I brought a patient into the ER the other night and found myself right in the middle of a classic EMS conundrum; that of a dramatically improved patient. My patient had had a severe allergic reaction and was all but unconscious, laying on the floor when we arrived at the scene. There was no family around that could give me any history to my patient's condition so I was forced to treat based on presentation using my best clinical judgment.
The treatment for anaphylaxis is pretty straight forward and after forming my clinical impression I immediately began administering the appropriate medications. During the 10- minute trip into the hospital the patient began to "come around" and answer my questions; by the time I got her in front of a young (and new) PA she was wide awake and sitting up in bed. The PA then proceeded to take 20 minutes and interview the patient about her current condition and past medical history, a luxury I that never had. In the end the PA, in an entirely too condescending attitude, began to question my treatment as being overly aggressive.
I took this experience as an opportunity to exam my ego. My initial reaction was to become defensive about my treatment of the patient and lash out in a retaliatory attack against the self-important PA. Staying in the moment I recognized what was going on and thanked the PA for her guidance/input, and left to do my paperwork; a win-win for everyone involved.