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“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler






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    Monday, November 24, 2003
     
    Midnight Caller

    I was fathoms deep in REM sleep when the pager went off. I usually snap awake within a couple of seconds when this happens, but that night it took nearly a minute to shake off denial, pick up the phone, and dial my voicemail number.

    I recognized the voice of the woman leaving the message. She's a nutcase (I know this is judgemental and un-PC and all that, but I'm going to be honest) who has called many times in the past, always requesting antibiotics on slim grounds. Fortunately, she's not a member of my practice; she belongs to one of my partners who is known for having a large stable of wacko patients. While I was listening to her message and trying to write down her phone number, the pager went off again. Same woman. Total time elapsed between pages: maybe four minutes.

    She wanted antibiotics again, despite just having completed a course of antibiotics. She was coughing, you see.

    "Are you taking anything for your cough?" I asked.

    Of course not, she didn't need cough meds, she needed antibiotics, she replied.

    I begged to differ. This led to a discussion that lasted a good ten minutes (that's par for the course with this woman). I told her I would call medicine for her cough and call her primary care physician the next day, but that I didn't think she needed another course of antibiotics one day after finishing the previous one.

    Another time I got a phone call in the middle of the night from another patient (also a member of Doctor X's practice) who left a long, semi-hysterical message on the voicemail about how she couldn't sleep and she was going nuts and she really, really had to sleep. So I called her up and, lo and behold, she had a prescription of chloral hydrate sitting in her house all ready to use; she just wanted to talk to somebody first. Half asleep, I told her yes, yes, just take the medication.

    On my next call night, she pulled the same trick again at one-thirty in the morning. Same hysterical message on the voicemail.

    This time I dialed her up and, when she answered, I hissed, "Don't you ever do that again!"

    I never heard from her again.

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