One of my patients is dying from a brain tumor. He has severe pain from a number of related and unrelated issues, and since I'm the doctor he sees the most I've ended up prescribing his narcotics.
Recently, though, his pain has been worsening, and nothing I've given him is touching it. I've tried increasing pill strength and changing narcotics, to no avail.
Because of his severe pain, I finally admitted him directly to the hospital, to try and get things under control with injectable narcs while I decided on the next step. As always, I told his wife to bring in his pill bottles for me to review.
Sitting in the room with them yesterday, I began making my usual notes on what pills, how many were left in each bottle, etc., to make sure he was taking them correctly. As I opened one narcotic bottle after another I found that, in spite of different labels, they all contained the same white tablets with the same number stamped on them.
So I took out my phone to look up the number.
All the bottles were full of generic Tylenol. No wonder nothing touched his pain.
Further investigation revealed his daughter, who was the one picking them up, was selling the pills and replacing them with Tylenol before taking them to her elderly parents.
I hope you rot in hell.
She will rot it jail, though, right Doc?
ReplyDeleteWhat a nasty puke of a daughter, i hope they turn her in and charge her with a crime, I really hope she suffers severe consequences for this and gets it sooner rather than later. My heart hurts for the father that has suffered so much pain, physical and now emotional. I lost my beloved father in 2001, I can't even remotely imagine doing such a heinous thing to my dad, what a puke.
ReplyDeleteOoouch . Hope he pulls through and some time in the future she needs pain relief .
ReplyDeleteThat is so sick. Unbelievable. Could you report her to the police, at least?
ReplyDeleteI have no words...
ReplyDeleteLove is like oxy, indeed.
ReplyDeleteI wish we could make narcs OTC and just quit fighting with the scammers, the addicts, and the chronic pain patients. I don't know a provider who writes for narcs in any context who is not being aged and embittered by this endless losing battle against dysfunction.
What a horrible person. I hope you reported her theft to the police. That poor, poor man and his wife, having a selfish child like that.
ReplyDeleteHope you can report her to police...and not let the parents know it, as would break their hearts. Hard call, Doc. But thank goodness you caught this, so that poor man can now get some relief.
ReplyDeleteI thought nothing could shock me any more, but this...wow. Cold.
ReplyDeleteThere she is: my daily bread.
ReplyDeleteThis post hit me like a truck. That's awful.
ReplyDeleteI hope your patient is finally more comfortable now...and that you know what he's been up against in addition to the tumor.
ReplyDeleteI hope, fervently, that some day bitch needs narcs for intractable pain...and she can't get them.
ReplyDeleteIf there is a hell, I hope there is a special place for her.
ReplyDeleteGeeze...I hope she gets the book thrown at her for elder abuse, theft of narcotics, possession, probably possession with intent to sell.
ReplyDeleteIt makes you want to weep. It makes you weep. --Queen Anne's Lace
ReplyDeleteThat is so terrible! It's hard to comprehend. What an evil person.
ReplyDeletethat is horrible and heartbreaking. I agree, I hope she rots in hell in misery and pain. Might throw her a tylenol every few days.
ReplyDeleteThat is an amazing catch in your part. I don't know many people that would go the extra effort to actually opening the pill boxes and try to calculate how many are left. I guess when you admit your personal patients, you may be more likely to - but fantastic work nonetheless.
ReplyDeleteFirst, I pray the pt is getting relief now. Second, I am not sure of the ethics/rightness/etc. of calling the cops, but I HOPE you can.
ReplyDeleteThis is a tough call. Your pt and his wife will be devastated if she gets hauled off. How awful (small word that does not cover how bleak and soul-sucking her arrest will be) for him and his wife.
BUT I hope this daughter faces some retribution. Maybe cold turkey w/o any sort of help?
Aw, [bad words], I just remembered something.
ReplyDeleteDoc G, was it hard (red tape wise) to do whatever referral you do to get the old gentleman a liver check? Tylenol is terribly hard on the liver when you know you're taking it and in what amounts. :(
The poor old couple.
This is so sad on so many levels. The mind boggles that this poor mans daughter knows he is dying and in excruciating pain, and yet she steals the very thing from him that could help comfort him.
ReplyDeleteThrowing her in jail while he is still alive will only add to his stress and misery; and yet that is exactly what she deserves. I hope Karma gives her a swift and mighty kick in the ass as soon as her father is finally at rest.
Finally, I think we all need to say a prayer for the wife who will have to deal with the fall out from all this, even after her husband passes.
Too bad a little bit of your patients brain tumour couldn't be transplanted to the daughter to take root.
Far more common than anyone would ever suspect. I had a client who hired a junkie to install air conditioner systems, guy would filch pain pills everywhere he went. My client wanted to know what to do with the guy... simple tip the local gendarme for a traffic stop and search attendant. Worked like a charm, no one is the wiser.
ReplyDeleteWithout Dr. Grumpy's diligence, this thieving would have continued until the patient's death and beyond, if the thief could manage it. Dr. Grumpy investigated, figured out the problem, and helped his patient. 3 cheers for the Doc!
ReplyDeleteThat's just completely disgusting! I know it's difficult to put your own child in jail, but she needs to know she's caught. The patient needs to find a delivery pharmacy or a trusted friend in the future. I'm very saddened by this story.
ReplyDeleteI've seen how badly uncontrollable pain effects people.
ReplyDeleteTo purposefully leave a stranger in severe pain would be mind boggling to me. Your own family? No conscience.
He has to be feeling so much better from a physical stand point after getting a few doses of the real stuff?
ReplyDeleteHe's so lucky you took the time to sit down & figure this all out!
As a mandated reporter is this something you're required to report to the authorities?
What a fucking bitch. I swear to God, this makes me so mad--when my dad was dying I had to fight tooth and nail to get his comfort prioritized (my mom was in denial and palliative care was "giving up" to her). I was so incredibly upset by the idea of him spending however long they could manage to keep him alive with machines in pain and discomfort--it seemed like the most horrible form of torture. And this lady just does it to her dad. For money. Unbelievable.
ReplyDeleteAs a pharmacist, I am not as shocked as some - I have seen it more than once and the pharmacy been accused of switching the morphine out for a brand of apap only sold at WalMart - Sadly, I am just puzzled that the patient and his caregiver/wife did not notice that all the pills looked the same.
ReplyDeleteOfficer Cynical--PLEASE PLEASE PLEASE go after her!
ReplyDeleteDr. Grumpy, I'm sure it's awfully hard on you, but I'm glad you caught the problem.
Hmm -- hopefully your admission orders for pain control got quickly adjusted to take into account his actual opiate naivete? I cannot come up with a suitably gruesome punishment for that abortus of a daughter. *sigh*
ReplyDeleteI can't think of anything to say that isn't ridden with expletives. I seriously can't.
ReplyDeleteMy thoughts exactly, Anonymous @ 12:23.
ReplyDeleteGood on you, G.
It's bad enough when they steal them for their addiction but to steal them simply for money is even worse.
ReplyDeleteI disagree with TheTracker--I don't think society would best be served by making the heavy pain drugs OTC. That would lead to too many people being hooked by accident. Rather, what I would like to see is that addiction is an appropriate reason to prescribe them--including the current C1s. Remove all the special restrictions that go along with those categories because there would be no reason for gaming the system anymore. (I would retain the categories themselves as an indication of the addiction risk of the drugs, though.)
As for this vile daughter, any chance of an attempted murder rap due to the acetaminophen dose involved? And she's lucky her father didn't die of an overdose in the hospital.
You know you can have her arrested, right?
ReplyDeleteAs Kristin said, "There are no words."
ReplyDeleteIf I knew that man, my heart would ache for his dilemma, but I am thankful that you took time to show you cared. I wish we all could give him a hug, (and you, too).
The addicted mind is an unwell, sick mind. It will do whatever it has to do to secure opiate-receptor activation. And, yet, choosing to seek treatment for the addiction is ethically a matter of the person so addicted's choice.
I was raised with no religion - never felt the need for an afterlife. I am a pacifist. I don't believe in capitol punishment. I never slapped my children. This is one of the few times I have questioned any of these beliefs. This makes it easy to see how a society formed around vengeance and retribution can look pretty reasonable.
ReplyDeletePlease tell us you reported her ~ to the police, or APS or someone!!!
ReplyDeleteThank the universe you looked at the meds ~
She deserves to rot in whatever her version of hell is...
This is what jails are for.
ReplyDeleteThis is much worse than stealing money or cars.
Worse than the usual pill theft, because the patient could not have achieved anything by locking the pills up -- they were stolen before he got them.
Speechless.
ReplyDeleteMay G-d grant her justice.
ReplyDeleteHopalong Ginsberg
As bad as the pain itself was, the pain of learning what your own daughter could do to you was, I'm sure, even worse.
ReplyDeletewe see this same sad situation far too often in hospice...
ReplyDeleteThis is more common than you think. Walmart tylenol seems to be the switch out drug of choice. First reaction of the patient and family - blame the pharmacist.
ReplyDeleteAm I the only person on the planet who never blames the pharmacist? The one time my favorite pharmacy gave me the wrong thing -I- apologized to -them- for not checking the bag before leaving the store, and not recognizing that I should have seen a box, not a bottle. Pharmacists make mistakes, just like everyone else, so you need to pay attention, too, and not blindly assume.
ReplyDeleteAlso, I'm with everyone else. I hope you reported her and had her ass arrested.
I hope you reported her! No conscience!
ReplyDeleteRead my blog Here!
Moose, I don't blame the pharmacist either. I also use a local independent pharmacy so the one time that they did fill a prescription short, I went in and said that it could have been my fault, and they gave me enough to get to my next refill. They know me, they know what I take and why, and this wasn't a controlled substance.
ReplyDeleteA pharmacist would be obligated to report the known theft. I should hope Dr's are held to the same standard. Poor guy..
ReplyDeleteYou are correct Dr.G SCUM is mild compared to my mind. Karma will come back to haunt her...
ReplyDeleteThat's the same punch in the gut I got when I learned that a pharmacist was replacing chemo in bags with quarter or half strength chemo. There is surely a special place in hell for them. But to do it to your own father? That takes a special someone.
ReplyDeleteI'm at a loss for words. If he still was able to notice, this must have been the most disappointing thing ever. To be dying in pain, literally, because your child is selling your narcotics. How incredibly sad and aggravating.
ReplyDeleteNo Moose & tbd88, you two are not the only ones who don't blame the RPH. They still, after @ least 6 years, are always incredibly surprised when I insist on dealing w/ "rejected scripts (PA, QL, etc.)" instead of expecting them to to deal w/ it (among many other things that don't need mentioning). If more patients would take responsibility for their RX needs than maybe RPH's wouldn't need to quote extra long wait times or develop ulcers for being spread too thin.
ReplyDeleteI hope your patient's pain is better controlled, Doc!
What a sad, sad story. I ache for your patient's physical and emotional pain. Glad you figured it out before he was put on a high opioid dose as an inpatient, where they may have made the assumption that he was tolerant to the outpatient meds that "weren't helping", and could very well have accidentally killed him. I hope he is in a lot less pain now and can continue receiving care in his home.
ReplyDeleteI must say I am stunned and dishearted at the many callous remarks here. Clearly those of you calling for the daughter to rot, etc. have absolutely no experience, understanding, or compassion for people who are addicted to heroin, morphine, etc./related drugs. These are crippling and overpowering urges that yes, do cause the addicted person to make horrible choices that often hurt the people they love the most. This example shows just how tightly drugs can grip people, that they will do something so cruel to someone they care about.
Anger and shock are normal responses to this story, but imprisonment won't make anything better for her father. She is already living in a hell of her own creation - in the throes of addiction and with the knowledge that she stole her pain-riddled, dying father's drugs for her own use/benefit.
This hits close to home, and it makes me so sad. My 65 year-old mother is dying from cancer and has had extreme pain the whole time. She's on a lot of different highly potent narcotics (including ketamine, methadone, hydromorphone). I often pick up her meds, and I would never DREAM of changing out her meds for personal profit. We recently returned a bag full of Ketamine to the pharmacy when her dosage changed, and I couldn't wait to get it out of my car. This person belongs in jail. For serious.
ReplyDeleteugh, that's so terrible. I hope the daughter was arrested and charged, and that she has a long prison sentence to reconsider the direction her life has taken.
ReplyDeleteObviously the daughter had zero love for her parents.
ReplyDeletePlease tell me she's in jail.
And people are surprised at the level of burnout in American physicians. Having to be constantly vigilant for this sort of thing does not help one's ability to be present for one's patients.
ReplyDeleteEveryone asks about the daughter, but I am curious about the father. Now that the problem with the medications has been resolved is he responding well to the pain medication? Is he at least comfortable? Perhaps a narcotic patch would be easier than pills for application and management. It's a terrible position to be in, incurable disease, incessant pain, and then betrayal from someone so close. The wife/caregiver could probably use some help and counseling as well.
ReplyDeleteThat's just awful. Period.
ReplyDeleteAs an ER nurse I've been exposed to just about everything...
... but that tale cuts the rest.
Just when you think you've seen and heard it all...
My heart breaks for that poor man and his family.
His own daughter.... I have not the words and I'm not even a parent!
Kudos for going the extra mile Ibee Grumpy! Your dedication to your patient will not be missed!