Wednesday, March 24, 2010
The other evening, a lady came to the ER seeking to use her God-given right to healthcare and her Medicaid "insurance" to get some pain pills.
While in the busy waiting room, she managed to position herself in front of the triage nurse and have a "seizure". Of course, it's poor form to leave a "flopper" in the waiting room floor, so she was placed into a room ahead of other patients.
Once in the room, I walked by and glanced in long enough to make an assessment that she was faking (I didn't really need to break stride to do this). We let her flop around a while until she got tired of it and finally stopped.
When I went into the room to see her a while later, the story was that she called her doctor and he just couldn't work her into his busy schedule that day, so he told her to go up to the ER to get a Rx for pain pills until he could see her the following week. I asked why he just didn't call a few pills in to the pharmacy for her, but she couldn't figure out an answer for that one.
Almost on cue, she began to "seize" again. It was a thing of beauty. She did the "reverse worm" all the way down the stretcher and out onto the floor. I grabbed her trapezius on one side, and the nurse grabbed her trapezius on the other and we hauled her back onto the stretcher.
When she heard me give the order for a catheter and a drug screen, she began to "un-seize" quickly. She claimed to be taking several seizure meds faithfully, and just needed her pain pills refilled.
Her labs returned negative for any of the seizure meds she claimed to be taking.....and positive for all 6 of the items on the drug screen!
When I went back to talk to her, she was furious that her neck was really sore from where we had pinched her (she was supposedly seizing at the time and shouldn't have been aware of this). When confronted with her lab findings, she was enraged. There was NO WAY that any of it was correct. Maybe some cold medicine had turned the cocaine screen positive, or possibly some vitamin supplements turned the amphetamine screen positive etc.
When I told her that I wouldn't write a script for any pain pills and she could hit the road, I expected a fight. Instead, she turned very gentle and friendly and handed me a form that was clutched between her nicotine stained fingers.
It was a disability form, PRE-filled out stating that I had witnessed her having seizures!!!
I love my job!!
Posted by erdoc85 at Wednesday, March 24, 2010