The John Galt Memorial Freestanding Emergency Center

Coming soon, to a neighborhood near you.

Looters and moochers not welcome.

On Vacation

Aloha.

Misunderstanding

A nurse walks into the room and greets her patient, who is busy typing on his laptop in no apparent distress. He looks up at her briefly but says nothing and continues his work.

"So tell me what brings you in to see us," says the nurse, a bit perturbed by his rudeness. He completely ignores her and continues to type without saying a word.

She leaves the room in a huff and tells her colleagues about the jerk in room 2, only to learn that he is a deaf-mute patient who communicates by typing. When she returned, she found he had finished typing his chief complaint and a brief history.

Self-censoring the Medical Record

A patient presented to the ER with a benign complaint at 3 am. She was incidentally noted to have moderately elevated blood pressure, and she appeared much more awake and talkative than the usual 3 am patient. She admitted to recent cocaine use but requested that I not mention that fact in the medical record for fear of possible repercussions. She was a HENRY with good insurance and didn't want to jeopardize those things if her secret were somehow discovered.

Since the blood pressure wasn't dangerously high and the drug use was not even tangentially related to her initial presenting complaint, I complied with her request, documenting only that we discussed lifestyle modifications and secondary causes of hypertension, etc.

When electronic medical records become more common and more widely (if not universally) accessible, I suspect there are going to be an increasing number of patients who will be hesitant to tell us embarrassing and potentially career-threatening information about themselves. Perhaps big brother shouldn't have any more information about us than necessary.

With the possibility of a nationalized healthcare system and the subsequent rationing of care and passive culling of the herd that looms on the horizon, even a one-time chart notation of serious drug use might make receiving certain services more difficult when viewed through the eyes of a cold-blooded single-payer bureaucrat charged with distributing scarce resources. If one happens to need a kidney transplant in a decade or so, it might be better to have a clean record.

But when patients don't give us the whole story, it can make our job very difficult.

Night Nurse

Tell her try your best just to make it quick
Whom attend to the sick
'Cause there must be something she can do
This heart is broken in two
Tell her it's a case of emergency
There's a patient by the name of Gregory

Night nurse
Only you alone can quench this Jah thirst
My night nurse, oh gosh
Oh the pain it's getting worse
I don't wanna see no doc
I need attendance from my nurse around the clock

'Cause there's no prescription for me
She's the one, the only remedy