One of the things that I've observed so far working in the ER is that there are very few truly unique stories. Sometimes it feels like we're dealing with the same old suspects again and again in varying shapes and forms. If this is indeed true, then it seems to me that there should be a way to reduce the number of ED and hospital visits and improve general health by using preventative measures or by some form of public health initiative.

Let's start with the GYN corner - the usual suspects are STDs, because someone (not necessarily the patient) was careless, and vaginal bleeds, usually because someone is miscarrying. The miscarriages, more often than not, are in patients who have not had prenatal care, and are using or abusing one substance or another. This is not ALWAYS the case, but more often than not it is. So what can we do here - lots of public health education on how to prevent STDs, how to take care of yourself when you're pregnant, and what clinics are for.

The peds corner is full of fevers, ear infections, tummy aches, strep throat, and the like. Most of the time it's mothers who don't want to wait for an appointment at the peds clinic or with their pediatrician and decide to come in. Kids get sick, a lot. And there are usually plenty of home remedies and things you can do. Again, I am not denying that there are definitely those true emergencies that MUST be seen immediately, but most of the time the right dose of tylenol will take care of that fever.
NOTE: If your child is really sick, please don't hesitate to go to the ER.

Then we go to the Crisis/Psych corner. Besides the people who are really in Crisis, and are suicidal or homicidal because of life events or because they've not been taking their medications, we have the other usual suspects - overdoses, drunks, and people who are "acting out". Is there a way to make sure that patients have and take their medications on time? That's what day programs are for, but is it enough? From the repeat visits that we see, often from the same people, I am guessing it's not enough. For the drunks and drug users that we have to cater to every night, I really don't know what to say. It's a lifestyle choice that's costing our health care system.

And finally, the adult medical cases - heart attacks, strokes, renal failure, sepsis, UTI, dehydration, cellulitis, abdominal pain, headaches, etc. There is no overarching theme to all of these that I can point out, but there are a few things, which again are a matter of public health education and individual choices, that can make a difference.

- If you don't watch your diet and increase your activity, you will end up in the ER. It will be hard to effectively treat you because obesity leads eventually to some level of debilitation, to heart attacks, and increases your risk for almost every terminal disease under the sun. If you watch your diet and that of your children, and increase your physical activity, and that of your children, you are on your way to a healthy life.

- If you keep smoking you are increasing your chances of having a stroke and other cardiovascular issues, not to mention cancer, COPD and other respiratory problems. Smoking is one of the top killers in America. You may think you look cool lighting up that cig, but tomorrow you may be that guy walking around with an oxygen tank who can't catch a breath.

- If you don't drastically cut down your alcohol consumption you may have to learn the meaning of hepatic encephalopathy, and that's not a good thing. Your liver is precious, and it does a lot in your body, you really don't want to lose it. Moreover, excessive alcohol consumption also cripples your brain and many other vital organs, and you are opening the door to a deluge of other diseases. To make matters worse, you may end up in the crisis corner at some point, in restraints.

There are so many things I could add, but I wonder does it make a difference? The bottom line is this, you get one body, one shot. Educate yourself about your health and get on the path to making the right choices. You'll be surprised the difference it will make 50 years down the line.

Aging brings it's own set of physical vulnerabilities and troubles, don't add to them.