A murderer asks me for a consideration

Miscellaneous and Personal Stuff I Must Share
1

My patient is 87 years old and a survivor of lung cancer. He’s still healthy enough to live on the general unit of the prison, rather than the infirmiry. His eyesight is deteriorating because of cataracts, and he is scheduled for evaluation for cataract surgery, courtesy of the state taxpayers, so he’ll improve his vision.

The man is in prison for murder. At the age of 85, he murdered his wife in a fit of jealous rage, believing that she was being overly attentive to other men. I don’t believe there was evidence presented that she was fooling around, only that she would talk to other people against hubby’s wishes. The man is not senile, nor does he fit the criteria for medical insanity, much less legal insanity.

Had the man pleaded for compassion based on his illness, his age, and diminished capacity, along with remorse, he probably would have avoided prison altogether. But since he stood before the judge and declared he was without regret for his actions; indeed he would do it the same way over again, except for the getting caught part, the judge sentenced him to 20 years.

Now he complains to me that when he goes for his appointment to see the eye specialist, he must wear wrist manacles and leg irons. They are uncomfortable, and do slow him down, but I’ve found they are not a true hindrance, nor are they actually contra-indicated medically. But he feels they are undignified, and unjustified, given his age, infirmity, and lack of ability (as he perceives it) to overpower a guard and flee. He asks me to support him in his request to have reduced security. Indeed, he asks that I order reduced measures for him. Otherwise, he will refuse to go to have his eyes checked.

I tell him no. Actions have consequences, this is a consequence. He still has choices, and he can choose to see the eye doctor, or choose not to. He bears the responsibility.

He is not happy with that. He wants to argue.

I use two words I have found useful in this job.

“No. Go.”

He leaves my office. I don’t know what he will choose to do. I hope he will choose to take proper care of himself, but if he does not, it won’t bother me.

2

Your place of business will likely produce more interesting stories and experiences than probably any other place I can imagine.

What a strange guy. I’d hate for a murderer to be threatened with losing his dignity.

3

I think you did right Qadgop. If the wrist manacles and leg irons aren’t a medical problem why would you request they be removed? It isn’t your job to make him take care of himself, just provide him with the means to do so.

From this, and prior posts about your job you seem like a good doctor and a good man. Don’t let him make you second guess yourself.

4

Ah, the power of not having to please your customers. You handled it well.

5

Yep, remember this aint retail.

You did the right thing Qadgop.

6

Man. Do you ever get to deal with patients who aren’t manipulative, psychopathic, violent or just plain jerks?

7

It’s a fine line (I found) . I think you evaluated the situation fairly, and came to your decision in the same manner (ie, the facts were that his infirmities did not require the lessening of restraints, his conviction required them, therefore and ergo, restraints stay), vs. falling into either trap available (a. aww, he’s old and frail and so on or b. he’s a murderer, so F*** him and what he wants)>

8

I don’t think so, pravnik. Even in today’s society, where the attitude is “lock em up and throw away the key”, you still have to act pretty badly to get sentenced to a state correctional institution, rather than probation, home monitoring, or a county jail. These guys don’t even tell me that they’re innocent!

Actually most of my encounters with patients aren’t like the ones I write about here; most aren’t much different than those I had out “on the street”. But the ones that are different tend to be really, really different.

9

Qadgop - I admire your professionalism. I’m very afraid of doctors, but reading your posts makes me slightly less so. I have good health insurance, but went over 25 years without going to the doctor. I did finally go (to have my hearing checked) and the doc found a goiter and a thyroid problem. Now I’m on thyroid meds. But I’d still rather be sick than go to the doctor. But I read your posts and realize that you do care. I can only hope my doctor is as good.

StG

10

You know, hon, sometimes when I read your posts about treating people in prison, I think that you should be proposed for sainthood. I know that is going to make you feel like you need to upchuck, but there it is…that is the way I feel.

You are a very loving and compassionate man.

As far as this current patient is concerned, you did the right thing. (As always, as near as I can tell.) He did the deed, he feels no remorse…I don’t care if you are 8 or 80…if you understand right from wrong and you choose wrong…you need to pay the consequences for your actions. And wearing manacles to get your cataracts dealt with seems to me to be a fairly light consequence of his actions.

He gave up the right to dignity when he killed another human being. He gave up his right to comfort when he killed someone who (presumably) loved and trusted him.

You might ask him, should he ask again…“Would your wife feel that wearing shackles to a Doc appointment was too severe a punishment?”

I think not.

11

Scotticher, I doubt that would affect the man. Remember that he knows he did right to kill her, so throwing that in his face won’t make any difference to him. Why, he might even resent the implication.

I’d say the guy sounds like a loon, except that telling the judge he’d do it again only bumps him down to blithering idiot (which is an insult to b.i.’'s everywhere).

It’s not Qadgop’s job to judge his patients, only treat them, so he answered right according to what he thinks is best, as if he needs validation from a total stranger.

12

I am not sure that I read this right, but if you think I DISAGREE

13

I am not sure that I read this right, but DIDN’T we just agree here? If I did not make myself clear…I agree with you.

And oops…I have NO idea how that happened. The board is acting wonky for me this evening.

14

Thanks for the proposed sainthood, scotticher, but I’ll pass on it. Keep in mind I generally only post the stuff that makes me look good. I generally leave out the incidents where I’m a self-absorbed narcissistic slacker. The board doesn’t have enough bandwidth for me to post all those!

The whole incident came down to “is there a medical indication to change his security measures? No. So we won’t change them.”

15

How do you think they got there? :eek:

16

Qadgop, this is the second time I have read one of your threads and been completely amazed at the stuff you have to deal with in your day-to-day job. I’m a third-year medical student, and these are the kinds of questions they set for our ethics debates. I doubt that I could ever do your job and stay sane, and I’m full of admiration.

tritone

17

Yeah, I know they’re felons and all, but I was wondering if any of them are actually, I dunno, honest about it. Maybe I watch too many movies :wink: