The Disruptive Patient
This post was inspired by my Facebook friend Bob Rupe of ‘Bluegrass Motors.’ He recalled an interaction with a less than cooperative customer. It brought to mind a patient encounter from years ago.
It was a late night at the hospital. Back in those days we did not have hospitalists on the staff, so we picked up a lot of cases on unassigned call. (folks who needed admission but did not have a regular Doc) A husband demanded to see me about his wife’s condition in the I.C.U. I was down in the ER and went up to check on things.
“My wife needs to check out. You need to fill out the paperwork so she can leave.”
“Uh, well, sir. I understand that you want her home. I tell you the truth though, it isn’t safe yet. She needs to be on the cardiac monitor another 48 hours.”
“Well, by God, I say it’s time for her to go home.”
Uh oh. This was trouble. “Why do you say that?”
“For her to be in here looks bad for me.” (Her problem was self-inflicted) “It’ll get out in the community why she’s here, and I won’t allow it.”
I tried one more time. “Honest to goodness sir. It isn’t safe. It’s possible she could die.”
He glared at me. “You gonna sign her out or not?” His voice grew louder. “Do you know who I am?”
I wanted to say, ‘Yeah, you’re the guy who is driving his wife crazy,’ but I held my peace. I thought for a minute. “Hm. Let me go look over her chart. I’ll be right back. I need a cup of coffee; can I bring you one?”
In those days, we had just hired our first hospital security people. I had seen Ben down in the ER. Ben was my patient, an ex-Marine, about 6’4″ and 250 pounds. He was imposing even without his side arm. I went to the ER.
“Care for a cup of coffee, Ben?”
“I’ve got a fellow up in the I.C.U. we might have trouble with. Can you troop up there with me?”
I went back to to the room. Ben tagged along behind and waited at the door.
“My friend Ben brought your coffee. Care for cream or sugar?”
“Me neither. I like it black too.” I sat down and sipped on mine. “I went over your wife’s chart. It isn’t safe for her to leave. Ben here will see to it the word doesn’t get out in the community. It’d be bad for a man of your standing.”
“Don’t worry. Ben’s very effective. Through the years I only recall him shooting one person.”
Silence. He seemed to lose his resolve to intimidate.
I was glad. Use of force is against my code of ethics. I always call in a specialist for that.
The man’s wife recovered and went home in three days. We lined up all the right follow-up. They never came back to see me. In a way I hate that. I wondered how things went for her over the years. That was one more mean-spirited man.