The other one was an attending ER doctor that when my wife came in the ER with what could be considered a psychotic state he refused treatment even so much as blood work. Just vitals ands they were way off. He kept on refusing while waiting on the state and she finally went unconscious in an exam room that I found her in completely unresponsive. Her vitals BP pulse etc were very elevated as well. I gave complete history including medications etc. She had a Cardiac History and I suspected either stroke or aneurysm. She had already had a spinal infarction.
When I found her in the exam room I yelled for help and a nurse came in saying we'll do something. Next in walks the doctor. I said she's unresponsive this is not normal she won't wake up. He just stood there and was fixing to walk off. I was getting pretty angry at this point and yelled help her you Stupid Idiot no mental illness does this he still refused. So I took her out of the hospital for a level one hospital.
They were highly interested till I was just a bit too honest and told them what had happened. They used amonia and got her back around and they too changed their tune to transfer. I asked them for some diagnostics to be done first and especially our primary care doctor be notified. About four days and nights of hell later we got the answer. Thanks to some discussions I had in FR I remembered some threads on SSRI's and some swearing they were very dangerous.
To shorten this up at about the fourth day I came home and went on line to a search engine. Trazodone +Zoloft +Adverse reactions. I had hits. Better yet I had THE hit. I'm not a doctor but reading an article I saw what was going on. I went back to the hospital. I talked to the floor supervisor and said I need to talk to her doctor it's urgent I think I know what's wrong and she needs the treatment now or she can stroke. She said he comes in tomorrow you can see him then. I said OK you will not give her any medications except Ativan unless you have my permission. Next morning house doctor was mad. I took him out in the hall and said I think she has Serotonin Syndrome. He said that's just pure rubbish. I said read it then doctor and then tell me who wrote this. It was his hospitals pharmacology professor. He said well Ok now when can I transfer her. I let him have it and said you better never say that word after what's happened someone goofed big time.
Next morning {fifth day} someone must have been scared or doing CYA. The MRI and CT SCAN I had asked be done the first day got done. A fresh bleeder was there. Thankfully small.
The thing that convinced me though was for the first two days she was non stop awake and violently thrashing. Her skin was blotchy and her BP & pulse elevated her breathing was on O2 when she'd keep it in. Then real early the third morning she was returning to normal quite aware of her surroundings etc. Then in walks in a shrink who spent 5 minutes with her and said well let's up the Zoloft. Next day at noon the nurse gave it to her.. In about one hours time all symptoms returned and stayed with her two more days. They still didn't catch on. At day six she was discharged partly Amnesic.
Had the first doctor bothered to do a PDR he could have gotten the same information I did. He was too interested in doing a patient dump. Her history warranted more than what she got. He wasn't interested in it either. I didn't sue him. But Chief of Staff got a letter though and he had treated her before for a pressure sore in the ER. I said if I ever hear of another person being done this way by the ER attending we will contact them as a witness.
That likely carried far more weight in getting the issue addressed than a lawsuit. It proved we weren't out for money but wanted an injustice addressed and corrected. In 23 years of doctors those two were the only ones I felt needed to go find another line of work.
BTW the first hospital I took her too even had a Pysch unit. He didn't even bother to call them nor her primary care doctor even after I requested he do so because she could have told him it was not true psychosis. Beyond some expected depression and anxiety she had no serious mental history.
The only reason she had not gone over the edge sooner was because she was on a small dosage of Xanax which is a Benzo and the class of drug used as an antidote for Serotonin Syndrome. Ironically she was on the SSRI's for PTSD because of the dentist. She was needing a full mouth extraction and was literally scared to death. From this though came the good news.
The Oral Surgeon who agreed to do it insisted on a treadmill test first. This was done a couple of days before the Serotonin episode. Turns out the treadmill revealed no heart issues beyond what the SSRI's were creating. For nearly 18 years she took BP meds she didn't even need. She had been on the SSRI's maybe three months. Things can get weird. We got the Cardiologist report after she got out of the hospital. He said he saw a slight abnormality. We explained what had happened and he said that explains that then.
Like I said some doctors are GOLD and some need other jobs as they know not what they do and don't care. All are human and I realize that also.
I've had doctors give patients meds that absolutely refused to consider a cause of bizarre symptoms till I show it to them. Even eye drops can have systemic affects.... it's a real "eye opener" (pun) when you show them that eye drops can affect heart rate and blood pressure.
Demerol is one of the worst. Especially with some of the Parkinson meds.
I've unfortunately worked on a kid that was killed by a dentist doing IV sedation without a pulse oximeter or cardiac monitor.... really STUPID. So he finished the case and since all he sees is the mouth and it's not moving, he thought all was well. It wasn't.
I think the best advice is to be present or have someone else present that cares. If you ask a question and it's not answered then you need to try to leave if you can. The problem with ER's is that it's not an "office" and you have little choice when you go there.
Most of the board certified docs I know are thorough but all it takes is one lazy, sleepy, impaired, psychotic miscreant doctor to give them all a bad name.