Feet First

“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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    Sunday, May 22, 2005
    Crazy Rabbi

    That's what we all call him. Yes, the whole of The Firm, fifty-odd physicians strong, knows him. All the local ERs know him. The outside docs that cover the weekend night call shift know him.

    He calls himself a rabbi, and he's definitely crazy. Ergo, the Crazy Rabbi.

    Typical encounter goes like this. STAT page. Voicemail message: (nervously, rapidly) "Please call xxx-xxxx. I am in pain, please call. Thank you."

    No name, no explanation. At this point, we don't need one because we KNOW who it is; we all recognize his voice. Yes, he's called that often.

    When you call back, you get this. "I am in pain, I need antibiotics." (Or, variant: "I have a shot of Rocephin and I need you to give it to me.") He always states he has either a urinary tract infection or a prostate problem or, my favorite, "something is wrong with my rectum."

    "No," we respond. At this point he either goes ballistic on us or he hangs up and goes to the ER. We have received several irritated messages from the ER - in fact, multiple ERs - about this guy; every hospital for ten miles around knows who he is. We have tried to get him to come in to the office for evaluation (he has claimed to be the patient of about five different MDs in The Firm) but he almost never does; he no-shows about 75% of the time.

    I once called the number he left and got his mother, who promptly screamed at me, "He's crazy! Don't call him!" - but if we don't, he will call back within fifteen minutes leaving an even more hysterical message than the first time. (As an aside, I would mention that having the patient's mother tell you he's crazy is not a good prognostic sign.)

    Lately the calls have tapered off. Of course - we doctors being a superstitious lot - the mere act of my posting this entry may be enough to bring him back down on our necks, but I will hope for the best. I could not resist telling you about this fellow, though - he is definitely one of the most memorable patients we've had recently.



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