As many of you may recall, I am a maximum security prison physician. It’s a job I find quite rewarding, and I find that quite often, I am able to make a difference for inmates, at least as far as their health goes.
But I do get my share of interesting patients. What follows is a case in point. The event is heavily anonymized, but the facts are essentially as presented.
Inmate #666666 (#6 hereafter) was displeased with living in a maximum security institution. So much that he concocted an escape plan. He went so far as to co-opt his cellmate (hereafter referred to as “cellie”) in his plan. Or at least he told his cellie about the plan. Cellie’s actual participation may have been limited to listening to #6’s ramblings about it.
'Ol #6 knew that our institution was difficult to escape from. In fact, it’s been years since anyone managed it directly. But he felt he stood a chance if he were taken to the local ER. Therefore he decided to pretend he was sick, in order to get taken out to a place where he hoped security would be more lax.
(This hope may have been a bit naive, given the fact he’d be wearing handcuffs, legirons, and a bright orange suit during the entire trip.)
#6 further decided that it would not be sufficient to actually feign illness, as our nurses have a reputation for keen clinical acumen. He decided he would actually need to make himself sick, in order to better increase his chances of getting taken out. To this end, he procures his cellie’s albuterol inhaler.
Now, #6 has never used albuterol; he’s never needed it. But he’s seen his cellie use it for asthma attacks, so he’s got the basic idea down. He’s also seen his cellie say, after 2 or 3 puffs of albuterol; “gosh, I must have taken a bit too much. My heart’s really pounding now!” So #6 decides that albuterol should work perfectly. And with good inmate thinking (or perhaps just american thinking) he concludes “if some is good, more is better!” So he takes somewhere in excess of 2 dozen inhalations, nearly the entire albuterol inhaler’s contents.
Quickly his pulse picks up. His heart leaps into his throat; he’s feeling dizzy, with chest pains, nausea, and terrible tremulousness. He can’t sit still. It’s also late at night, during a change of shift, and the guards don’t immediately show up when he starts voicing his distress!
He tries to enlist his cellie to summon help. But cellie is now rather cheesed off at #6. Cellie’s albuterol is gone! Cellie might need that later! Cellie never really liked #6 at all anyway (he farts too much for one thing, a critical failing in a cellmate), and never paid much attention to his escape plan babble. So cellie tells him to shut up and lay down, and where the hell is the rest of my albuterol, anyway?
Eventually an officer is summoned, to find #6 twitching, hopping up and down, and complaining of chest pain. #6 also states he must go to the hospital. Cellie now chimes in, saying “he took all my albuterol!” #6 is frogmarched down to the Segregation Unit, twitching and vibrating, and our trusty PM nurse is summoned to see him there. Meanwhile, cellie is interviewed further, and the escape plan is uncovered. On cell search, a note with #6’s to-do list is found: 1) Use albuterol. 2) Go to hospital. 3) Escape from hospital.
Our knowlegeable PM nurse finds that while the patient’s eyeballs are spinning in their sockets, and his tongue is actually vibrating while his heart beats at a rate of 150 a minute, there’s really nothing critically wrong with him. She confers with the on-call physician who agrees #6 doesn’t really need a trip to the ER for this particular overdose. Time will suffice. Orders to have our nurse check on the patient and his vital signs every 2 hours are given. PM nurse complies, and every two hours, checks the patient. This gives her an opportunity to share with #6 her opinion of his physical status, intellect, character defects, and moral standing in both the world at large and in the prison’s hierarchy. #6 declares his urgent need for medicine to help him sleep and relieve his headache. He gets tylenol. He also gets information from the RN on the moral virtues of suffering one’s own consequences.
Hours pass. I arrive in the early AM. I am apprised of the situation, and of the need for me to squeeze #6 into my already crowded schedule. Since he’s down on the segregation unit I must see him there, rather than in the clinic. PITA.
Eventually I see him in the company of two guards. They are not unkind, but they are quite amused by the entire turn of events. “Good morning, Mr. #6”, I say jovially. “How are you?” His head hurts. He hasn’t slept and he feels icky. No more chest pain. “And how many puffs of albuterol did you take?” He’s not sure, but at least a dozen. “Had you ever taken it before?” He avers that he had not. “And you did this why?” He eventually offers words to the effect that it had seemed like a good idea at the time.
Exam reveals everything is slowly settling down. His eyes and tongue no longer vibrate, his heart beats normally. I educate him on the perils of experimentation with medication, and tell the officers to take him back to his cell.
“But wait a minute, Doc!” #6 shouts. “Aren’t you going to give me something to make me feel better?” To which I reply (really and truly I did 
) “No. With this sort of overdose, there’s nothing to do but give it time. And you’re in the right place to do the time!”
I’d print this out and mail it to my brother but the guards who filter the mail might think I was trying to give him ideas!