August 4, 2012

drug seeker

I take the extra two minutes to log onto a computer to quickly check the patient's chart.  I refuse to be that doc who walks in clueless.  It reads on the reason for visit as follows:

1. Diabetes
2. Medication refill

     Sweet.  This should be straightforward.  My lunch break started 15 minutes ago and I'd like to be able to eat.  Within 60 seconds of walking into the room, I kiss any hope goodbye of a lunch that doesn't involve inhaling the food in 4 minutes.  Clearly what was communicated to the nurse making the appointment was in stark contrast to reality as the patient clearly didn't realize that to be diagnosed with diabetes, one must actually be diabetic. 
     Crazy idea, I know.  High blood sugars?  Diabetic.  Normal blood sugars?  Not diabetic.  We are taught real cutting edge stuff like that.  Want to hear something even more wild?  We don't give insulin to people who have completely normal blood sugars.  It could kill them.  Wild, right?  This seemed to fall on deaf ears.  While the patient is talking, all that is running through my head is, "please stop inventing symptoms and conditions so I can have ten minutes to eat."  I go to present my "findings" to my attending doc and as I soon as I open my mouth to try to give the history, I start laughing inside because I can either get angry or I laugh it off.  A psyche referral isn't even on the table as the patient was no danger to anyone and got angry at even the insinuation that some mental health might be a good idea.  Besides, they weren't really psychotic (I've seen that, too, and I had nothing but empathy for the patient but that's another story).  They just thought they knew more than the doctors.  My hunch is they want to feel important by having a doctor pay attention to them.  My attending shakes his head as if to say, "crap, there goes my lunch, too."

I will once again rely on the genius of The Simpsons.  THIS was my patient, only a younger and non senile version of Grampa Simpson.  I should've had fun and used the approach of Dr. Nick.

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