True story here. One night as some of my co-workers and I were sitting outside the hospital on break we saw in the distance two people walking alongside the road. Not knowing where they were headed on this foggy Summer night, we dismissed the idea that we had even acknowledged their existence. We continued the usual co-worker conversation between nurses, lab technicians, X-ray technicians, and the like.( For those of you not privy to such information; aggravating patients wanting their pain medication two hours early, annoying family members insisting their diagnosis of the illness must be noted on the chart, and of course, the "closeness" noted between THE couple of the week highlights the conversations of most hospital workers taking breaks on the nightshift.) 

 Yet, on that night the two we could barely distinguish just moments earlier had made their way to the entrance of the hospital Emergency Room. "Long walk to visit a patient!" One co-worker said.

"I bet I will see him in the ER waiting room, then in one of the ER Bays needing treatment." I thought quietly to myself. For I knew who one of the guys were; what we as Medical Professionals like to refer to as "Regulars", or "Frequent Flyers".

Sure enough, when I returned to the lab there were orders there for the basic lab work done in ER. A CBC ( Complete Blood Count ) to check for infection, anemia, hydration, etc. A BMP ( Basic Metabolic Panel ) to check a patient’s electrolytes, kidney function, lung function, etc. Just routine labs, it was just a routine phlebotomy.

 What was not routine however was the patient's status when I opened the door of the room the patient occupied in this state of "EMERGENCY". Writhing in pain, twisting, groaning, complaining, "Help me stop this pain! God, I can't take this! Can't they give me anything for this pain?"

  "Didn't I just see you walking toward the hospital with this other guy?" He replied, No. "You seemed to be fine just 10 minutes ago" I thought. Of course, the previous conversation did not occur, for I am a Medical Professional. I had to treat the situation as a MEDICAL EMERGENCY. And it was, for him at least. More the case of a MEDICAL NECESSITY. He had to get that prescription of pain medication. 

 In the medical field, especially in Emergency Rooms across the nation, similar events take place every day, every hour, every minute, and every second.  Although it is not my job as a member of the Laboratory Team to make these decisions, doctors and nurses have to deal with these types of issues and treat patients accordingly.

 So exactly how do we know when it’s a real emergency? Good question. The fact is, it’s about a 50/50 guestimation. The usual suspects we know of. They give themselves away by making their third trip to the ER, that week. The new generation “frequent flyers” however trick us. We aren’t aware of their wiliness until after the fact.

 Don’t get me wrong though, you do have your bona fide Medical Necessity patients. These are the backbone of the hospital. They are at the hospital because they need to be. When they arrive at the door, you know what you have in front of you.

 As crazy a tie-in as it seems, the above are what we like to call in the medical field, your “Knowns”. They are a given. They are your New England Patriots. They are your Indianapolis Colts. They are your Baltimore Ravens. Like last year, this years versions of the aforementioned teams are a given. They will bring it every week. They will win a lot of games. They will make the playoffs.

  One could come to the conclusion that these teams should called be the “regulars” or the “frequent flyers” but that has been reserved for my newly noted term, Medical Emergency Pretenders. Yes, these teams don’t seem to bring it every week. These teams give their fans fits of rage and feelings of euphoria. Or both at the same time. On the same play, nevertheless. They are the new generation of pretenders in that just when you had discharged them, here they are back in the ER two or three days later with the same scenario. Complaining of the same symptoms. On the pain scale of 0 – 10, with 10 being the worst pain imaginable ( i.e. getting hit by a semi and living, falling from an 8 story building and living), they will tell you, “ 9, 10 when it’s at it’s worst”.

  Let’s take for example the current AFC West leading Kansas City Chiefs. When they began the season 0-2, scoring 13 points total in the two losses on the road at Houston and at Chicago, many naysayers were calling this possibly the worst offensive team in history. Since they let Trent Green go many said, Damon Huard just couldn’t get the job done in KC. And when the critics weren’t kicking Huard (who did have less than 200 yards passing in both games) they were beating up on Larry Johnson. But why wouldn’t they? Johnson, who carried, literally the team last year is gearing up to do it again this year. However, the team cannot rely on Larry Johnson to do it all, so they brought back KC’s favorite son Priest Holmes to help LJ with the load and sent Michael Bennett to the Bucs.

 Although the team sits at 3-3 now after the unimpressive start, they are as much pretenders as those who come through the ER, by ambulance for kicks, complaining of abdominal pain. Get this Chiefs team an Abdominal Series, STAT! Yeah, coach Herman Edward’s squad have gone 3-1 since, but scoring 13 at home in a win against Minnesota (2-3), and winning at home against Cincinnati (1-4) is not that impressive. What is impressive though is going to San Diego and handing the struggling-at-the-time Chargers (3-3) a 30-16 Loss. Their remaining schedule however is stockpiled with playoff teams. Green Bay, Indianapolis, Tennessee, Detroit highlights their non-division slate. 26-22. That’s the record of the teams remaining on their schedule, including divisional foes Denver twice, revenge-minded San Diego, and at improving Oakland. They proved to me they can’t beat an elite team for they lost at home to the Jacksonville Jaguars (4-1). Larry Johnson gained 12 yards rushing in that game, and the team scored 7 points.

 Pack it up Kansas City, your season’s over and you have ten games to go. You can whine, fake cry, and scream for pain medication all you want. But you are a definite Medical Emergency Pretender.

 As bad as the Chiefs have looked at times this year, no team has needed a resuscitation as badly as the 1-4 New Orleans Saints. They remind me of the kind that complain that they can’t catch their breaths, but fail to tell you they keep holding it just the same. What began September 6th and ended October 7th was a stretch of 4 consecutive losses to start the season, and proved that this team needed to be on the ventilator as much as it needed to breathe on its own. Their only close game was a home game they lost to Carolina by 3, 13-16. Before that they gave up 103 points in the first three losses. Ugly on the field and ugly on the scoreboard. They did though travel to the great Northeast and beat a questionable Seattle team.

 For a team that led the league in scoring last year, scoring seems to be a problem this year. 10, 14, 12, 13...the numbers they put up in their first four losses. Scoring 28 at Seattle in the win was pretty impressive however. Maybe this team has gotten on track after they woke from the nightmare that was adjusting their game without the services of Deuce McCallister, the heart and soul of the once dynamic offense. Reggie Bush inherited the full-time position at tailback and only time will tell if he can stand up to the grind of a 16 game season. He has looked better recently though, tallying 97 yards rushing in the win at Seattle.

With some luck, more luck, and better play this years Saints team can turn their season around. I think it started with getting that first win. The Pro-Bowl QB Drew Brees though has to figure into the equation also and make better decisions. Being in the NFC South Division doesn’t hurt things either. This division literally has a different winner each season. Can the Saints make it back to back division champs? I think so. They have a favorable schedule in which the combined records of their remaining opponents is 25-32. This team could conceivably go 10-6. Anything is possible these days. Crazy as it sounds after an 0-4 start, it’s just as possible as it could be probable.

Consider there is only one team remaining on their schedule that has grounded itself with an identity and as a force. That would be the Jacksonville Jaguars. And the Saints get to play them in the Superdome. So what if they are 0-2 in the division? They still get to play Atlanta twice; as well as home games against lowly St. Louis, and unstable teams such as Arizona and Philadelphia.

While looking at their remaining road schedule, it’s not unfathomable that the team can go 9-2 the rest of the way. Playing at San Francisco, Houston, Atlanta, and Chicago means this team has a chance. This team has hope. This team may need the ventilator to keep them alive, but can breathe on its own if indeed it has found an identity once more. What more does the team have to lose? They closed the season last year turning blue, but caught a second wind in the playoffs and made it to the NFC Championship Game before losing to the Chicago Bears. Has this team loaded with playmakers and coached by a savvy Sean Payton caught its first breath of air this year? I think so. We won’t call this team Pretenders. No, not with a division crown that could seemingly be theirs. They still get to play Tampa Bay at home. They still have life left in them. Their season is just starting.

A Saint’s team that has everything to gain by diagnosing the problems, knowing the symptoms, and getting to that Emergency Room like a man with his umm, member, caught in the fly of his Levi’s can’t be called Pretenders. No, this team is what I would term a Medical Emergency Contender.

Gear up New Orleans! You’re in for one heck of a ride. Gear up Saints! You’ve got work to get done and you have 11 games to prove to the Nation of Haters that YOU will go 10-6; win the division, make the NFL Playoffs!Take a deep breath. Relax. Look at what you can accomplish as Contenders!

Unfortunately, not all the teams that are on this early "bubble" of contention will fare as well as the New Orleans Saints. Let us take a breif look at a few other teams coming off of a win last week. Let the stats do the talking and the Medical Emergency Pretenders do the walking.

The Cleveland Browns:

You've had a good run through 6 games. Any Browns fan will gladly accept a  3-3 start from such a bad team for so long. You almost feel you have to blame someone on this team. So yes, Derek Anderson came walking through them ER doors. He came confidently. He was only there to have a 4 inch gash above his right eye be stitched. He has lifted the team on his shoulders like a bag of saline. Which is about the equivalent of how far this team will go. Just a few electrolyes. That's all this team is. They have to get some meat on that defense. It's great to score 41 on Miami's defense. It's not so great to allow 31 points to Miami's offense.

You have a decent non-divisional schedule ahead of you. All I need to say is next opponent is at 0-6 St. Louis. Starting here your next opponents have a combined record of 22-34. That's a great sign for this offense.

But you never made it to the ER doors Anderson. You were dreaming of a season ending 11-5 record. Back to reality. You are in the AFC North. You go 8-8 and miss the NFL Playoffs.

Cleveland Browns you are discharged. Dare I say that you are a Medical Emergency Pretender?

Browns fans: You guys and gals are not alone! Doesn't that make you all feel better? The passionate fans of The Minnesota Vikings will be holding back the tears at seasons end also. Cheer while your team has Adrian Peterson. He may not be there long. There is hope, but slim my friends.

Minnesota's opponents over the next 11 weeks are a combined 33-27.Yes, you will hang around the cellar dwellars in the NFC and stay in the dark too long. You may find what you were looking for over the last 3 games of the seaon. But it will be too late. Like Peterson himself, you Vikings are the little boys that stick the beans up their noses and scare the parents. You seek medical attention. You don't find any.

Minnesota Vikings: hold your collective heads high for you are Medical Emergency Pretenders!

Man, I've been rough on these teams!  Can we find any team with a win last week that could get some medical attention? Get some love from the nursing staff? Sure we can. There's a team in Jacksonville that has come through the ER with a UTI. The team requests no treatment. Just a little some'n some'n to ease the pain. Just a little annoyance they boast!

The Jaguars have an archrival. Why couldn't a Jaguar tear into a helpless Colt? There is no reason they can't. Jack Del Rio has his team right where he wants it. Being 4-1 and residing behind the AFC South leading Indianapolis (5-0) is quite alright with them. They know they can beat them. They have the momentum. They have won 4 in a row. They have the Colts coming to their house this Sunday.

The Jags are nasty. They have a nasty defense that has given up 13, 7, 14, 7, and 17 points over 5 games. They know they are nasty! But still yet they find gentleness and kindness as they take the Colts to the ER. Severely wounded and bleeding profusely, the Colts knew what was coming. The Colts could not stop what was coming. The Jags themselves only reside in the waiting room. They hear the opponent will make it through. They don't hesitate to get up and leave.

The Jacksonville Jaguars, despite the fact that your opponents over the next 11 weeks have a combined record of 30-24, at seasons end you will have that impressive resume and an 11-5 record. Go ahead and admit this team into in the NFL Playoffs. For you, my friends, are Medical Emergency Contenders!

For whatever reason, the Jaguars stop at the door of the ER and notice a familiar foe. A team patiently waiting to see if their opponent is alright after the thrashing they laid upon them this coming Sunday. Why do the Jaguars even stop to acknowledge their in-state rival Tampa Bay Buccaneers? Maybe the Jaguars wonder if the Detroit Lions are alright themselves. The nasty Jags do not. These Jags want the Bucs to know they own the state.

It becomes a stare down for the first minute or so, but Tampa Bay does not back down. They have the same number of wins as the Jags. But they have that one extra loss the Jags can hang their hats on for now. Marked long ago before training camp, was the date October 28, 2007. Bragging rights on the line. These Buccaneers host this same nasty Jacksonville team.

Tampa Bay walks away from the ER knowing the Lions were just a tune-up for the upcoming Jags. Just one of three teams left on the Bucs schedule that has a record above .500. This team knows they face opponents each week that combine to have a losing record with 30 losses scattered among them.

Tampa fans thought it had lost a valuable limb that could not be replaced the last time they visited this ER. Another Cadillac injury. Those common MVAs ( Motor Vehicle Accidents) happen all the time. The Bucs don't hesitate to grab Michael Bennett from the Chiefs. The Bucs know that they lead the NFC South and want to cling to that lead so this I say to them:

The Tampa Bay Buccaneers, you pirates of the south, you will be stealing your place in the NFL Playoffs. You guys, you are officially Medical Emergency Contenders!

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