What Would You Say

There are times when we know things we would rather not know, and see things we would rather not see. We are bound by the privacy laws, and so we have to tread lightly when we see someone in trouble. 

People come through drivethru without their drivers license on a regular basis. We have to record the ID information on the hard copy prescription, and it has to be a valid picture ID (driver's license, military ID,

State ID, or Passport). For some reason, people take offense when we ask them for their driver's license. My first instinct, when they start to get sassy, is to call the police and tell them there is a person in such and such model car just leaving my drivethru who is driving without a license. I have never done this, because it's just not worth it 

Things start to get a little murkier when the person who drives up to the window is obviously impaired. I say obviously, although there are people who seem to be in a permanent state of impairment. Either way, if your speech is garbled, your eyes are at half mast, and it takes several seconds to turn your head in my direction when I ask you a question (picture the cartoon turtles on Looney Toons), chances are you have no business behind the wheel of a car.

Ditto for the elderly patients who cruise slowly up to the drivethru, see that they are too far away, and back up and pull forward several times before they zero in on the drivethru drawer. Or the ones who pull up, start to roll forward, and slam on the brake. Or the ones who hit the building or run over a cone, and pull away as if nothing happened. I have almost been taken out by one of our patients who lives by a local fast food joint. My quest for a greasy burger almost turned fatal when Mary pulled her big boat of a car out of her driveway in a Mr. Magoo maneuver, narrowly missing several other cars who had to swerve and slam on their brakes to miss her." Oh by George, Angus, why are people always honking at us?''.

There are some things that are more heartbreaking than others. I remember a little girl, about 4, standing in the cart in her bare feet, wearing a saggy two piece bathing suit with her hair still wet. It was 9:30 at night and the air conditioning was going full blast, so she was shivering. Her mother fit the meth addict profile, sores on her skin, stringy hair, tattoos, piercings, shaking, talking too fast, not tracking, bad teeth, bad hygiene. She purchased the decongestant of choice for the local meth cook. I couldn't do anything about it, and I think about that little girl every once in awhile and wonder what I could have done to help her. The ones that are really sickening are the ones who try to get their kids to 'say thank you to the nice lady'' which is a ploy to 

seem like a great parent and use the child as leverage to soften us up in case we suspect anything. 

There are cases where people use their kids to get pain medications. We see emergency prescriptions from dentists, rapid care facilities, and hospital emergency rooms on evenings and weekends. When we see the same child's name at different stores, from different prescribers, with the same group of adults, we hope to God they are not hurting the kid to get doctors to prescribe this stuff. We refuse the prescriptions from people known to do this, but always worry that the kid may actually be hurt and need the medicine. And what kind of sick bastard would do this? 

Another dilemma we encounter is the patient who has always been on top of things, who starts to slip, and we start to notice. How far do we let it go before we say something? We are lucky to live in a small community where we can usually contact a family member and discreetly hint that maybe someone needs to start checking on Aunt Susie, because she doesn't seem to be able to keep track of her medications like she used to. This is tricky because of the privacy laws, but we can usually get the person's relative or friend to catch our drift without breaking the law. 

We do the best we can to stay objective and professional, and still try to do the right thing when it comes to the stupid and dangerous things people do. I like the show "What Would You Do'' with John Quinones because it really brings up some moral dilemmas we all face. To get involved or not. To say something or do something, or just walk on by.

What we see is mild compared to what social workers, emergency room personnel, foster parents, child advocates, elder abuse investigators, policemen and firefighters, and a whole lot of other people have to see. I don't know how they do it. 

BP