One of our nurses was checking a patient in a few days ago, and had the following interaction while taking his information. Let me preface with the fact that the patient was in his mid 40’s.
Nurse: ‘Do you work or go to school?’
Patient: ‘I don’t work. I’m thinking about getting disability.’
Nurse: ‘For what?’
Patient: ‘Oh, I don’t know. Maybe my nerves. I’m under a lot of stress.’
Nurse: ‘Really? What sort of stress?’
Patient: ‘Those people I ride the bus with are driving me crazy!’
In a classic example of sheer, American know-how, in a brilliant perversion of the entrepreneurial spirit that makes us great, this individual figured that disability was tantamount to a career choice. Like ‘I might become a pilot,’ ‘I might learn to be a plumber,’ ‘maybe I’ll go to law school,’ or even ‘I’ll go to New York City and walk dogs!’
In light of that, I began to wonder just what sort of disability I could get; then I started wondering what kinds of injuries or illnesses were unique to the practice of medicine in general, and to the practice of emergency medicine in particular.
For instance, could I get repetitive stress injury from typing too many orders onto the computer, born of our treatment algorithms, ‘pay for performance,’ and general spirit of defensive medicine?
Perhaps I could get ‘suture wrist,’ similar to tennis elbow. Or maybe, ‘bimanual hand,’ from doing too many stressful pelvic exams.
Certainly, walking on concrete for the past 18 years hasn’t made my knees feel very good. Maybe I’d be able to wrangle some sort of arthritis determination.
Of course, the weight I have gained as a result of stress eating can probably be tied to hours spent in the emergency department. At home, I’ll walk, play, ride bikes, jump on the trampoline, swim or wrestle the children. At work, since wrestling, swimming, bike-riding and trampolines are out, I just stand around between patients eating tortilla chips and salsa, chocolate, Chinese food, cups of peanut-butter designated for patients, bland saltine crackers or most anything else that sits unattended in the break room. ‘Omnivorus medicus chronicum.’
My senses have also started to slip; so there’s a possibility. My right eye cataract is driving me nuts, and my left has troubles too, despite Lasik. It may have to do with looking at computer screens. Or it may be some sort of cortical blindness that my brain has developed as a defense mechanism against very disturbing patients and family members; or from the strain of looking for imaginary redness, swelling and foreign bodies, and searching for unimaginably obscure insect bites.
My arms gets tired from writing vague information, and from performing the exams we have to document now in order to be paid. Is that a kind of repetitive stress injury?
And my poor nose. Assaulted for years by everything from draining wounds to feet that qualify as biological weapons, I may soon have a hysterical loss of smell, purely as a defense mechanism.
Of course, let’s not forget selective deafness. My auditory cortex simply has an ‘off switch’ that engages when any story passes 10 minutes, or begins with the words, ‘let’s see, it was back in ’63 when I fell and all this started.’ I also experience this loss of hearing when I hear any news report that says I’m doing a bad job, or not doing enough to help the country in the course of my daily practice.
Furthermore, I think we all get a little bit of PTSD. More on that later. But what sort of disability rating can I get from telling people, over and over, that someone is dead? That the news is bad? That I have no idea how to help them? Or that I simply won’t give them the same pain medications that their own doctor shovels into their Halloween pumpkins every month. Does that qualify? The combination of terrible things and ridiculous things must cause some kind of ‘pseudo-stroke’ syndrome, or ‘near psychosis,’ or ‘patient tangential story disorder.’ I mean, there are pseudo-seizures, right?
I should do some research. We may be sitting on billions in class action suits for doing what we do year after year, without anyone in positions of authority taking the time to recognize our unique risks and specially concocted work-related illnesses and injuries. Considering the enormous fear of cell-signals and wireless networks, despite any evidence of injury, I think my above-listed ailments should cause some very real alarm, or at least some very significant snickering and forwarding behavior!
Fortunately, I don’t in the least bit want disability. A best seller? I’ll take it. Strike gold on my property? No guilt at all. But simply to sandbag and decide work is too much, or too annoying, or to darn hard? It flies in the face of my upbringing. It insults my ancestors in their labors to survive. It would shame my great grandfather who refused his Army pension, saying ‘I don’t want or need their money!’ It throws back into the face of God the very gifts and health he gave me and continues to pour out into my life.
I may not always like working, but I’m sure as shootin’ proud I keep going back. And I’m equally proud that the idea of fishing for a disability diagnosis never crosses my mind.
Except during very busy shifts!
God bless you and keep you laughing…and working proudly!
Edwin
I just can’t seem to think of a catchy phrase to label the a disease for tolerating the dysfunctional family members of our patients…must be too tired cramming for finals. Isn’t there an antibiotic you can give me for that?! What do you mean you don’t have an antibiotic you can give me for that?! I should have some pill that will help me get over the stress of my finals. 😉
ROFL!! This is classic…and quite reminiscent of stuff I see every day on the job in medical records. Sometimes I am amazed at the things people claim for disability or workman’s comp…it’s almost like nobody wants to work and would rather find some way to live off the government. Personally I think it just demonstrates the general degeneration of the work ethic in this country. Truly sad, IMHO.
Anonymous Attorney
16 years ago
This is great, but sadly, doctors themselves often enable these people in the worlds of litigation, worker’s compensation and disability benefits by signing off on their vague and never-ending complaints. The doctor’s word is law here, and if the doctor is a mere cipher for the “patient,” untold numbers of people are getting benefits or money they don’t deserve.
Brad
16 years ago
On the flipside of what the Anonymous Attorney said are the everpresent “company doctors” in workers’ compensation claims. If we are going to talk about American entrepreneurial spirit, let’s please include the doctors who gladly take the check from the employer/insurance company and then give the patient a less-than-thorough exam and diagnostics. And doctor, while I am not trying to disregard your “suture wrist” or “bimanual hand”, there is a large segment of America who work in manufacturing/services and do actual physical labor. Employers and workers’ compensation insurance carriers are betting that these workers won’t know enough to document their… Read more »
AMcA
16 years ago
This brings to mind a story: a friend was on a Chicago Transit Authority bus which got into an accident. Immediately after the crash, a disappointed but apparently uninjured passenger was heard to say – “Damn! I thought I had my disability.”
Достаточно интересная статья. Думаю стоит добавить в избранное для дальнейшего изучения
LaurieBerg
14 years ago
Ed, is there a way that you could BAN LAWYERS from writing on your site? We’re not even safe here! How about the lawyer who sues the doctor because the doc eludes that a patient is a “drug seeker”. Lawyers have absolutely RUINED medicine.
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I think I have developed “carpal scriptitis” – from writing so many prescriptions by hand the past 2 weeks!
I just can’t seem to think of a catchy phrase to label the a disease for tolerating the dysfunctional family members of our patients…must be too tired cramming for finals. Isn’t there an antibiotic you can give me for that?! What do you mean you don’t have an antibiotic you can give me for that?! I should have some pill that will help me get over the stress of my finals. 😉
ROFL!! This is classic…and quite reminiscent of stuff I see every day on the job in medical records. Sometimes I am amazed at the things people claim for disability or workman’s comp…it’s almost like nobody wants to work and would rather find some way to live off the government. Personally I think it just demonstrates the general degeneration of the work ethic in this country. Truly sad, IMHO.
This is great, but sadly, doctors themselves often enable these people in the worlds of litigation, worker’s compensation and disability benefits by signing off on their vague and never-ending complaints. The doctor’s word is law here, and if the doctor is a mere cipher for the “patient,” untold numbers of people are getting benefits or money they don’t deserve.
On the flipside of what the Anonymous Attorney said are the everpresent “company doctors” in workers’ compensation claims. If we are going to talk about American entrepreneurial spirit, let’s please include the doctors who gladly take the check from the employer/insurance company and then give the patient a less-than-thorough exam and diagnostics. And doctor, while I am not trying to disregard your “suture wrist” or “bimanual hand”, there is a large segment of America who work in manufacturing/services and do actual physical labor. Employers and workers’ compensation insurance carriers are betting that these workers won’t know enough to document their… Read more »
This brings to mind a story: a friend was on a Chicago Transit Authority bus which got into an accident. Immediately after the crash, a disappointed but apparently uninjured passenger was heard to say – “Damn! I thought I had my disability.”
Great article, I’d like to learn a lot more about this. Any other useful links you could post?
Достаточно интересная статья. Думаю стоит добавить в избранное для дальнейшего изучения
Ed, is there a way that you could BAN LAWYERS from writing on your site? We’re not even safe here! How about the lawyer who sues the doctor because the doc eludes that a patient is a “drug seeker”. Lawyers have absolutely RUINED medicine.
Laurie,
I didn’t realize that was from a lawyer. Thanks for the heads up! I removed the comment.
Edwin
Good post overall. Enjoyed reading it.
Получилось тоже, хотя и не надеялся.