What? No drugs? You’re joking!
I saw a Hispanic gentleman with a complaint of cough, fever and chills. Although flu like, his lung exam suggested that he had pneumonia. His chest x-ray confirmed it. He was hurting in his chest, back and legs. His skin was sweaty and he looked uncomfortable, but he was breathing well and didn’t need to be admitted.
I gave him an antibiotic prescription, and as usual, I offered to give him some Hydrocodone for his generalized pain and cough.
He looked at me and asked, in broken English, ‘does it have drugs in it?’ He informed me that he operated heavy equipment, still wanted to go to work, and was concerned that it wouldn’t be safe for him to take a narcotic.
I could have kissed him on the mouth. Well, except for the whole fever and pneumonia thing.
Contrast that with many of my other emergency department patients! ‘Naw, I take Percocet every day of my life. Sure I drive with it! It’s like takin’ candy! Don’t you have nothing stronger than that, for Gawd’s sake?’
‘No, I don’t need no help with the children. I use Fentanyl patches for my Fibromyalgee all the time!’
‘Sure I was swerving a little! I take Lortab, Percocet, Lyrica, Fentanyl Patches, Klonopin and Neurontin! My back pain is just too bad not to, and I got to drive places!’
‘No I wasn’t driving while I took that pain pill. I was just using my moped.’
We are an incredibly over-medicated culture, and nowhere is it worse, nowhere more damning of the addictive nature of humanity, than in the South, where pain prescriptions are revered like gold nuggests and disability payments have the allure of the Holy Grail!
So to Manuel or Juan or Hermy or Jorge, or whatever his name was, ‘you’re awesome!’ Let’s just hope Americans can learn the same lessons and realize that not every problem is solved with sedation, and not every pain pill is worth risking your own life and everyone else’s.
Edwin
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I totally agree, but I have to wonder, if you feel this way, why is it your habit to routinely offer hydrocodone for the aches and cough of a respiratory illness? That seems like overkill.
Is that your response to good news: kissing on the mouth? Is this a southern custom, perhaps?
I think I may need to stay up north where a pat on the shoulder is more customary.
Was he a citizen? Sometimes it seems like the only folks who’re very interested in whether they can go to work are illegals.
Sorry, but the intermountain west can rival you…If they ain’t cooking meth they’re in the ER for their “hydros”.
Last week a 5 year old kid was brought in by ambulance. Deep hand laceration. He had thrown a fit when his mommy had tried to give him his PM meds. Grabbed a bare bulb over his bed. Fingertip burns and a palm lac.
I saw the line of bottles( prescribed by a child psychologist 200 miles away) on the counter. Abilify, Trazodone, Ritalin, Geodon and benadryl.
The mom was lucky to be able to be home with the kids since she “had her disability”…Note the possesive always…MY disability…Dx: Multiple personality disorder….
Kid was actually pretty good for the sutures. Better than most 5 year olds….There’s more…but it’s just a comment.
It is a sad, but true fact of my ED that normal people are so rare that I also just want to kiss or hug them.
When I see a normal patient (ie someone with a job, who has no alterior motive, with a normal pain threshold, and has a singular chief complaint that makes sense) I don’t want them to leave. I will spend extra time in the room with them to avoid the reality of that which awaits me in the next room. It’s the same relief people have when they are rescued from a desert island.
Sometimes I will whisper to the Nomal patients, “please, don’t leave me here, take me with you, please!!” As I hang on to their pant leg for dear life.
It makes you wonder how many people actually read the warnings on their meds. I have to take two medications daily that list “may cause dizziness” on the warning labels. One lists “may impair ability to use machines” and the other “may cause drowsiness.” I’m a full-time student who does some driving.
Maybe my statement should be, “It makes you wonder how many doctors read the warnings on the meds they prescribe.”