Yesterday was my first day back to work on full duty after three weeks of absence and/or light duty. Patient "Smitty" has a cyst on his back. It's large. It sort of looks like an ant hill on the middle of his back.
Smitty is wasted. He appears to be a lovable stoner. Smitty is telling me how pretty I am. Can't really blame the man. I understand that my blatant beauty is intoxicating. However, he was probably stoned before he even encountered me. Yes, Smitty was slurring his words, stumbling while walking and being a bit of a pain in the ass.
Stoned.
Smitty begins his visit to our office by telling me that he is claustrophobic and that he "needs something to calm him down" before we remove the cyst. I tell him that we do not do that sort of thing for a little cyst to be drained. We simply numb the area locally.
"But I am very panicky! I get very nervous! I'm very jumpy!"
"Then perhaps you would rather have this another time, when your primary care physician can prescribe you something to calm your nerves."
"I ain't got a primary care doc."
"Might be a good idea to get one then, considering all the problems you have with your nerves and all."
Then out of nowhere:
"CP, you wanna go to dinner with me?"
"No Sir, I don't. But thank you."
"You sure?"
"Absolutely sure, Sir. And I think my husband would agree with my answer."
"Yeah. My wife probably wouldn't like it much either."
*sigh*
"Sir, can you turn around, face the wall. I have to numb that area for you."
"Are you goin' to give me a pill or somethin'?"
"No Sir. We already went over this. Do you want to proceed?"
"Are you going to go to dinner with me if I am brave and do this?"
"No Sir. I will not. Honestly, it doesn't matter to me whether you remove the cyst or not."
"It doesn't?"
"Not at all. Now, are we doing this or not?"
"Sure."
"Fine," I say, and go about the task of numbing the area.
"I'll need pain medicine when this is over too," he says.
"Yeah. I kind of figured you were going to ask."
"No dinner? You sure? I love you, you know."
"Positive, Smitty. I promise you. I'm sure."
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The cyst is removed and sitting on the tray next to Smitty. I walk back into the room when the doctor is done to set about bandaging the man. I catch him sticking the scalpel, blade and blood soaked gauze into his pocket.
"Smitty! What are you doing?"
"You don't keep these scalpels. I want them!"
"We do keep those blade handles, Smitty. We cleanse them, sonic clean them and then sterilize them."
"What about the blade?"
"No, we dispose of the blade."
"I want to keep mine."
"No."
"Why not?"
"Because it is not safe for you to stick a blade in your pocket first of all. Secondly, it is covered in biohazardous material and I cannot let you leave with it. Or the bloody gauze you stuck in your pocket either."
"It's mine though!"
"No, Sir. When it was still in your BACK, it was yours. Now that it is on MY surgical tray, it is MINE and my responsibility to dispose of it."
"You're no fun, CP."
"So I've been told, Smitty."
He hands me a few pieces of bloody and gooey gauze. None of them contain the cyst we just excised from his back."All of it, Smitty."
"Huh?"
"Give me all of the gauze. All of it. Now."
He reaches in his pocket, reluctantly, and hands me the rest of the gauze."I was gonna practice being a doctor, CP!"
"Well, I imagine you are going to have to go about it the old fashioned way and read a book and go to college."
"Nope. I'm gonna be a doctor and I am going to start right now, by giving YOU a breast exam."
He proceeds to make 'squeezing' gestures at my breasts with his hands."Great," I say, with a very menacing smile. "And I will play pretend to be a plastic surgeon by giving you a face lift with my right hook. Try me."
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Smitty finally leaves the exam room and heads to our coffee station, where we offer our patients the courtesy of free coffee or tea. Smitty proceeds to open the cabinets, rumage through them and then, inexplicably sticks his hand under the hot water tap and runs the water on his hand.
"Oh SHIT! That burned! I'm gonna sue!"
"You poured the coffee water on your own hand, Smitty. I don't think you have a case."
"Some lady made a million dollars at McDonalds for doing that!"
"Hers was an accident and she wasn't stoned."
"I'm not stoned."
"Sure you aren't, Smitty."
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Smitty is now at the front desk, sticking handfuls of candy into his pocket while waiting to be checked out. Much to my dismay, I notice that our doctor has written him a prescription for Tylenol 3 to manage his pain. I sigh. Great. Feed a drug seeker. Now he'll never leave us alone. Smitty is on his third handful of candy. I take the bowl away and move it further behind the desk where he cannot reach it.
"Aw, CP, c'mon! Come out to dinner with me."
"No."
"Then at least give me back the candy. I was a good boy."
"No."
Smitty then proceeds to climb up onto the counter on the front desk in a feeble attempt to make another grab at the candy dish."Smitty!"
"Huh?"
"I have your narcotic prescription for pain in my hand. If you do not get off the counter and out of my office RIGHT NOW...I will stick it in the shredder. Do you WANT your prescription?"
"Yeah."
"Get down off the counter."
"'Kay. I'm down. Give me my pills. I'll go. And CP?"
"What Smitty?"
"I still love you."
"Makes my day, Smitty."
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Fast forward three hours later.
Receptionist: "CP? Phone call for you. Line 4. I think it is that guy from earlier."
Huge, heavy sigh."Yes, Smitty."
"CP? That you?"
"Yes, Smitty. How can I help you?"
"I lost my prescription."
"Hm. Sorry to hear that."
"I'm gonna come up to get another one."
"No can do, Smitty."
"Why not?"
"I cannot give you another prescription for a controlled substance, knowing there is another one floating around out there somewhere. It is against the law for me to give you two prescriptions for the same controlled substance on the same day. So, I would suggest you pick yourself up some Extra Strength Tylenol and make the best of it."
"But I'm in pain, CP!"
"Sorry, buddy. Can't help you. Next time, be more cautious with your prescriptions."
"I love you, CP. Don't tell your husband."
"No problem there, Smitty. I assure you."
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Fast forward to today. I am at our other satellite office.
Receptionist: "CP? Line 2. It's Lynn."
"Hey, Lynn. How are you?"
"Great, CP. Hey listen, we just got a call from a guy named Smitty."
"Oy."
"You know him?"
"You can say that. He offered to feel me up."
"What?"
"Nothing. So, what did he want?"
"He told me that he found the prescription that he lost. He filled it. He wanted to tell you that. And he also said now he is out of the pills because he accidentally dropped them in the toilet. He wanted to know if you could refill them for him now, since it's the next day. He also said you were supposed to call him about your...dinner date?"
HUGE, HUGE, HEAVY AUDIBLE SIGH."Lynn, do me a favor? Call him back. Tell him that NO ONE is filling his prescription for him."
"Oh yeah, he told me to tell you that he is a recovered alcoholic. Sober for two years, so that you don't have to worry about him abusing his drugs."
"Great. I feel so much better now that I have that information. I think I will order him a morphine pump."
"Really?"
"No, Lynn. NOT really. Just please tell him there will be no more drugs. There will be no more refills. There will definately be no dinner date and, if he doesn't stop with this nonsense, there will be NO MORE appointments with this office, got it?"
"Got it."
"Swell, Lynn. Have a great rest of your day."
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Fast forward several hours later.
"CP," says the doctor, "I hear you had an incident with that cyst guy yesterday."
"An incident? I don't know that I would classify it as an incident, necessarily."
"I hear he said some inappropriate things to you."
"You heard correctly."
"Well, next time he comes in for a follow up, make sure to keep the door open."
"Excuse me, Sir?"
"I said..."
"No, Doc. I heard you. I just mean...what do you mean by next time?"
"When he comes in for his follow up..."
"You are having him come BACK? May I ask why?"
"He has a follow up scheduled and he has a second cyst to remove."
"Sooooooooo, what you are telling me is that it is okay for him to come in, steal equipment and biohazardous material, burn himself, be disruptive to the staff and sexually harass me. Is that correct?"
"Well, even if I discharge him as a patient, I have a legal responsibility to him to continue his care for at least 30 days."
"What about your legal responsibility to ME?"
"What do you mean?"
*blinks*"What do YOU mean, what do I mean? I mean, lets call a spade a spade here, Sir. I am not exactly threatened by this man. If he attempted to give me a breast exam, I would have twirled him like a baton, snapped him like twig and disposed of him in a dumpster. However, someone who is NOT like me, who does not have my personality might feel very intimidated to have someone who is obviously a drug addict make a sexual remark and gesture in their direction. Further, what if that remark and gesture was made toward your front office staff. Or what about one of your patients in the waiting room? Perhaps a young girl who is here for acne or something? Do you want that sort of responsibility and liability?"
"Unfortunately, that is my responsibility as a doctor."
"What about your responsibility as a man, Doc? Would you want to know that your wife or daughter encountered a person like that at their work or school? Incidentally, if I press charges against him for sexual harassment or the like and get a restraining order, he can't come within 500 feet of me or my place of business. How would that conflict with your duty to this patient?"
"Hm. Let me see what I can do about this."
"Good idea, Sir. Very good idea, indeed."
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Given all this information...one can only wonder. How is it that someone with so much experience and intelligence have so little common sense when it comes to such an important matter? Is a the cyst of a drug seeking addict more important than maintaining the integrity of your office or the safety of your staff?
Sure, you took an oath to uphold the health and welfare of your patients. However, what happened to just doing the right thing as a human being?
The nurses are all extremely pissed off and considering to walk out, should this man be allowed back in the office.
Me? I kind of liked the idea of playing plastic surgeon on the fucker...but alas, they just won't let me play make believe.
Shame.
I really wanted to change Smitty's reproductive organs with a hacksaw, you know, just to practice.