“Get
in the back,” my partner instructs him. We exit the vehicle to help
him. As we pile single-file into our over abused taxi, my partner
initiates patient care with the standard interview. In my 13 years as a
paramedic, this part always seems to excite me in an evil sort of way. I
have grown accustomed to the thought, what will these people think of next?
Unfortunately for me, nothing new this time, just the same old boring
crap. This gentleman (I say that in the loosest definition of the word)
proceeds to explain just exactly how his foot hurts. He describes the
pain and how it has been hurting for weeks. He went to the doctor
“again” today for the pain, and the doctor gave him a prescription for
some pain medicine. However, he just did not have time to go and get his
prescription filled, and now he wants us to take him to the emergency
room. Yes, you heard me, he wants to go to the emergency room for a two
week old injury that he has already been seen for by a doctor at least
twice because he did not get his prescription filled and now that it is
three o’clock in the morning he has decided it hurts bad enough to
warrant an emergency.
Our
government has mandated that I am not allowed to refuse care to this
individual, as I am not qualified and goes against every thing that the
Hippocratic Oath stands for; even when I know he is being ridiculous.
Furthermore, I would loose my job if I told this individual exactly what
I think of him. So, off to the emergency room we go. En route I ask the
infamous question, by which the very fabric of the ambulance business
survives (if we don’t get this information the company does not get
paid), “Do you have any insurance?”
“Yes,” he replies. “Do you want to see my Medicaid card?”
You
would think a response like that would elicit some sort of emotion in
me, but no. I probably hear that same statement at least two times a
night. I have grown accustomed to the uneducated and realize that they
and they alone have mastered the system. I am merely a pawn in this game
of chess. There are certain people who view Medicaid as health
insurance even though Medicaid is not health insurance at all; it is a
government assistance program that pays for healthcare for a certain
demographic of people (usually poor or the elderly) who may not be able
to obtain health insurance on their own.
By
regulations of my supervisors, I must call the hospital and tell them
what type of patient I am bringing to them. The nurse is unsurprised by
my report and she tells me to take him to triage, where they sort
patients by injury or illness and assign them a level of priority. The
patient overhears the conversation and keys in on the word triage. He
immediately begins to protest because he obviously has enough knowledge
to know how the system works. He immediately begins an informal
dramatization. The way he carried on you would think that he has just
stepped on a land mine and now his foot seems to be hanging to his leg
by a mere thread. There are absolutely no signs of trauma and/or loss of
use, but he tried to convince me that if he could not be seen
immediately he might loose his entire leg. His protestations gain no
ground with me, for I too have been long associated with this game.
Everyone involved in hospital care knows that triage equals a long wait,
and everyone sicker than him (in this man’s case that will probably be
everyone) will be seen before him.
Upon
arrival at the emergency room, I open the door so the patient can exit.
After another round of trying to convince me he was dying, the patient exits and
we casually make our way to triage (better known as the waiting room).
He is walking just fine and I am actually struggling to keep up. He
seems to know the way and he appears to be in a hurry to get there. I
give my report to the nurse and return to my truck. I am always rushed,
and I have to hurry and finish so I can be ready to perform another life
saving task.
Shortly
after I get back to the truck, about three minutes had passed since I
last saw my patient, I look toward the main entrance to the emergency
room and to no surprise my patient walks outside. He pauses in front of a
man, and I watch as the individual with whom he is now conversing gives
my patient a cigarette. I continue to watch as my patient turns and
begins to walk down the sidewalk; he left the hospital. So, I guess he didn't really need a doctor after all, maybe he just needed a ride
downtown. My patient fades out of sight as I finish the necessary
paperwork for this trip.
I have now been a paramedic for twenty years, and I still have to just shake my head sometimes and keep my mouth closed. Sadly enough, this story is not fiction. I love my job, but I can't say that I miss those days working downtown.
Feel free to share your own funny 911 story, and thanks for reading.
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