[MrVandemar]

It's possible the ER doc meant most powerful that he could legally prescribe given the clinical presentation; or perhaps he was just saying that because you don't give someone medication and say "well, you just got a basic painkiller, it's near the end of the its use-by, maybe it'll work", you say "We're giving you the best". It's the placebo effect, albeit with a medication that should work regardless.