him, he'd have my e-mail address and one more way to worm his way into my privacy. But if I didn't, I wouldn't have any clues at all about what was coming next.
What a hand to play by myself. Didn't I know anybody I could talk to about this who wouldn't just advise me to move to Afghanistan? No, I did not. Not even Marv.
The phone rang. I jumped and then took a moment to steady myself before I picked it up. One letter from Willy and I was already spooked. "It's the ED," Melissa said. "The on-call doc wants to talk to you."
"Who is it?" I asked.
"She didn't say," Melissa answered.
"Put her on," I said. In my heart of hearts the ED was still the ER to me, but it was true that the "emergency room" had been a lot more than a room for a long time now: a small city was more like it. "Emergency Department" really was more accurate but still bothered us old-timers. An ER by any other name was still an ER.
"Michael, this is Suzanne. I'm in the ED, and we have a patient of yours down here, a woman named Camille Robbins."
Fortunately, Suzanne Stenson was one of the sharpest psychiatric residents Jefferson had ever produced. This was fortunate because dealing with a crazy patient wasn't half as bad as dealing with a crazy psychiatrist.
"What brought her in?"
"Who is more like it. You know Harvey, runs Sweet Tomatoes? He found her hiding in the shrubs this morning outside her house. Her damn dog wouldn't let him near her, and he was getting ready to call the police when she seemed to come out of it and called the dog off. It looks like she was having some kind of flashback.
"Harvey drove her in. She was disoriented and confused and in and out of flashbacks."
Oh, Lord. I just hoped Harvey knew something about dogs. I had the feeling he didn't, or he'd have called the police the first time that Rottweiler looked at him.
"Michael, the problem here is the dog came with her. I hate to say this, but the staff down here are more worried about the dog than your client. Nobody here wants to get within two feet of him, which is a big problem since your client is clutching his lead like it's a lifeline. She says he's a seizure dog. Is that true?"
"It's a 'she,'" I said, "although I'm not surprised you didn't get close enough to look. Her name is Keeter. As far as I know she is a seizure dog, which means that she can go anywhere. She's also an attack dog so be careful."
"Look, if people here were being any more careful they'd shoot her."
"Why don't I come down and see Camille."
"Why don't you."
"By the way, she just told you I was her therapist or she asked to see me?"
"She asked to see you." Good. That meant we had at least some connection, however new and fragile. Suzanne went on, "One more thing, Michael. She needs to be admitted, but we can't admit that dog."
"Legally, you have to. She's a service dog."
"Legally we do, so we're not going to recommend admission for Camille because of it. Nobody thinks she would part with her, and we just can't put that dog on the ward. Risk management would go nuts, the other patients would go nuts, and I am well and truly worried the dog would go nuts. Just so you know, it's not an option."
Great. I had a woman so confused she was hiding in the shrubs having flashbacks, and hospitalization was out. But I couldn't really argue with it. I wouldn't put Keeter on the ward, either. What if Camille did lose control of her and she ate five or six patients? On the other hand, what was I supposed to tell Camille if she wanted to be admitted?
Probably the truth —which meant I'd have to take the flak for it later. If the higher-ups wouldn't admit Camille because they had no way to manage the dog, they'd never be willing to tell Camille that. That would be admitting she needed hospitalization and they didn't provide it —too much liability if something happened to her later. The administration would want the resident to tell Camille hospitalization wasn't needed.
Medicine has always had an
What a hand to play by myself. Didn't I know anybody I could talk to about this who wouldn't just advise me to move to Afghanistan? No, I did not. Not even Marv.
The phone rang. I jumped and then took a moment to steady myself before I picked it up. One letter from Willy and I was already spooked. "It's the ED," Melissa said. "The on-call doc wants to talk to you."
"Who is it?" I asked.
"She didn't say," Melissa answered.
"Put her on," I said. In my heart of hearts the ED was still the ER to me, but it was true that the "emergency room" had been a lot more than a room for a long time now: a small city was more like it. "Emergency Department" really was more accurate but still bothered us old-timers. An ER by any other name was still an ER.
"Michael, this is Suzanne. I'm in the ED, and we have a patient of yours down here, a woman named Camille Robbins."
Fortunately, Suzanne Stenson was one of the sharpest psychiatric residents Jefferson had ever produced. This was fortunate because dealing with a crazy patient wasn't half as bad as dealing with a crazy psychiatrist.
"What brought her in?"
"Who is more like it. You know Harvey, runs Sweet Tomatoes? He found her hiding in the shrubs this morning outside her house. Her damn dog wouldn't let him near her, and he was getting ready to call the police when she seemed to come out of it and called the dog off. It looks like she was having some kind of flashback.
"Harvey drove her in. She was disoriented and confused and in and out of flashbacks."
Oh, Lord. I just hoped Harvey knew something about dogs. I had the feeling he didn't, or he'd have called the police the first time that Rottweiler looked at him.
"Michael, the problem here is the dog came with her. I hate to say this, but the staff down here are more worried about the dog than your client. Nobody here wants to get within two feet of him, which is a big problem since your client is clutching his lead like it's a lifeline. She says he's a seizure dog. Is that true?"
"It's a 'she,'" I said, "although I'm not surprised you didn't get close enough to look. Her name is Keeter. As far as I know she is a seizure dog, which means that she can go anywhere. She's also an attack dog so be careful."
"Look, if people here were being any more careful they'd shoot her."
"Why don't I come down and see Camille."
"Why don't you."
"By the way, she just told you I was her therapist or she asked to see me?"
"She asked to see you." Good. That meant we had at least some connection, however new and fragile. Suzanne went on, "One more thing, Michael. She needs to be admitted, but we can't admit that dog."
"Legally, you have to. She's a service dog."
"Legally we do, so we're not going to recommend admission for Camille because of it. Nobody thinks she would part with her, and we just can't put that dog on the ward. Risk management would go nuts, the other patients would go nuts, and I am well and truly worried the dog would go nuts. Just so you know, it's not an option."
Great. I had a woman so confused she was hiding in the shrubs having flashbacks, and hospitalization was out. But I couldn't really argue with it. I wouldn't put Keeter on the ward, either. What if Camille did lose control of her and she ate five or six patients? On the other hand, what was I supposed to tell Camille if she wanted to be admitted?
Probably the truth —which meant I'd have to take the flak for it later. If the higher-ups wouldn't admit Camille because they had no way to manage the dog, they'd never be willing to tell Camille that. That would be admitting she needed hospitalization and they didn't provide it —too much liability if something happened to her later. The administration would want the resident to tell Camille hospitalization wasn't needed.
Medicine has always had an
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