Watching him navigate his way back to the stretcher brought to mind images of a sailor trying to walk across a ship’s deck in the middle of a typhoon. He plopped back down on the gurney and promptly fell asleep. It wasn’t long before he was snoring like a hippo.
I quickly sewed him up (no need for local anaesthetic this time, folks), peeled off my gloves and got up to make arrangements for him to be observed in the department for a few hours.
I was halfway out the door when I heard a slurry, nearly unintelligible, “Heyyy doc, hang on a shehcond…come ovah here… .”
I turned back, intrigued. Was this guy actually going to thank me? That’s a rarity at 3:00 a.m. Most times I consider myself lucky if I don’t get barfed on.
“Heyyy doc… .”
“Yes?”
“Can you lend me 20 bucks?”
Drug Charades!
Anyone who’s worked in an ER knows about drug seekers. They’re those incredibly annoying chuckleheads who are forever trying to con us into giving them prescriptions for certain drugs. OxyContin is their Holy Grail, but Percocet, Dilaudid, fentanyl patches, or just about any narcotic will do. Sedatives and stimulants are also welcomed with open arms.
Drug seekers all seem to have cribbed notes from the same manual. They come to the ER after regular clinic hours because they know it’s harder for us to crosscheck their hinky stories when other doctors can’t be reached. It’s not uncommon to hear tales of woe involving pills that have been misplaced, stolen or eaten by the family pet. To improve their odds of getting something high on their wish list they usually claim to be either allergic or immune to all non-narcotic analgesics.
Most of these characters hobble to their allotted cubicle so melodramatically, you’d think they were on the brink of death. They’re quick to display any old wounds or surgical scars they might have. Those with no physical evidence of disease to bolster their credibility usually complain of disorders that are difficult to quantify objectively such as headache or back pain. Most seasoned ER docs come to automatically suspect malingering whenever unknown patients present with symptoms of this ilk. This attitude is unfortunate, because it undoubtedly causes us to treat some bona fide sufferers with less compassion than they deserve.
Some of the more inventive drug seekers can really put on a good show. A few years ago one fellow suckered me into giving him intravenous morphine for presumed kidney stones several times until I clued in to the fact that he only writhed about in agony when he had an audience. When I tiptoed back to his room and observed him surreptitiously he was humming a Def Leppard tune while leafing through an old People magazine. As it turned out, he had been covertly adding blood to his urine samples to trick me into thinking he had hematuria. Why on earth would someone with that much drive and creativity waste his time slumming in my ER? He should be down in Hollywood making millions alongside DiCaprio and Depp.
The list of popular swindles and scams is as long as your arm, but an exhaustive review of them all is not what I had in mind for today. No, today I just want to talk about a small subgroup of highly entertaining drug seekers: the Charaders.
In regular charades one player pantomimes a role or phrase while the others try to guess what it is. A correct guess results in jubilation and a strong feeling of camaraderie. In Drug Charades, the patient ropes the unwitting doctor into a game of trying to guess the name of the medication they’re after. Although they don’t mind dropping Godzilla-sized clues to facilitate the process, they usually try not to say the actual name of the drug themselves. Why? They’re hoping the fleeting euphoria the physician experiences when he or she finally guesses correctly will help generate a big, fat prescription.
A game of Drug Charades involving a novice physician and a veteran drug seeker might go something like this:
“Good evening, sir! I’m Floogie Howser, Doogie’s younger brother. How can I help you?”
“Well, this morning I accidentally dropped my pills into my neighbour’s aquarium and his guppies ate them all.”
“My goodness! Are they okay?”
“What?”
“The fish! Are they okay?”
“Oh, yeah, they’re fine; just a little sleepy. Listen, is there any way you could refill the prescription for me? I’m not supposed to go without my pills, and my regular doc’s on vacation in Antarctica.”
“No problem, sir! What kind of pills were they?”
“Painkillers.”
“Do you remember the name?”
“Not really, doc – I don’t pay much attention to that sort of thing. I think it started with a P, if that’s any help.”
“P?”
“Yes.”
“Gee, I can’t recall the names of any painkillers that start with the letter P.”
“P-e-r, I think it was.”
“P-e-r?”
“Yes.”
“Per, per… I’m awfully sorry, but I’m drawing a complete blank.”
“Per-co-something. They were round and white.”
“Per-co, round and white, Per-co… Hey! Could it have been Percocet?”
“That’s it! Wow, doc, you’re incredible!”
“Thanks!”
“So… can I get some?”
“Certainly! Will 200 be enough?”
Once in a while I like to have a little fun with Charaders:
“Hi Mr. Pinkman, my name is Dr. Gray. How can I help you today?”
“Well, doc, last night someone broke into my lab, ah, I mean apartment, and stole all my pills. Do you think I could get a prescription for some more?”
“Well… .”
“Just enough to tide me over until my regular doc gets back.”
“What type of pills were they?”
“Painkillers.”
“Hmm. Do you remember the name of the medication?”
“I’m not sure, but they were round and white.”
“Aspirin?”
“I think the name started with an O.”
“O?”
“Yes.”
“Orudis?”
“No, that’s not it.”
“Hmm… .”
“It might have been Oxy-Something.”
“Oxygen?”
“No.”
“Oxymoron?”
“No! Come to think of it, the last three letters were t-i-n.”
“Oxytin?”
“Nine letters… .”
“OxyBontin?”
“There’s a C in it… .”
“OxyContin?”
“Yes!”
“Never heard of it.”
Haute Cuisine
A few weekends ago Jan and I were scheduled to return to Hogtown to try our luck at another show and fancy restaurant, but our flight got snowed out. Undaunted, we decided to give one of our little town’s newer eateries a try. After securing a babysitter we donned our finest and headed out.
The moment we entered we knew it wasn’t going to be a five-star culinary experience. For starters, the oversized television set above the bar was broadcasting a WWF wrestling match at teeth-rattling volume. Some steroidal goon in a lucha libre mask and a velvet cape was whacking a similarly attired Cro-Mag over the head with a metal folding chair. The other immediately obvious problem was that there were only five people in the entire restaurant – a group of four chatty snowmobilers plus a waitress who didn’t look much older than the babysitter we had just left behind at our house. So much for ambiance.
Our waitress led us past dozens of empty tables only to stop at one right beside the garrulous quartet. The stench of gasoline was overpowering.
“Is this table okay?” she asked.
“How about somewhere a little more, uh, private?” I replied, sotto voce.
She moved us to a more suitable spot, gave us our menus and departed.
Five minutes later she returned to take our drink orders. Jan requested something a friend had told her the restaurant stocked – Heisenberg on tap. The waitress apologetically informed her that it was no longer available because the owner had moved the draft tank to his other restaurant. Shucks. Jan settled for a Blue Light. I ordered a Sling. Yes, you read that right – a Sling. I love girly drinks, especially the ones with those colourful little umbrellas in them. What can I say?