In tragedy, practicing medicine both an honor and a privilege

For the past four years, this is James Beck’s routine: After a morning spent guzzling $5 vodka, he stumbles into a Dunkin’ Donuts parking lot, lying on the cement with his dusty oversized coat splayed open to reveal a cachectic chest. A concerned patron (cigarette and coffee in hand) will call 911 and, in accordance with protocol, an ambulance will deliver him to our emergency room. Upon his arrival, we unpredictably greet our guest, sometimes with a jovial, “Hey Jimbo!,” other times with rolled eyes and a reluctance to approach the stench of his urine-soaked khakis. James, too, is unpredictable: occasionally flashing toothless grins and chuckling, other times shouting expletives and vomiting onto the floor. Two slices of hardening wheat bread glued together with grape jelly and a smear of peanut butter: that is all that James asks for. A stretcher and a diet soda would be nice, he says, but he’ll settle for a chair he can spend another twelve hours slumped in, safe from the blowing snow and unforgiving streets. During each visit, a nurse, tech, and doctor examine James. They take vital signs, listen to his crackling lungs, order X-rays when he falls, provide IV fluids, or dispense ibuprofen to lessen the ache in his bones. Every month, Medicare pays over $10,000 for this modicum of care. There are no doubt thousands of James Becks throughout the U.S., occupying beds and consuming resources while other patients wait for space. Continue reading ... Your patients are...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Emergency Medicine Hospital-Based Medicine Source Type: blogs