The Emergency Room Mismatch

The receipts behind Chapter 10

Waiting in a triage queue will not diagnose your pain. In Chapter 10 I follow a man in agony at two in the morning through the emergency room, show why three in a hundred back-pain patients need that room and ninety-seven are in the wrong one, and explain where a great many long-term opioid prescriptions actually begin. The emergency physicians are not the problem. The missing door is.

The book makes the argument. This Deep Dive shows the evidence, claim by claim: the study, who was in it, the number and where it sits in the paper, what it does not show — and the questions to bring to your own physician. It is written to be handed to your doctor.

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Frequently asked questions

Should I go to the ER for back pain?

Most of the time, no. Chapter 10 of The Pained Brain shows that three in a hundred back-pain patients need the emergency room, and ninety-seven are in the wrong one. The ER is built to tell you whether you are dying. That answer matters, but not dying is not a diagnosis of the pain you came in with.

What will the ER do for back pain?

The emergency room works out whether your back pain threatens your life. For most people the answer is no, and they leave without a diagnosis of what is actually causing the pain. Chapter 10 also shows that the ER is where a great many long-term opioid prescriptions begin. The emergency physicians are not the problem; the missing door is.

Why do so many people with back pain end up in the ER?

Because the right door is missing. In Chapter 10, a man in agony at two in the morning has nowhere else to go, so he waits in a triage queue, and waiting in a triage queue will not diagnose his pain. The chapter follows him through that night, and this Deep Dive gives the studies behind each step of it.

Educational material. Not medical advice. If you are in the St. Louis area and want this looked at properly, that is what the Padda Institute is for.