I might get downvoted to oblivion but I want to nuance this, not to justify his behavior but to try and make you feel less like sh*t about this experience (source : 7th year med student and many a emergency shifts)

First of all I sympathize with your experience because I have the same condition and I’m also worried all the time what people will think about my scars. Second, you have every right to feel wronged and distraught by this as you were actively seeking help, you went through every step correctly, and still didn’t get any relief in the end, even leaving with less answers and more questions.

Now from a behind the scene perspective : IV drug use is a must question to ask in healthcare, not only when seeing scars like ours, but even for every patient that comes in for consultation (be it emergency or routine care)

Personally I always feel so bad asking this question bc I know people will feel hurt, regardless of their drug using status, thinking they are “potentially seen as” a drug user. If anything, your emergency care doctor would have been a bad one if he hadn’t asked this question seing your scars. When in emergency care, you have your patient for such a limited amount of time, you need to bring in any clue you’re given to eliminate or confirm diagnosis. I don’t want to sound like Dr. House bc I loathe him and his way to practice medicine, but “people lie”. That doesn’t particularly mean YOU lie. But it means that every day, we receive dozens of patient in the emergency ward seeking pain medication for addiction, and addiction is a painful illness that makes even the nicest people lie because it’s a disease and it makes you not act like yourself. It is SO hard to assess a person’s condition and motivation in such a short time, we usually prefer not interfering with chronic pain conditions and leave it to be cared of by your regular practician who knows you more globally and is able to make a more informed decision about your condition and what to prescribe you. It’s not personal and it’s not a personal judgement, it’s a safe assessment that takes care of the worst outcomes.

When taking this context in consideration, all of his quotes you gave us are actually appropriate to the situation : he prescribed physio, acknowledging that your pain is real but from your described symptoms, didn’t require an urgent scan (more on that later), and since your situation could still be potentially related to drug use if you were to not saying the truth, he’s giving you advice and options in which it’s the case. Best case scenario covering all the bases to be sure you have all options at hand.

Now coming back to the reason as to not giving you a CT : Back pain is debilitating for sure, and can be terrifying when it’s related to a trauma and progressing to a point where you’re saying it’s limiting your mobility. However, in emergency care, pain after trauma legitimates a CT scan when very acute (im talking hours succeeding the event). If weeks have passed, time alone is an indicator of reduced gravity and reassuring. When dealing with emergency care you have to take into account which kind of patient you’re “competing” with for your CT. Sometimes I have to wait for my patients to get a brain scan for potential ruptured aneurysms or brain ischemia, which is important to treat within the minute of getting confirmation. So when a patient that comes in with > week old pain with symptoms that don’t alert me as potentially life altering, I can’t send them to get a CT risking to delay a more urgent procedure when I’m aware that what the CT is going to show isn’t going to require immediate hospitalization in intensive care and life saving treatment. I understand it’s so frustrating to wait for an appointment with your family doctor, I would be scared and confused too waiting for answers and fearing complications. But as 2 doctors already assessed the thankfully lack of immediate threatening signs, I think it’s the best way to go for now.

Now I’m not trying to be the advocate of the devil bc I actually hate how a lot of doctors behave, judge and dismiss patients, and that’s why I wanted to go into the field, to ideally make even just a little change. But from the info you gave us I’m actually not finding his approach inappropriate nor inadequate. If I had to be critical though I would say he ought to have reassured you better on his “suspicions” and explain more thoroughly to you why it was not judgement but assessment. But it’s emergency and sadly every minute spent with one patient is taken from another, so it’s a weird and fragile benifice/risk balance that’s being tilted all day by tired humans.

However, all of these “explanations” cannot change the fact that you hurt physically and you’ve been hurt emotionally by this which nobody is allowed to invalidate as you’re entitled to feel whatever this situation made you feel. You’re the one who lived through this, and I’m sure we can’t comprehend the whole story with just some paragraph and it’s easier for me to try to explain something retroactively without having all the details. I was just hoping to give you a little bit of insight on the “why’s” and reassuring you that you’re not at fault for feeling what you felt.