Dr. Grumpy is always looking for junkies. I try not to deny pain meds to those who need them, but at the same time I hate people who abuse them. They make it harder for those who need them to get them.
Every doctor has been taken by a junkie at some point.
A few years ago one of the ER docs called me. He had an old lady at the hospital, who was visiting from out of town, and had a flare-up of her Trigeminal Neuralgia (a condition with awful facial pain). He asked if I could work her in that day, so I told Mary to put her on the schedule.
She came over from ER. She was very sweet, in her mid-late 70's. Fully dressed in a Salvation Army uniform (even with a little hat with the red badge). She had a long history of Trigeminal Neuralgia, which hadn't bothered her in several months. It was late November, and she was a ranking member of the Salvation Army who'd come to town to help organize the annual holiday bell-ringing campaign.
She gave a good history for Trigeminal Neuralgia. I put in a call to her regular neurologist, but the office was closed for lunch. She'd left her Neurontin and Percocet back home, and needed refills, so I wrote her for some and sent her on her way.
I went on with my afternoon. After about an hour Mary nabbed me between patients. While straightening up the lobby she'd noticed sweet old lady had left the Neurontin script sitting on top of the water cooler. I figured it was an accident, and she'd call looking for it.
Then her "regular neurologist" called. They'd never heard of this patient.
Ten minutes later the ER doc called me. He'd just gotten a call from a police department in another state. They were looking for my patient. She'd stolen a Salvation Army uniform several weeks earlier, and was traveling around, using it to collect as many narcotics as she could. She'd take some, and sell the others, and keep on the move. They'd found she'd filled a script in my city, and were calling local ER's to alert them.
I have no idea whatever happened to her. On one hand, I felt sorry for this old lady who's life was reduced to being a traveling fugitive junkie. On the other hand, I was pissed for having gotten taken, and certainly she was giving the Salvation Army (for all the jokes about bell-ringing, they're a good organization) a bad name.
And, in some strange way, I had to respect her ingenuity and skill as the opponent she was. And laugh at how I'd been beaten by my own view that a sweet little old lady, especially one in a Salvation Army uniform, couldn't possibly be a junkie.
Junkie's and other low-lifes are a common source of amusement on medical blogs. But in reality they're far from funny. For an excellent look at this forgotten, but more realistic side, I recommend this post by my colleague Phathead.
