So there is this clinic that I like to work at periodically that serves those of Detroit that cannot afford normal health care but that are still either working or trying to find work. And there is this doctor there that seems to like me as a med student, either that or they're just friendly to all med students. I say this because she is very good about making patient encounters a learning experience. But she is this petite woman. So one day this guy comes in dressed in "urban cowboy" apparrel and you just know when people with big leather boots come in that they are just looking for a prescription for some more drugs.
Long story short, the guy was in an accident a few years back (in his defense he did nearly die), but he grossly exaggerates his pain (10 out of 10--everywhere in my body!) in order to try to convince her to give him another prescription for some opiods. And to try to be even more convincing he tried to act completely out of it, I guess because he thought that by acting like he had no mental faculties he would be a better candidate. For instance, even though he had to write his name and the date at the top of the mental coherence test (which he got right), he suddenly thought that it actually was "November" not "February."
But thank goodness the doctor wasn't buying any of it, and before we went back into the room to give him the "bad news" she told me to be ready incase he got hostile in response to what we were about to tell him. So I ran through a few scenarios in my mind in case I (being the only one of us within 70 pounds of this guy) had to defend the both of us. Luckily he took the news pretty well inasmuch as he didn't get violent.
So I sat down on the stool while the doctor explained in detail why he wasn't going to get what he wanted, while he did his best to roll out some answer like, "Well, I just think that when I was on the Oxycontin I was in a good place, a place were I wanted to be." But when she asked him where he wanted to go from here, e.g. pain free or working etc, he didn't have an answer. Even more troubling, his medical records showed that he had tried to kill himself on a couple of occasions by overdosing on pain medication.
As this was going on, I noticed that the doctor kept trying to get my attention for some reason. When we finally made eye contact she motioned towards the door with a look.
So I got up and moved towards the door. When I talked to her later, she said, "I was trying to get your attention forever but you were just sitting there on that stool!" She didn't say it in an angry way, but rather she was more just pretending to ream me out. To conclude she told me, "Never let a potentially angry patient get between you and the door."
Oh and the guy also made some vague references to feeling "homicidal" without his pain medication, his one thinly veiled threat from the encounter.
Long story short, the guy was in an accident a few years back (in his defense he did nearly die), but he grossly exaggerates his pain (10 out of 10--everywhere in my body!) in order to try to convince her to give him another prescription for some opiods. And to try to be even more convincing he tried to act completely out of it, I guess because he thought that by acting like he had no mental faculties he would be a better candidate. For instance, even though he had to write his name and the date at the top of the mental coherence test (which he got right), he suddenly thought that it actually was "November" not "February."
But thank goodness the doctor wasn't buying any of it, and before we went back into the room to give him the "bad news" she told me to be ready incase he got hostile in response to what we were about to tell him. So I ran through a few scenarios in my mind in case I (being the only one of us within 70 pounds of this guy) had to defend the both of us. Luckily he took the news pretty well inasmuch as he didn't get violent.
So I sat down on the stool while the doctor explained in detail why he wasn't going to get what he wanted, while he did his best to roll out some answer like, "Well, I just think that when I was on the Oxycontin I was in a good place, a place were I wanted to be." But when she asked him where he wanted to go from here, e.g. pain free or working etc, he didn't have an answer. Even more troubling, his medical records showed that he had tried to kill himself on a couple of occasions by overdosing on pain medication.
As this was going on, I noticed that the doctor kept trying to get my attention for some reason. When we finally made eye contact she motioned towards the door with a look.
So I got up and moved towards the door. When I talked to her later, she said, "I was trying to get your attention forever but you were just sitting there on that stool!" She didn't say it in an angry way, but rather she was more just pretending to ream me out. To conclude she told me, "Never let a potentially angry patient get between you and the door."
Oh and the guy also made some vague references to feeling "homicidal" without his pain medication, his one thinly veiled threat from the encounter.
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