epiphany in the Big House

I’ve now logged 4 weeks as a full-time doc to convicts in prison. It’s been quite interesting, and actually rather pleasant. Our nurses are quite dedicated to delivering competent health care to the underserved, and in this last month, I’ve treated more AIDS, Hepatitis C, and active tuberculosis than I did in the previous 5 years of practice in the “real world”. And I’m treating twice as many diabetics than before too. And I was treating a hell of a lot of diabetics before.

And I’ve also come to employ another persona here. And I love it! It began when a patient came in complaining of a problem, and I took a history, examined him, then started to tell him what I thought should be done for his non-trivial but non-life or health-threatening concern. He kept interrupting me, complaining about his mistreatment by society, how his PO (parole officer) had it in for him, and how I should call his mother to find out just how badly he’d been treated. Oh, and he had lawsuits pending.

Now this is a guy in for his 6th DUI, so he’s a slow learner. After 5 minutes of gently trying to redirect him, I am suddenly inspired to cut to the chase.

Dr. Q: Be quiet and listen to me! If you want me to help you, you will stop talking and pay attention!

Offender: But doc, you…

Dr. Q: I said, be quiet! This is what I think is wrong with you, this is what I will do about it, this is what you need to do about it. Do you have any questions?

Offender: I want you to call my lawyer and tell…

Dr. Q: What we have here is a failure to communicate. It’s time for you to go away. Now.

It felt wonderful! I finally don’t have to think “the patient is also a customer whom I want to come back to see me again”!

Don’t get me wrong, I will continue to do my best to take care of their legitimate medical concerns, but I will NOT get involved in the games! And my god, they do play them! Games to get narcotics, lower bunks, special mattresses, to avoid work detail, etc. etc. etc.

I find I must start every patient visit with a healthy degree of skepticism. Not cynicism, mind you, but skepticism. Looking at every statement and thinking “is that true? How can I confirm it?” It’s good training for dealing with my own 13 year old.

Further bulletins as events warrent.

Gee, I’d *** JUST LOVE*** to be your kid…

(pls don’t treat your kid like a convict :slight_smile: )

thank you

Good for you, Q.

While not equating prisoners with children I find that, like children, I relate to ALL people better if I set strick limits on their behavior. It takes me out of their social context and keeps things businesslike.

Well, my young teen’s relationship with the truth has been more like that of a nodding acquaintance or waving at it from across the road, rather than fast friendship. As such, I feel skepticism is the wisest parental outlook, until evidence to the contrary is consistently presented. As Arthur Miller wrote in Death of a Salesman, “attention must be paid!”

Hey Quag,

Any experience with mental patients? Before I dropped out of a nursing school program I did a rotation at a mental hospital. Just curious if you have had the experience and/or insights. I imagine it’s not too dissimilar to prison work.

Chrome

hi Chrome.

Seems at least half the patients coming into the prison have a history of mental illness. Maybe more. They get to see a psychiatrist, and get medication if needed, but it’s still suboptimal as far as a therapeutic environment goes.

**
Did you actually say this? :cool:

Qadgop
I’ve been checking for an update on your life behind bars for weeks! Please keep 'em coming. Give us details! Drama! Humour! Pathos! Though it is going to be hard to top your penis post story.

Interesting patient encounter: New patient comes in for his admission physical. I see he was in prison just 4 months ago. I ask him how he ended up back inside. “I went in a bar”. Huh? “My parole officer (PO) caught me in a bar. Part of my parole agreement was that I wouldn’t drink. He caught me drinking. I told him that if I couldn’t drink, I’d rather be back in prison. So here I am”.

Talk about your reality disconnect.

Qadgop, you continue to be the health-care provider I’d want to be if given the choice to be one.

You rock!

This is hilarious. Please post more good stories.

I asked one patient what he did for a living before prison. His response? “Street pharmacist”.

Did you ever take your son to the prison so he could see what kind of work you do?

Wow, it’s sort of like how kids run to the school nurse to get out of P.E. or class. Except with felons.

Do you ever get scared?

I hereby designate Qadgop the Mercotan as my Primary Care Physician[sup]TM[/sup].:slight_smile:

His health plan is pretty easy to enroll in, but they make it real difficult to get out of the plan

Abe Babe, you make it sound like Qadgop’s with the mob.

Robb, you did read the part about how he works in a prison, right?

Yes, I did. I was trying to be funny. I thought it was hard to get out of the mob. This could be why I haven’t quit my day job. :wink:

But… um… it’s it’s hard to get out of prison, too. If the thing is funny because of prison, it’s kind of a non sequitur to try to make a mob joke…

::wanders away, confused::

Hey, I wanna get narcotics, a lower bunk, a special mattress, and avoid work detail, too! What games should I be playing?