
The guy there, i mean my boss, i mean my senior, well, he isn't a dentist either.
In fact, the problem is that hospitals and emergency departements are unfortunately full of physicians but not of dentists."
"- And so, about my tooth ?"
"- And so, about your tooth, here is your prescribtion.
I wish you good luck for the rest of the treatment. With the dentist.
Normally, there are a lot of them available on mondays. Dentists, i mean.
Did i use too much the "dentist" word ? What time is it, already ?"
"- Four a.m. . Goodbye, Doc."
"- Actually, i am only a medstudent, as far as i am concerned. Only a medstudent. Under the resident stage, so not really important. But it is me who's pernickety.
M'am ? Hello ?"

Because i believe that everyone has already met The Ethereal Toothpain of the middle of night.

Like a scottish ghost never at peace, it goes from any University Hospital to any University Hospital, from any big hospital to any tiny hospital, from any "developed" country to any other "not-so-lucky" nation.
It cracks preferentially after the twilight, most oftenly in the last hours before dawn. Those exact long hours during when all the senses are shaken and the tiredeness is everywhere under the strained white coat.

Nobody have found a remedy to cure that Pain yet.

Legend has it that it will last until a dentist will be on call as well as a brave orthopaedic surgeon for the whole night.
Waiting for that we, unfortunate members of the medic-corp, are doomed to meet them wandering about in the Emergency departements in the middle of the night. Only equiped with our poor WHO grades of painkillers to fight back.

Oh, High Priests of the Health Board, do hear our humble prayer.

The one whose twisted ankle wheezed.

Emegency Room - Traumatic Care
6th year.

She is sitting in her wheelchair a sheepish smile on her face, sniffing now and then.
Her ankle is badly swollen but walking isn't that difficult.
There is no true diagnostic hesitation : the severeness of the strain will be, at most, medium.
I reluctantly fill the radio voucher.
One of my senior physicians informed me earlier that, on his shift, "Every single ankle strain coming into the ER will come out with an Xray. Even if the official recommandations are telling that it isn't necessary".
Why ? SIC ( Suing-In-Coming).

Strenghtened by my medstudent innocence, my will to do well and the total emptiness of the waiting list, i auscultate her.
They jump at my eardrums.
"- A little bit asthmatic, maybe ?"
She makes a shy smile and sniffes.
"- Yeah, not perfectly alright lately."
No kidding.

Twenty minutes later, when my senior comes in, he looks quickly at the ankle, doesn't even glare at the radio, approves my prescription and go straight to... The chest Xrays. He turns himself to look at me, his eyebrows raising.
"- She didn't sound really clear, i couldn't act as if i didn't heard."
"-Mmmmmyes."

He politely asks the girl one or two things, gives her her prescription and doesn't give her a thing for her lungs. "And if it doesn't get better, go and see your GP."

I know that the Emergency departement is there to take care about the casualties.
I know that in the trauma department the consultation motive leads straight to the prescription.
I know that the ER isn't there to take care of the common cold or the chest infections that are perfectly well (even if they occur on asthmatic people).
I know that the recording of the history and the clinical exam have to be quick because there is a lot of "urgent" people waiting for a further care and not a standard primary care of general medicine.

Nevertheless, this time I found a unstable asthma and a little chest infection going along with an ankle trauma.
What if, because of "care-optimisation" and SIC-abuse, I harvested unhelpful Xrays but missed much more critical things ?
What if i forgot the little questions leading to the current troubles ? The massive osteoporosis leading to a fracture, the badly located metastasis leading to the common backpain, the extensive melanoma  concomitant to the high bloop pressure ?

I know that we are not omniscient and that things will (hopefully) be done one step at a time.

But it is hard to give up. Yet.
I want to believe a little bit more in the "extensive scan" provided by a standard consultation. I can't yet accept the agreement consisting of leaving a lot of untrated/undiagnosed pathologies around just because the patients didn't mention anything. Or because their physisian didn't ask.

Utopia, here i am.