But what about my hair?
Ninety-nine percent of my patients are delightful. And then there's Mrs. Downer. Whiny, unhappy, weepy, and non-compliant. Every phone call. Every visit. For twenty years. No matter what medication I prescribe, she either gets some bizarre side effect or claims she can't afford it because it isn't on the $4 pharmacy list. (Though she seems to have no trouble coming up with $7 a day for her two packs of cigarettes.) Every visit starts the same way. I ask, "How are you today, Mrs. Downer?" and she responds, "I'm in terrible shape." She then plunges into a list of twenty complaints for symptoms that are ALL self-induced: morning hack (she refuses to quit smoking because she might gain weight), shortness of breath (Duh!), fatigue (try going to bed before 2 am), knee pain (if you lost 100 pounds it would sure put less strain on your knees. Have you considered Weight Watchers?). She even complained about fingernail ridges (what do you expect with a diet of Twinkies and Coke?). One visit, after listening to over an hour of complaints, she had the audacity to ask me to code the visit as a "Well-woman check" because her insurance paid 100% for those. Well woman, my eye!
As a consequence of her smoking, she developed severe peripheral vascular disease necessitating surgery. Livid that the doctors and nurses wouldn't give her pain meds every minute on the minute in the massive doses she wanted, she stormed out of the hospital against medical advice. Once home, she fell and ripped open all her stitches and even severed an artery. She bled so profusely she required transfusions and an emergency surgery. Then the entire incision dripped with pus from a Staph infection. Yet she refused to pay the $35 co-pay to obtain the necessary antibiotic. Her poorly controlled diabetes made the infection even worse and soon gangrene set in. She required a below knee amputation. But did she quit smoking? Eat better? Take her medications? Control her blood sugars? Lose weight? No!
Before long, her other leg clogged up and necessitated re-vascularization surgery. Unfortunately, her surgery could not be scheduled for over three-weeks as the surgeon was leaving for his vacation.
Mrs. Downer whimpered and whined. "I can't possibly wait three weeks. This pain is excruciating. Do something." I glanced at her medication sheet. The surgeon had already prescribed enough pain meds to kill a moose. She gripped my arm, eyes pleading. "If you won't help me, just shoot me or give me an overdose so I won't have to suffer any more. I just can't take it anymore." She wailed and carried on so loudly the whole building could hear her.
I called the surgeon's office and explained how miserable she was and how she HAD to have the surgery moved up. (I also told them she was making my entire staff miserable with her five times a day phone calls. If the nurse and receptionist were busy, she'd even call my billing clerk and beg her to "just shoot me and end my suffering.")
Turns out, the surgeon's office was barraged with her phone calls even more than we were! In fact, the last receptionist had quit just to escape her incessant phone calls. To my delight, the surgeon took pity on us all and volunteered to delay his vacation a day to operate on Mrs. Downer day after tomorrow. We made all the necessary arrangements with the hospital, insurance company, and anaesthesia. I walked into her exam room grinning.
"Wonderful news! Dr. Legpain is so concerned about you, he even delayed his vacation a day so he can operate on you this Thursday. Isn't that fantastic?"
She stared at me then shook her head. "No, I can't do it Thursday. I have a hair appointment. Ten o'clock. And on Friday, I've got my manicure. But I could do it Monday. Tell him to make it Monday instead."
No matter how much I tried to explain the surgeon wouldn't delay his vacation five days because of a manicure appointment, she wouldn't budge. All she would say was, "I won't go into the hospital with my hair roots all grey."
Talk about unreasonable. One minute the pain is so excruciating she wants me to shoot her, and the next, she's more concerned about her hair and nails! (At that point, if I'd had a loaded gun, I might well have shot her!) I had never been so tempted to snap the Donald Trump line, "You're fired!"