I recently had a complaint made against me at work, which is a rare occurrence. This was a 50 year old woman with a history of diabetes who came in because she had an open wound on her ass. We were admitting her because it was a diabetic sore. When you admit a patient, it takes a couple of hours to secure them a bed and send them upstairs.

She had an A1C of 12.6, meaning that her AVERAGE blood sugar level is 315. At that level, your blood gets thicker, meaning that it can’t perfuse as well, and as a result she had already had one leg amputated. She just isn’t managing her diabetes.

After six hours in the ED, we managed to get her blood sugar down to “only” 177, and had been refusing to feed her because her sugar when she came in was over 400. When I told her she couldn’t eat, she said she would fix that, and took some of her insulin when I wasn’t looking, which caused her blood sugar to drop into the 40’s. Then we had to give her an ampule of dextrose, and it really complicated her care.

She was upset with me that we were sending her upstairs without “fixing the problem” that she came in for. I told her that her problem was caused by her not managing her diabetes, and that continuing to eat sugary foods and not taking her medication would mean losing other body parts, and would eventually kill her. This wound was not something we could “fix” in the ED, and would require a stay in the hospital with specialized wound care nurses working on the wound, and with her constantly trying to eat sweets, it likely would never completely heal.

So she complained about me for being rude. My boss agreed with me, and told me that sometimes people don’t want to hear the truth that they need to hear.

Categories: MeMedical News


Grumpy51 · April 7, 2024 at 6:40 am

Can’t tell you how many times ED doc tells the patient they’re being admitted, I go into see them, tell them I’m with hospital medicine, that “we’re the ones that get you in the hospital, coordinate your care while you’re here, and, when you’re well enough, get you out of the hospital.” I spend 30-60 minutes in with the patient- getting information, doing an exam, discussing their lab/XR results, and how we’re going to treat it. My last question is always “any questions?”. Can’t tell you the number of folks who say “so I’m being admitted?”

The frustrating ones are the ones who say “no one told me I was being admitted!” You mean the ED doctor didn’t tell you?? I didn’t tell you when I walked in??

This is why Bonhoeffer’s Theory of Stupidity is so important….. and why stupid people are so dangerous. In your example, she had already lost one leg to diabetes, yet wasn’t concerned about her high sugar…… only wanting something to eat.

Your example is one reason why healthcare is so expensive. She wants to lose the other leg or go septic?? Let her….. freedom is a dangerous thing, choices and actions have consequences, and we (healthcare) interfere with those consequences on a daily basis….

Don Curton · April 7, 2024 at 6:55 am

I am so glad I have a career where I don’t have to deal with the public. Even dealing with other professionals, I find that most people don’t want to deal with the truth, but at least there’s some level of professionalism involved.

Skyler the Weird · April 7, 2024 at 7:11 am

She sounds like my Aunt who burned to death in bed when the Oxygen she was using to breath because of emphysema from years of chain smoking caught fire because she couldn’t resist another cigarette.

SiG · April 7, 2024 at 7:47 am

It’s what the American Get Diabetes Association recommends. Just eat that sugar and cover the blood sugar spikes with Insulin.

As Nina Teicholz of the Nutrition Coalition says, “it’s like advising someone with a nut allergy to eat nuts with an Epipen nearby. “

jimmyPx · April 7, 2024 at 9:17 am

Yet I’ll bet a $1 that she refuses to take Metformin or Ozempic to help control her sugar levels because it “hurts her tummy” and it makes it so she can’t stuff her face !

    ModernDayJeremiah · April 8, 2024 at 4:23 pm

    Metformin doesn’t act as you describe. The GLP-1 drugs, like Ozempic, Trulicity, and Mounjaro, do have GI tract effects.

      Divemedic · April 8, 2024 at 7:19 pm

      The main adverse reactions to Metformin are:
      Lactic Acidosis
      Abdominal Bloating, diarrhea, nausea, vomiting, metallic taste, and reduced Vitamin B12 levels.

Nate · April 7, 2024 at 9:42 am

At least your boss agreed with you. I’ve had managers who would have prioritized patient satisfaction over honest care. Fuck Press-Gainey.

Slow Joe Crow · April 7, 2024 at 10:50 am

The 12.6 A1C and glucose of 315 is terrifying. I have an A1C of around 6 and average glucose os 120 or so. No wonder she lost a leg and had a wound. With that mindset she will be blind and legless, or dead right quick while I am climbing mountains and batching about insulin prices

Henry · April 7, 2024 at 10:59 am

I admire your patience in dealing with an obviously non-compliant person. I salute the doctors and nurses who give their time and expertise to patients who not only fail to take their personal health seriously, they actively undermine their health while wasting the time and resources of the overtaxed medical community.

Igor · April 7, 2024 at 11:49 am

Until and unless she recognizes she is addicted to sugar, she will continue to have worsening problems.

I have no answers as to how to convince her to give up this destructive behavior other than to lean on Christ and ask him to assist her in the fight. But, as always, the first step is to recognize that she has the problem and WANTS to change her ways. It’s a sure path to pain and destruction otherwise.

    Divemedic · April 7, 2024 at 12:03 pm

    I gave her the information and she didn’t want to hear it. Not my problem any longer.

IcyReaper · April 7, 2024 at 12:18 pm

Maybe you could calm her feelings down by sending her one of the 3lb Hershey’s chocolate Easter bunnies as a I’m So Sorry you are a moron gift.

Cederq · April 7, 2024 at 1:50 pm

Only one complaint? You are not really trying Area… Don’t fret this has been a problem since medicine was invented. People refusing to comply and not able to grok simple instructions that have been reduced to a 4th grade reading and comprehension level. I was firm and bullshit averse to patient non-compliance and tell them in certain terms if they didn’t follow the regime we outlined for them they were going to die of be horrible maimed because of their stupidity or plain laziness. That there was no magic pill that will cure them. Back then we were a little freer to explain in a more graphic and no-nonsense explanation and didn’t have to worry much about someone’s precious feelings or race cards.

Dirty Dingus McGee · April 7, 2024 at 2:08 pm

Diabetes, even when you manage it somewhat, is a bitch. I found out almost 3 years ago I was diabetic when I was admitted to the hospital for an infection that went sepsis. Blood sugar that day was over 500. So, no more sugar, lowered my carb intake, went to whole grain breads, basically upended my diet. Since I have taken an active role in managing it, using Metformin, sugar stays around 130-140, with an A1C of around 6.3-6.9. Even managing it in that manner, I had a melanoma removed, about the size of a dime and it took FOREVER to heal, over 12 weeks. Followed the doctors order to the letter and it still took that long.

But I would prefer to NOT lose body parts, and I’m kinda fond of having sight so I’ll forego the chocolate chip cookies, most of the time. If a couple a week are gonna kill me, I’ll eat a case of them and get it over quick.

Comfortable Shoes · April 7, 2024 at 5:33 pm

Lost 150lbs and got off all that crap after selling the diabetes gear on CL when insulin was $12 in Canada and $98 here in FUSA under comrade commissar Xhou Bai Den.
Just watched an How America Became So Stupid video that explains a lot.
Now fitting into my 34″ waist jeans from HS.
Soft weaklings with no discipline have brought us to where we are and engineer bud has ultimate faith that America will self-correct but it has never been this stupid.
Walking after every meal, usually a salad with some pork or beef for protein, along with Iron Will and discipline is how I got here.

    Grumpy51 · April 8, 2024 at 8:53 am


    I started practice in 1997, and pushed to have treadmills and exercise bikes in our waiting rooms….. still don’t have them. US healthcare is NOT about getting people healthy (check out Healthy People 2000 – goals for the US to achieve by the year 2000, yeah…. NOT!!). It’s about removing the immediate consequences from people so that our healthcare costs sky-rocket in later years.

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