Monday 2 July 2012

Bad to worse

Some of these stories just write themselves. I sometimes have to think about how to turn a patient encounter into a blog post. But sometimes, like last night, I get a vision as it's happening.

At 10PM, a call came in for a victim of an 8m (25 ft) fall. The call itself was nothing unusual. What was unusual, however, was everything else about this case.

The 48 year-old female patient arrived a few minutes later, and I asked her what happened today. "Nothing today."

Uh, what? "Then when did you fall, ma'am?"

"Oh, 2 days ago. But my back started hurting and I started peeing blood today. So I called for an ambulance." The red flags were already going up.

She refused to tell us her last name, asking us to call her Betty (not her real name). After her workup (including CT scans from head to toe) revealed absolutely nothing wrong with her (including crystal clear urine), she continued complaining of severe back pain, so bad that she couldn't move.

Riiiight. This didn't add up at all. "But you've been walking around for the past two days, right?" I asked her, not believing a word of it.

"Well, I'll be honest with you," she started. "I've been taking oxycodone and Valium, and that's the only thing that's allowed me to move around."

I glanced at her blood work - her blood alcohol level was 0.391, several times the legal limit.

"So you've been self-medicating with narcotics, benzos, and a hell of a lot of alcohol?"

She looked at me like I was crazy. "Well, I was supposed to be in court yesterday for my DWI from last year, but they couldn't proceed with the trial. But my back is killing me, so what prescription are you going to give me?"

THIS is her game? She got out of her DWI trial, so she got hammered on booze and narcotics? And now she's trying to score more from me?

"Not today, madam" is what I said to her, but "OH HELL FUCKING NO!" is what I was thinking. You were unlucky enough to get the doctor who doesn't give a fuck if you lodge a complaint against me. You will NOT get your fix from me.


  1. Why do people treat doctors like there dealers

    1. Because to them it makes since.... If you don't think about it...

  2. This does not surprise me at all! I'm honestly surprised her entire family wasn't in the waiting room waiting for the script though.

  3. Doc, I was actually turned on to your blog through FML. I enjoy your writings, and look forward to future posts. It makes me sick to think people try to use doctors to get high. Those people are the reason for the looks and reactions I received during a recent spinal injury. No one wanted to believe I was in as much pain as I said I was, and dismissed my case many occasions without proper treatment, because my condition while not rare in general, Iis rare for someone of my young age. After two months of constant agonizing pain and a heap of doctors to go with it, I had to have a complete spinal fusion, with screws, rods, and a cage to boot. If people weren't so quick to cry wolf, my complaints would have been taken seriously and I could have gotten help much sooner than I did.

    1. That sucks. I had a spinal fusion surgery for scoliosis when I was 13; my whole spine is fused with the metal rods and screws; I never got the cage though. My scoliosis was at a 63 degree curve so it would be really stupid for a doctor to ignore it.

  4. Good...For....You.
    And for all of us actually.
    Thank you.

  5. Those of us who truly NEED opiate pain medication on a daily basis in order to live a somewhat normal life say THANK YOU! It's drug addicts like that who are making it almost impossible for us with chronic pain to be treated with respect.

    I have nothing to hide. I have one doctor and one pharmacist so my prescription history stays clear. I just want t be treated like a human being.


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