Sex, Drugs, and Public Health

August 20, 2009

“ First … Kill All the Lawyers ”

Filed under: Uncategorized — cbmosher @ 5:16 am

Mrs. X lay in the back of an ambulance recently, IV running into her vein, rolling back and forth on the gurney. She was on a long trip to a specialty hospital, a couple of hours away.

Whatever was wrong with her, her kidneys were working just fine.  With each little road bump, her bulging bladder sent electrical shocks to her brain.

“I have to pee,” she told the Paramedic.

He braced himself with his hand against the wall, placed his feet wide apart for balance like a subway rider, and rummaged through a bunch of stuff behind a sliding panel.  He pulled out a large oval of plastic.

“Here.”

“What’s that?”

“A bed pan.”

Distain replaced the discomfort on her face.

“I need a bathroom,” she said indignantly.

“But…” the Paramedic tried to explain that they were still more than an hour from their destination medical center and that using the bedpan or holding it were her only options.

Not to her, they weren’t.  She was insistent.  Very insistent.  The Paramedic slowed down the IV.  While that move was scientifically logical, it was way too late.

The Paramedic braced himself again, one hand on either side of the rolling, sometimes lurching vehicle, and inched his way up to the front.  He explained the dilemma to his driver.

“Wadda you wanna do?” the driver asked.  “Stop at a Burger King?”

The Paramedic envisioned himself explaining that decision to a doctor, or worse, to his supervisor.

“That won’t work,” he said.

“I need to go now!”  Mrs. X’s voice was rising.  Probably her blood pressure was, too.  Not a good thing. Not while she was on his ambulance.

“All right,” relinquished the Paramedic.  He turned to his driver.

“We’ll be passing Memorial Hospital in a few minutes.  We can let her use the bathroom in the E.R., then be on our way.  An E.R. is safer.  And they’ll understand.  Radio them, would you?”

Then he inched backward, both hands and both feet braced, until he could sit next to his patient again.

“OK, Mrs. X.  We’re going to stop and let you – ”

“You need to talk to them,” the driver interrupted the Paramedic.

He started to roll his eyes, but controlled it in front of his patient.

“OK,” he said softly, confidently.

“Memorial E.R., this is Ambulance unit 24.  I have a 53 year old female we’re taking to University Med Center as a transfer from St. Joseph’s who – ”

“That’s correct.  St. Joseph’s.  We’re from the next County over, just passing through. The patient needs to go to the bathroom.”

“Well, no, we can’t go back to St. Joseph’s just for a bathroom stop.  That’s an hour back the other way.  We’d like to ask that you – ”

“She says she can’t hold it until we get to University.  That’s another hour and a half yet.  So if we could just – ”

“Yes.  Of course we have bedpans.  The patient was offered one, but refused.  Said she can’t use it.  So if we can just stop for a couple of minutes – ”

“Say again?”

Mrs. X tugged at the Paramedic’s pants and wrinkled her face in urgency.

“She has complications with her surgically implanted shunt.  So we’re taking her back to her surgeon at the Cancer Center.  She’s stable.  We’re within three minutes of your facility now, so could we PLEASE – ”

“No Ma’am.  I’m not shouting.  I just need you to quickly give me the OK to – ”

“Why can’t you let her use your bathroom?  She’ll just go, and we’ll be on our way.  I’ll accompany her.”

“You will NOT!” Mrs. X interjected.

“I’ll accompany her into the E.R.,” he spoke toward his patient, “and wait for her while – ”

“What regulation is it against?  She just needs to go.”

“But No! I mean, no.  She’s not here for care in your E.R., just to use the – ”

“What lawyers?”

“But – ”

“Look, we’ll assume all responsibility.  All she needs is – ”

“Yes, ma’am.  Understood.  Thank you.”

He slowly, with a bowed head, hung up the microphone.

“Well?” asked the patient.

“Well?” asked the driver.

He snapped out of it, became commanding again.  “Pull into the parking lot at the E.R.” he told the driver.

“About time,” muttered the patient.

“But don’t back up to the door,” he added.

“Say again?”

“Just park it!”  He lowered his voice, “like a visitor.”

“Better hurry,” her voice sing-songed.

The Paramedic took a deep breath.  “Mrs. X, we can’t use their bathroom.  But we can – ”

“What!!  What do you mean?”

“Regulations.  Legal concerns.  If you set foot in their E.R., they’ll have to process you as a patient.  Start all over, as it were.  It would take an hour or two.”

“Would they bill me?”

“Is the Pope Catholic?”

“All I need is – ”

“I know,” he interrupted her.  “I know.  But they’re afraid they’d get written up for some violation. Or maybe sued.  It’s either go through their E.R. as a patient, or – ”

“Would they let me pee first?”

“That’s out of my control, ma’am.  They’d probably want your insurance card first, then need to register you as a new patient, then – ”

“Gimme that bedpan and wait up front with your ears closed.”

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