GREAT READS → IN THE BALANCE Issue 758 · May 1, 2019

Testing, Testing

That’s the paradox of testing: If you look long enough, you’ll find something. And that’s the balance we’re looking for: Treat the emergency, but don’t create it

By Baruch S. Fertel, MD, MPA, FACEP

6 min read May 1, 2019

With Zivia Reischer

That’s the paradox of testing: If you look long enough, you’ll find something. And that’s the balance we’re looking for: Treat the emergency, but don’t create it

ome people say the ER is another universe, separated from the rest of the world by pain, fear, the heightened sense that you’re out of control and anything could happen. Or it could be that the choices we face in the ER are the same as we face on the outside — just magnified.

Terry was 17. I recognized her from around the neighborhood. Mom and Dad brought her to the ER in a state of controlled panic — she had been playing basketball, tripped, and hit her head with a sickening crack on the asphalt.

Those who come to the ER are in a state of emergency, but they’re not all in need of lifesaving care. It’s our job to assess and treat each patient at the level of care that the patient requires.

Not always easy.

I looked at Terry. At a glance, she seemed fine. She answered all my questions normally, was able to track my finger in all directions, and could count down from 100 by sevens (if that sounds easy, try it). Her grip was strong. Her balance was fine.