The Fat Entitled Whiner

I was talking to dad today during a leisurely breakfast here at the hospital--both things are sadly far too rare, and so I was thoroughly enjoying myself as we talked about interesting cases I have seen here in LA. He works with other medical students as well, in his practice, and so I get to hear stories about interesting people he comes across.

He was telling me about a young female resident that reminded him of me, and her experience with a patient. A young illegal immigrant from Mexico was hit by a car and came into the hospital with bleeding in his brain, eventually requiring surgeries to place a mesh and several months in the hospital. The mesh became infected, but not all problems can be fixed, and the danger of him having it removed was greater than the danger if it stayed--and so he was placed on expensive antibiotics to control the chronic infection in his brain, and would have to be on them for the rest of his life.

But he was illegal--no citizenship, no insurance--and so the authorities contacted the mayor of the small mountain village where he came from to determine how to get him home. It turns out that the mayor had a burro, and so he would travel down to the city and collect the man from the airport when they shipped him back. All the resident could do was send the man to the airport with 6 months worth of antibiotics, and let him go home to die.

I was telling dad about the dichotomy that exists in my mind when I hear these stories. On one hand, the little girl in me wants to save everyone--on the other, I have paid thousands and thousands of dollars for the right and ability to save people, and in uninsured cases like this, the rest of the hundreds of thousands of dollars it takes to do so are also coming out of my pocket. That's not right, any way you look at it.

And then there are patients like the one upstairs, who has been here for almost a week for "chest pain," weakness, more chest pain, back pain, neck pain, nut pain, paralysis, brain pain, trouble breathing--you name it, he has it. Oh, and he's "allergic" to Tylenol and Motrin--only Dilaudid and morphine will work, Doc, I'm in so much pain, can we increase my dose? I just wanna feel better, Doc, I'll stay here as long as it takes. I'll do whatever it takes. Including eating on the days we schedule his testing, twice, so that we have to reschedule them for the next day. We all know he's full of crap; of course he wants to stay here. Here is where the medicines are, here is where the nurses are at his beck and call--here is a several-thousand-dollars-a-night hotel is his for the asking. So every day he comes up with new excuses, and threatens to sue us if we send him home with all the "symptoms" he's having--and policy being what it is, we're not allowed to tell him how easy it is to test if people are faking, and that he's failing miserably. If I had my choice, I'd've kick him out on his butt yesterday, with pleasure.

If money is just lying around to be wasted on lardy, unhealthy, duplicitous people like this man--and it's not, but for the sake of argument, let's assume--then I'd much rather spend it on the man who is going to die alone in his village while the man upstairs eats himself to death.