Sunday, July 11, 2010

Everybody needs a hobby.

The new neurology intensivist fellow came up to me in the hallway. "I hear you have a way with whackjobs," he said.

"Uh....they seem to like me?"

"Good. Come with me. I'm having problems and I need some help."

So off I went with the New Dude to see what, exactly, problems he was having. I was expecting somebody who really needed a psych consult rather than the run-of-the-mill patient I was introduced to.

It was the same old story: four pages, single-spaced in a small font, obviously drawn up over years and years, listing a couple hundred drug allergies. A list of surgeries, complete with editorial commentary ("Not necessary" and "Surgeon cut in wrong place" and "anesthesia overdose, nearly died")(you'd think, after having something like twenty surgeries, if *everybody* kept fucking up, you'd just quit having surgery). Two additional pages of complaints and demands, including that plastic anything was unacceptable because of chemical transfer and only organic food should be offered.

Behind all of that sat a vaguely plump, vaguely pale, vaguely average-looking middle-aged woman without much facial expression. She had an electric widget in her hand, which I had seen before: it's sold, at great cost, by one of our local guys, who claims it'll prevent everything from poisoning to anaphylaxis. She held the widget protectively, no doubt ready to press it to her temple at a moment's notice, should I whiff of perfume or dioxin.

We had to get a history. Some sort of usable history, sans editorializing and without extraneous detail about what houses Jupiter and Vulcan were in at the time of her last gut surgery.

It took an hour. One solid hour from start to finish, with Dude noting things down on his little pad of paper, and me practicing the most therapeutic forms of redirection and point-keeping-to-ing that I could. Turns out there's not a lot wrong with her: no hypertension or hyperlipidemia, no diabeetus, no chronic anything except a general malaise and dissatisfaction with her life. Nobody died in her family of anything but old age, and she'd never really been sick to speak of, at least not sick enough to be in the ICU or anything, but there were those multiple chemical sensitivities and all the allergies and....

And, and, and, and. And fucking and.

At the end of it, I didn't think to ask what she came in for. Probably something with a name like "generalized pain syndrome" or "rule out lupus" or just "boredom".

As we walked down the hallway to get some coffee, the New Dude thanked me profusely. "I'm going to start calling you my Mental Health Nurse," he said, in an attempt at Neurologist Humor.

"Don't even," I said. "I am so not making a habit of this for you."

"D'you think it's just boredom, that makes people do that?"

"Dude, I don't know. All I know is that every time I see somebody like that, it reminds me of what I do not want to grow up to be."


messymimi said...

I knew a nurse several years ago who said those people just made her sad. She said she really thought it was loneliness that kept them coming in. Like the elderly people who call 1-800 numbers to order stuff they never use when it comes to them, just to have somebody to talk to.

Anonymous said...

Reminds me of somebody I knew in college (when we wrote on skins). This individual, whose name you would never believe, was NEVER pleased with anything. Sooo, one o my buddies, who was in the School of Nursing at Unlimited U, got a semi-illegal potion to Turn Her Urine Green.

We heard no more complaints after that.

Not recommending ... just suggestinjg.


'Drea said...

I think it's great that you have a knack for dealing with difficult, um, special people even though you don't want to be the go-to person for difficult people which is understandable.

Did you take some *extra credit* courses in psychology or are you just a patient person? Just askin'...

Luis said...

Mark Twain called them "collectors of allergies" about 150 years ago. Some things never change.

Jo: Extra points for "diabeetus".

Sue G said...

I feel chronic fatigue coming on just from reading about her.

Anonymous said...

You are my hero. Please, teach me your skills of patient interview re-direction. I must learn...

Anonymous said...

yeh, my ED gets these patients as well - always middle aged - older women.
Really annoying as they always seem to come in on an extremely busy evening and are oblivious to anyone else but themselves.
They always seem to have endless allergies / a written list of illnesses and operations (however minor) dating back decades.

Anonymous said...

Where can I get one of those widgets? It sounds wicked cool

NNR said...

Perfect example of a patient for whom "feels sick" would be a perfect admitting diagnosis.

Penny Mitchell said...

Friend Kim's grandfather stated, vehemently, every freaking day of his life, that he was dying. Every. Freaking. Day. That was ALL he talked about.

He lived to be 102.

Stellar use of a life, there, asshat.

shrimplate said...

I know that patient.

Anonymous said...

I triaged one like this, on the weekend. Just about did my head in,
Stated "10/10 pain" - whilst sitting at triage smiling and chatting to friend.
Had pain for 24 hours and had not taken anything at home for pain (despite having strong analgesia at home).
Wanted something for pain.
Refused analgesia.