Hi again. Well, it's been quite some time since I posted last, and it's really touched me that some of you sent me a message or two saying "when are you going to post again?" I admit, with kids, family and just the day-by-day stress of living, there are a lot of times that I don't want to take the time to write anything, so thank you to those who have given words of encouragement.
Apparently there's been a fulcrum shift at Disability. Whereas the majority of claimants I used to see may have had something wrong with them, but probably could work, my recent claimants have all had horror-stories for lives, and genuinely have needed some help. I'm not sure if I've said it before, but I really try not to talk about the people that really need help - they don't need some Disillusioned Doctor yapping about them on the internet. This is the reason, as you might have guessed, that I haven't posted in a couple of weeks. In addition to that, my hours at the Juvie got decreased due to budget cuts, and therefore I don't have that material to go on, either. Hopefully, however, the run of actual problem patients will end soon, and I'll be able to return to an almost daily recounting of the funny things people say when trying to get money.
A short story for today. I rarely get frustrated at my patients, and ever more rarely do I want to take my stethoscope and perform a FATALITY. Today, however, I met my match. This gentleman was 50 y/o, smelled of cat pee, and had his hair "styled" like some Steven Segal/Chuck Norris love child. As I was filling out paperwork on the previous patient, I happened to overhear him give my secretary a hard time during his eye exam. He then proceeded to enter the exam room, throw an x-ray from (literally) 1986 on the exam table, and say "there's my old film, now when are you going to shot another one so you can tell me what's wrong with me?"
"We don't do that here," I responded. "This is just a history and physical, nothing more."
"Well then what am I doing here?" He yelled. "I thought this was for my x-ray exam."
He then whipped out a crumpled piece of paper (smelling of cat pee, of course), and said "here are all my complaints, what's wrong with me?"
I glanced at the paper. It listed in numerical order the following complaints (with his spelling...I kept the paper).
1.) Right beast pain
2.) Hard to breathe/infinzola/various lung diseasez
3.) Peepee hurts "dysuria"
4.) Lack of imagination/concentration/ <-----(I don't know if he meant to keep that blank...)
5.) It hurts my back
6.) Heat/Cold/Weather intolerence
7.) Don't liek things no more
8.) Toliet paper
I asked him about the last entry, and he responded "oops, must have confused that with my shopping list...but see, it shows I don't have concentration!"
I proceeded to ask him "so what of those complaints keep you from working?" and he, of course, responded "all of them." After trying to get him to narrow it down to one main thing, he started yelling at me, saying "I didn't know I was the doctor today, you're supposed to tell me what's wrong with me and will kill me, because I don't know! All I know is that I can't get a job because I was wrongly accused of a crime I didn't commit [I think that's a double negative...] and now all the Mexicans are taking over America!"
Once again, I tried to get him to narrow his complaint to one main thing that kept him from working, and after much yelling about Mexicans and America said "it's old age. Plain and simple, I'm getting old."
"Sir," I said, "You're 50. That hardly qualifies for old these days." Well, as you might imagine, he didn't like that.
More yelling. "How do you know what I'm going through? You're just a stupid doctor who probably has never worked a day in his life. And you're young, too! What's going to happen when you get too old to work, huh?"
So...I had come to a crossroad. Do I:
A.) Calmly ask him to leave, stating that obviously this exam is not working out.
B.) Try an empathic response such as, "I can see that you're angry at me being young and good looking, and I understand how you would feel upset about your current situation."
C.) Try and move on with the interview, ignoring his comments.
D.) Stethoscope to the groin, with reflex hammer FATALITY.
Sigh...I chose C...although I was tempted to try one of the other options. The fact of the matter is, if I asked this guy to leave, I wouldn't get paid, and I wanted to get something for the minutes of my life he had eaten away. Since I was running out of time, I said "last chance, what's the main thing that keeps you from working...aside from America, felonies and Mexicans?"
"Why, my back, of course."
Of course.
Anyway, the remainder of the exam proceeded without a hitch. As you might have guessed, his back was fine, and he left the office, taking the 1986 x-rays in tow.
And now for the disability quotes of the day:
Me: "So, can you tell me when your anger problems really started?"
Angry dude: "About 8 years ago, when my Grandma died soI had to start paying child support."
Me: "So you say you have problems dealing with people. How so?"
Man: "When they make me mad, I feel like an angry Goblin that just lost his broadsword."
Watch out for beast pain,
-DD
Tuesday, February 23, 2010
Friday, February 5, 2010
Friday Night Quotes
Well, it's that time of the week again. Are you ready for a deluge of disabled diatribes? I know I am, so let the quotes begin!
Juvie Nurse: "Are you feeling suicidal?"
Kid: "Not right now, but I've starved myself to death before, so I know what it's like."
"I need oxygen 5 to 24 hours a day, especially if I'm sleeping."
Me: "So tell me why you stopped working?"
Dude: "Well, I never got a raise or a promotion, so I figured something must be wrong with me. So I quit."
"I get anger issues about once a month, so I can't work."
(That same person said his anger problems started after he was born in breech presentation...)
"I need at least an hour nap each afternoon, and I can't find a job that will let me have that."
Until next week,
-DD
Juvie Nurse: "Are you feeling suicidal?"
Kid: "Not right now, but I've starved myself to death before, so I know what it's like."
"I need oxygen 5 to 24 hours a day, especially if I'm sleeping."
Me: "So tell me why you stopped working?"
Dude: "Well, I never got a raise or a promotion, so I figured something must be wrong with me. So I quit."
"I get anger issues about once a month, so I can't work."
(That same person said his anger problems started after he was born in breech presentation...)
"I need at least an hour nap each afternoon, and I can't find a job that will let me have that."
Until next week,
-DD
Tuesday, February 2, 2010
Y'all owe me something!
It was another wonderful morning at Disability Physicals. The local bum outside the building was seeking handouts, the room was freezing, and three people had already cancelled...for the third time. I arrived around 9:00, to an empty waiting room, and had just settled into my office when the door burst open, and a thin, nervous-looking man ran in. He stated that he was "here to get my physicals all done," and after an eye exam and a height/weight check, he was ushered into the exam room.
He was a thin man, head tucked in a sweatshirt hood, fingernails dirty. He slouched like some modern-day Quasimodo, one eye leering from under his greasy hair. He stated that "all my insides are a burning, and my mental keeps me from doing anything but think about doing nothing." A predicament indeed. He admitted that he had Hepatitis C, but although he was covered in "prison-made tattoos," and had been a "crank, crack, ice and meth whore" his entire life, couldn't figure out how he became infected with the virus. He stated that if he moved everything hurt, but if he didn't move, he couldn't stop thinking about moving. In addition, his equally Hugoian girlfriend added that "he likes to kick through the walls in the house, because it gives him something to do." You might have gathered from reading some of my earlier entries that I usually have something to say when people spout...interesting dialogue. This was not one of those times.
They rambled about how he "cries when he gets hurt," how he "sees spiders in the attic," and so on, with me simply sitting there, grinding my teeth to keep from laughing. I know that might sound a little cold-hearted, but I'll be the first to admit that I see spiders in my attic too. Anyway, I was finally able to ask my $10,000 question: "So which of these complaints keeps you from working?" and much to my surprise he stated "Well, I cut my foot with a knife, and all my memory came out with the blood." .... ..... Ok then. I didn't really feel like explaining that the memory circuit in his brain was in no way associated with his circulatory system, so I just sat there, nodded an empathic "go on," and let him continue talking. He started to yap about how he had been in prison his whole life because of his drug habits, and although he had been clean for two years, didn't understand why he didn't feel 100% better. I told him that organ damage from drugs is often permanent, and as you might imagine, he didn't take that well. He began to yell at this point, and the following diatribe ensued.
"Y'all owe me something for all the time I did. I needed all that medical care in the prison, but nobody took me seriously when I told them I was sick. As a result, I burn on the inside from my liver problems, and nobody will pay for my special liver tests. I deserve those things! I'm a person too! Just because I was selling drugs doesn't mean that I don't need stuff. The government needs to pay for my medical care because I gave my life to the State Penitentiary!"
I once again empathically nodded...and proceeded to the physical exam. He left shortly afterwards, almost vomiting in my trashcan because “that alcohol hand rub makes me all queasy.”
As silly as it is, the above monologue represents an interesting social conundrum. As a prisoner, one is paying their debt to society for the bad things they did. Unfortunately, and as a prison doctor I know this, resources are very limited for those incarcerated. Medical care, therefore, and especially complicated medical management, often gets overlooked for those detained simply because the system can't afford to pay for it. Some would argue that by breaking the law, one loses the luxury of receiving medical care beyond basic life necessities. On the other hand, prisoners are people, too, and therefore deserve the same level of healthcare available to those in the outside world, right?
The topic of responsibility often arises in these discussions. Should you and I have to pay for expensive medical tests and treatments for someone who will (most likely) never contribute to society, especially if they've done the damage themselves? Most people would say no, but that's exactly what we're doing. I'm not trying to sound harsh, but it really irritated me when the above patient started yelling about how he was owed special treatment because he was incarcerated on and off for 30 years, and had never lived a normal life. I've said it before, and I'll say it again. You are responsible for your own health. If you choose to do drugs, stick yourself with dirty needles and who knows what else, don't expect me to get all teary-eyed when you come down with some disease. Furthermore, don't expect me to shell out tax-dollars so that you can get expensive treatments for your poor choices. You are responsible for you, plain and simple.
And now for the disability quotes of the day:
Patient's mother's written response to the question, "Describe how your condition has changed your life."
"He once was extra above smart, now he ain't."
The same patient's mother's response to the question, "Do you have a good support group at home?"
"Everyone really loves him, his mom, his dad, his friends, even his BFF Kelly."
(Thank goodness for Kelly, I don't think he'd make it otherwise)
Man: "Let me show you how my knees pop all out of socket. Here I go!"
::He bends over with no problem::
"Well, I guess they're not going to do it today..."
Take responsibility for yourself,
-DD
He was a thin man, head tucked in a sweatshirt hood, fingernails dirty. He slouched like some modern-day Quasimodo, one eye leering from under his greasy hair. He stated that "all my insides are a burning, and my mental keeps me from doing anything but think about doing nothing." A predicament indeed. He admitted that he had Hepatitis C, but although he was covered in "prison-made tattoos," and had been a "crank, crack, ice and meth whore" his entire life, couldn't figure out how he became infected with the virus. He stated that if he moved everything hurt, but if he didn't move, he couldn't stop thinking about moving. In addition, his equally Hugoian girlfriend added that "he likes to kick through the walls in the house, because it gives him something to do." You might have gathered from reading some of my earlier entries that I usually have something to say when people spout...interesting dialogue. This was not one of those times.
They rambled about how he "cries when he gets hurt," how he "sees spiders in the attic," and so on, with me simply sitting there, grinding my teeth to keep from laughing. I know that might sound a little cold-hearted, but I'll be the first to admit that I see spiders in my attic too. Anyway, I was finally able to ask my $10,000 question: "So which of these complaints keeps you from working?" and much to my surprise he stated "Well, I cut my foot with a knife, and all my memory came out with the blood." .... ..... Ok then. I didn't really feel like explaining that the memory circuit in his brain was in no way associated with his circulatory system, so I just sat there, nodded an empathic "go on," and let him continue talking. He started to yap about how he had been in prison his whole life because of his drug habits, and although he had been clean for two years, didn't understand why he didn't feel 100% better. I told him that organ damage from drugs is often permanent, and as you might imagine, he didn't take that well. He began to yell at this point, and the following diatribe ensued.
"Y'all owe me something for all the time I did. I needed all that medical care in the prison, but nobody took me seriously when I told them I was sick. As a result, I burn on the inside from my liver problems, and nobody will pay for my special liver tests. I deserve those things! I'm a person too! Just because I was selling drugs doesn't mean that I don't need stuff. The government needs to pay for my medical care because I gave my life to the State Penitentiary!"
I once again empathically nodded...and proceeded to the physical exam. He left shortly afterwards, almost vomiting in my trashcan because “that alcohol hand rub makes me all queasy.”
As silly as it is, the above monologue represents an interesting social conundrum. As a prisoner, one is paying their debt to society for the bad things they did. Unfortunately, and as a prison doctor I know this, resources are very limited for those incarcerated. Medical care, therefore, and especially complicated medical management, often gets overlooked for those detained simply because the system can't afford to pay for it. Some would argue that by breaking the law, one loses the luxury of receiving medical care beyond basic life necessities. On the other hand, prisoners are people, too, and therefore deserve the same level of healthcare available to those in the outside world, right?
The topic of responsibility often arises in these discussions. Should you and I have to pay for expensive medical tests and treatments for someone who will (most likely) never contribute to society, especially if they've done the damage themselves? Most people would say no, but that's exactly what we're doing. I'm not trying to sound harsh, but it really irritated me when the above patient started yelling about how he was owed special treatment because he was incarcerated on and off for 30 years, and had never lived a normal life. I've said it before, and I'll say it again. You are responsible for your own health. If you choose to do drugs, stick yourself with dirty needles and who knows what else, don't expect me to get all teary-eyed when you come down with some disease. Furthermore, don't expect me to shell out tax-dollars so that you can get expensive treatments for your poor choices. You are responsible for you, plain and simple.
And now for the disability quotes of the day:
Patient's mother's written response to the question, "Describe how your condition has changed your life."
"He once was extra above smart, now he ain't."
The same patient's mother's response to the question, "Do you have a good support group at home?"
"Everyone really loves him, his mom, his dad, his friends, even his BFF Kelly."
(Thank goodness for Kelly, I don't think he'd make it otherwise)
Man: "Let me show you how my knees pop all out of socket. Here I go!"
::He bends over with no problem::
"Well, I guess they're not going to do it today..."
Take responsibility for yourself,
-DD
Monday, February 1, 2010
Interlude
Sorry it's been a while since I last posted, we've had some nasty weather lately, and as a result my subject material was put on hold due to the snow-induced long weekend. Anyway, I'll try and pick up the pace again this week, and weather permitting, I'll hopefully have some good stuff to blog about. Since we didn't have FNQ last week, I thought that tonight would be a good time to make that up. So, I now present to you the first-annual Monday Night Quotes. Enjoy.
Me: "So tell me what's keeping you from working?"
Teenage male: "I got the learning problems."
Me: "What type of learning problems?"
Male: "Well like in school, if I didn't study or go to class, I would fail the class. They tried getting me a tutor, but I never went to that, so I just figure I'm retarded."
Patient's written response to the question, "How has your condition caused you to change the way you live?"
"I wear my sunglasses at night, so I can see the light with my eyes."
(In case you didn't know, those are (basically) song lyrics from a 1980's song called Sunglasses at Night by Corey Hart. When I asked the patient if they liked Corey Hart, they said, "Uh...I guess so..." Apparently they didn't expect my mastery of 80's music!)
Me: "So you say your leg swelling keeps you from working. Why is that?"
Portly, angry man: "Well, I didn't really say that - my brother who's in nursing school said that I probably shouldn't work, so I took the week off. When my job asked for a doctor's note, my brother couldn't write one, I so got fired...and here I am."
Juvie Nurse: "So you hurt you hand hitting another detainee in the head?"
Juvie kid: "Well, I didn't really hurt my hand this time. But it's been hurt before, so I think it's acting up."
Nurse: "How did you hurt it before?"
Kid: "Punching people in the head."
Until next time,
-DD
Me: "So tell me what's keeping you from working?"
Teenage male: "I got the learning problems."
Me: "What type of learning problems?"
Male: "Well like in school, if I didn't study or go to class, I would fail the class. They tried getting me a tutor, but I never went to that, so I just figure I'm retarded."
Patient's written response to the question, "How has your condition caused you to change the way you live?"
"I wear my sunglasses at night, so I can see the light with my eyes."
(In case you didn't know, those are (basically) song lyrics from a 1980's song called Sunglasses at Night by Corey Hart. When I asked the patient if they liked Corey Hart, they said, "Uh...I guess so..." Apparently they didn't expect my mastery of 80's music!)
Me: "So you say your leg swelling keeps you from working. Why is that?"
Portly, angry man: "Well, I didn't really say that - my brother who's in nursing school said that I probably shouldn't work, so I took the week off. When my job asked for a doctor's note, my brother couldn't write one, I so got fired...and here I am."
Juvie Nurse: "So you hurt you hand hitting another detainee in the head?"
Juvie kid: "Well, I didn't really hurt my hand this time. But it's been hurt before, so I think it's acting up."
Nurse: "How did you hurt it before?"
Kid: "Punching people in the head."
Until next time,
-DD
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