got a flight to New York in two hours,” he said. “I think both of us know the importance of keeping on schedule.”
“You probably do a better job of that than I do, I’m afraid,” said Dr. Hadley, “but since you’re the first patient on my schedule today, I don’t have any excuse not to be on time.”
Their conversation was interrupted by a series of high-pitched beeps. Dr. Hadley looked at her right hip, but her cell phone was silent.
“It’s mine–the office,” said Mr. Farmington. “Would you excuse me for just a moment?” he asked as he was already dialing. “Terry!” he shouted into the receiver. “Hold my calls til I get to the airport. I’ll have to call them back on the flight.” Turning to Dr. Hadley, he said, “Sorry. Back to the business at hand. I’m feeling great, but I’m due for a check-up. Sort of like my old Rolls-Royce—in perfect condition, but still in need of a tune-up now and then.”
“Are there any particular things you’re concerned about that you’d like to have checked?”
“Do it all—whatever needs to be done. Don’t worry about the expense, of course.”
“Fine. I’ll do a physical, and then some tests, but there’s really not a lot that needs to be done for the typical patient of your age who’s feeling well.”
“Excuse me, doctor, but I’m not your ‘typical’ patient.”
“My ‘typical’ patients aren’t rich snobs,” she thought, but said, “Yes, of course. Everyone has unique needs.”
He seemed disappointed when at the end of the physical all she recommended was to check his cholesterol. “You had an extensive blood profile, ECG, and colonoscopy last year, all of which were normal, so there’s really no point in repeating those things already.”
“The colonoscopy I can do without, but as long as you’re drawing blood, I’d like to have everything checked. I want all the bases covered.”
“But…” she began.
“Just do it.”
She gave in. “Okay. It’s your money, or at least your insurer’s money,” she said, as she walked away feeling like one of his employees.
America is a society in which all of us are equal but everybody wants special treatment. Likewise, American medicine ostensibly tries to treat everyone the same based on their medical condition and not their pocketbooks–but fails. Even in countries like Britain which have socialized medicine, the rich are still able to purchase additional, specialized care.
When I was in training, there was even a special floor of the hospital where the well-heeled sick could recuperate with the aid of not only the nursing staff, but their own gourmet chef as well. Even though they paid extra for their privileges, this still seemed a little unfair to the rest of the patients who had to choke down their daily ration of broth and gelatin.
Rich people can be good patients, and there certainly are some doctors who cater to them: you can charge them more and expect to be paid. But there are limits to what your physician can do, no matter how much money you throw at her. Disease and death can only be bribed, not bought off altogether.
Do realize that a champagne-and-caviar lifestyle may be a sign of privilege, but not of good health.
Don’t expect that your treatment will necessarily be any different than anyone else’s with the same condition, regardless of income.
Do realize that money can’t buy happiness, love, or good health.
The Violent Patient
Dr. Dean Reitermann knew Martin Folsom was angry even before the patient began speaking: his uncombed morning hair stood out in mean porcupine-like spikes, his jaw was clenched with muscles that were visibly kneading across the bones, and his icy blue eyes glowered from behind glasses that sat slightly askew on his nose. With an optimistic smile, Dr. Reitermann extended his hand in a cheery greeting: “How are you today, Mr. Folsom? Nice to see you.”
“Humph,” he snorted. “Why don’t you stop this damn buzzing in my ear? Then it’ll be nice to see you.”
Dr. Reitermann began to wonder if he should ask Lynn, his office nurse, to come into the room. But being 6’ 2” and 200 pounds and having a black belt in karate made him confident that he need not be afraid of his slender young patient. “Let me take a look at you, then,” the doctor said, and began to peer with his otoscope into Martin’s left ear.
“What are you doing?” shouted Martin as he grabbed the physician’s arm and pushed it away. “You’re trying to plant some kind of radio in my head, aren’t you?”
Dr. Reitermann glanced down at Martin’s chart and now was reminded that the young man suffered from paranoid schizophrenia and was under the care of a psychiatrist. “Martin, have you been taking the medication that Dr. Carver prescribes for you?”
“Medication, medication, medication, medication,” he chanted. “You and him are trying to poison me.”
“No, of course not, we…”
But before the physician could finish his response, Martin snatched the chart from his hand and began ripping it up. “I’m destroying your plan!” he shouted.
Martin threw the shredded document into the doctor’s face. “Stay away from me!” Martin yelled as he reached out his arm and with one sweep knocked the canisters off the equipment tray.
Shards of glass, wooden tongue blades, and cotton balls now littered the floor, and the noise of the crash brought Lynn into the room. “What’s going on in here?” she asked as Martin ran past her.
“Nothing a little haloperidol won’t fix,” replied the shaken physician. A call to the patient’s psychiatrist soon resulted in Martin’s commitment to a hospital, until he was back on his medication and no longer a threat to others.
Violence in the workplace, while itself not common, is becoming a common source of anxiety among workers. Widely publicized incidents like an ex-postal employee who kills his former boss with an automatic weapon have made us all fearful for our own safety. A worker angry about being laid off, a customer spewing epithets over a defective product, or a colleague upset over a perceived insult can all trigger this fear.
Physicians and their staffs sometimes encounter verbal abuse from distraught patients, which can occasionally escalate into physical violence. In particular, physicians and clinic employees who perform abortions are terrified of this possibility. Regardless of one’s stand on abortion, one has to condemn such violence. And just remember, if you should happen to have an altercation with your physician, he knows where your vital organs are located and how to get to them!
Do remember that violence is not justified no matter how upset you are.
Do discuss your feelings with your physician if you’re upset about something.
Don’t be surprised if your doctor dismisses you as a patient if you’ve been verbally or
