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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