Hard Rain

Emergency roomA patient enters the emergency room in obvious distress. He tries to speak but the words are gibberish. The triage nurses are attempting to get the patient’s information from distraught family members. They ask:
1. Patient’s name.
2. Birth date.
3. Weight.
4. Type of insurance. (The patient has no medical insurance).

The right side of his body is shaking uncontrollably and he has lost the muscle control to sit upright. His eyes are vacant, he is not aware of his surroundings. He does not respond when the nurses ask him questions, he does not feel the stick when the intravenous catheter is inserted into his hand or the pinch when a potential vein is finally located to draw blood. He doesn’t feel the heart and blood pressure monitors being applied to his body.

The doctor enters and does a rudimentary exam not really seeing the man. He orders a medicine inserted into the IV. He tells the nurse to call radiology for a C.A.T. scan, neck and spinal x-ray and he leaves the room. As the patient is being wheeled to x-ray a nurse stops the gurney, injects another medicine into the IV and places a tablet into the patient’s mouth. He is not conscious of being placed onto the table of the C-scan or being positioned for the spinal x-ray. As the technician is attempting to put him into sitting position for another x-ray, the patient becomes aware of his surroundings and asks where he is. He is coherent for the first time in almost 4 hours. The tests are completed and he is returned to the emergency room. After several minutes, the doctor again enters the room.
The patient asks, “What happened to me ?”
“We don’t know”, is the doctor’s reply.
“Will it happen again ?”
“We don’t know, but if you start to experience dizziness or nausea or any loss of motor control come back in immediately. Since you have no insurance I will release you in about an hour.”
“If I have to come back will I be charged again or…”
“Of course, it may be a different emergency.”

Within two days the patient receives a bill for $ 4500.00

A week or so later, a hard rain begins to fall. The doctor returns home to discover that his roof is leaking. His carpets and furniture are being destroyed. He finds the number of a roof repairman and phones him. His voice frantic. « Would the repairman come immediately. It is an emergency ! » The repairman and his assistant arrive within the hour and climb onto the roof in the pouring rain. The repairman looks around to locate the problem. He tells his assistant to put some tar in the valley of the roof and as soon as the assistant is finished the rain suddenly stops.
When they come down from the roof the doctor asks : « Did you fix it ? »
“The roof is not leaking, is it ?”
“No, but the rain has stopped. Will it leak again ? »
“I don’t know. But if it does, you call me,” the roofer says and he hands the doctor a bill for $ 4500.00
“If I have to call you again to fix the roof will it be free of charge or will I have to pay you again ?” the doctor asks.
“I will have to charge you”, the roofer replies.
“If it leaks again it is because you didn’t fix it. Why should I have to pay you for something you did not repair ?”
“But doc, you have to understand, if it leaks again it is not because I didn’t fix this leak, it is because you have a new leak. Now will you be paying by cash or check ?”

NB Posez le curseur sur les mots et expressions soulignés noir pour obtenir la traduction française.

The ComtesseComtesse

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9 commentaires pour Hard Rain

  1. Comtesse dit :

    What makes you think I was talking about my father? I was not and the person involved is not as old as say.. the Cowboy.
    I was trying to illustrate my opinion regarding the fact that medicine is big business in the US. that perhaps we should treat the medical profession the same as any other business.
    I have just had a look at the bill.
    There is a charge for 229.00 pharmacy.
    The patient was given.. 1 Zantac, 1 5mg valium, an iv steriod and 1 darvocet

    There is a problem with the system and it needs to be addressed but it will not be as long as medicine is allowed to be a corporate venture.
    Whatever happened to the doctor’s oath, « First, do no harm. »?
    Oh, I forgot. Doctors today do not have to take the Hippocratic Oath.
    Instead, they take a Hypocrite’s Oath.
    It begins with: « Show me the money. »

    My family has been involved in the medical profession for years. My uncles were doctors who were lucky to see payment in the form of money. They were given chickens, maybe a bushel of corn or fresh milk.
    There that’s an idea! I think I will render payment in the form of produce and wait for the letter from their attorney.

  2. kbindallas dit :

    Cowboy, I think I can allow myself to comment on articles that deal with medicine particularly if they come from the Comtesse…

    To my perspective, the interesting point of this note is the fact that this patient has no medical insurance and therefore will hesitate to go back to the hospital if he needs care just because he is afraid of what it might cost him.

    But Comtesse, you should not compare a roof and a patient. You know that these are completely different situations. This reminds me of my personal experience with the daughter of one of my patients. Unfortunately, her father was very sick and surgery was considered although it was very risky. After I explained the patient and his daughter what were the potential benefits and complications they could expect from the operation, she faced me and said « All right doctor, we agree with the surgery but we want some guarantees ». I was really surprised by this assertion and after a while the only thing I could reply was « Your father is not a toaster, there is no guarantee with patients… ».

    This is a major problem in our modern societies (and particularly in America) : people know that medical science has made huge improvements and they hardly understand that it can fail. But the truth is that we still ignore most of the things and that fixing a stroke is a lot more complex than repairing a leak.

    Sincerely yours,

    KB

  3. kbindallas dit :

    Obviously my english writing has to be improved, I did not think that you were referring to your father.

    That being said, I agree with you that Medicine is a big business in the US. But you should not only blame the doctors for that. They are part of the system and can hardly have any impact on it. Changes can only come from higher authorities (politicians such as Howard Dean for example).

    When they work in a hospital, doctors are under pressure because they have to bring money to their department otherwise they will just be fired by the chairman who runs the department like a company. Of course this does not mean that they should not treat with compassion. But according to what I see here, most of them do, even if they charge a lot for that.

  4. Cowboy dit :

    I can’t explain why KB’s comment comes second and the Comtesse’s reply first. The Monde’s technicians worked on the blogs’ server this weekend. I think they stripped everything down and failed to put the parts back in the right place. don’t you think ?

    BTW he didn’t say you said it was your father (?)

    Hey KB, you can allow yourself to comment upon any article. You don’t have to stick to your speciality. Even though it is most welcome as you make it clear that OUR French doctors make a difference between a roof and a patient. I would have been afraid to consult for a headache and walk out of the emergency room with… shingle(s) 🙂

  5. Comtesse dit :

    Then we agree. I have posted earlier regarding the profits and the contributions made from pharmaceutal companies to the Repugnuts.
    Let me ask you something that has been on my mind since I first began reading your posts here and on your blog. What on this earth are you doing in Dallas?
    Have you come for specialization, perhaps at the University, or are you one of many who have come to make a few million dollars, pay off your med school debts and return home?
    I had an instance to be treated for an injury my last visit to France. I found the attention much more personal than it is here. (even though I do believe that treating an American made the doctor a bit nervous.)

    My eldest son lives outside Dallas, between Dallas and Fort Worth. Personally I wouldn’t go there on a dare and I’m not skittish in my traveling.. just picky. 🙂

  6. kbindallas dit :

    For sure, Dallas is not the sexiest city in the United States. But it has one of the most prestigious medical university and I must admit physicians are outstanding. This is the reason why I came here for a one year specialization in mini-invasive surgery.

    Since I grew up in France, I have no loans to refund (education is free in France) so I don’t need to make millions before I return home. Anyway, US doctors wouldn’t allow me to practice here, they don’t want french doctors to steal their business !

  7. Cowboy dit :

    US doctors know that compassion is priceless ! Ours are learning…

  8. Diana dit :

    I should have known better than to make a reply.

  9. Cowboy dit :

    Avis : J’avais oublé de passer ce blog à l’heure d’été. Il semble que cette négligence se soit traduite par une distribution un peu aléatoire des commentaires précédents. Exemple : le premier message est la réponse au second. Le lecteur risque de chercher en vain la logique d’un débat confus.
    L’erreur est réparée. L’équipe de rédaction présente ses excuses à KB et aux visiteurs éventuels.

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