My friend Mike runs the substance abuse program for the state Department of Corrections, and was running a conference about con’s getting out and back into society.
He asked me to go lecture these Probation Officers, and the odd Correctional Officer, for two sessions of three hours each on the subject of Co-opting Physicians in the Re-entry and Supervision Process. Didn’t tell me what I was meant to tell them, just “oh, talk to them about interacting with doctors”
How do you talk for three hours on something you really know nothing about? Talk about “the blind leading the blind.”
And “Co-opting Physicians” has an uncomfortably obligatory ring to it - but these guys are used to mandating what people have to do.
So I put together a Power Point of goofy pictures to try to keep the audience entertained while I stumbled along, mainly making the point that if the patient has not chosen to tell, their doctor may no nothing of their nefarious activities and interaction with the Department of Corrections - like the most ultimately curmudgeonly patient I had (who looked like the Unabomber) who was diabetic, hypertensive, alcoholic, depressed, anxious, smoker, who had heart disease and hepatitis C and was on chronic oxycodone for back pains , who I only found out was a regular smoker of marijuana and had used IV drugs (hence the Hep’ C) when I had to do a deposition on him (he is suing Pfizer because his nervousness reputedly got worse when I prescribed him Chantix - though this struck me as a bit of an optimistic fishing expedition, and somewhat insignificant compared with the abuse he had subjected his body to).
She only knowes what the patient tells her
Luckily my audience had a bunch of questions and it turned into more of a “shooting the breeze” session for three hours.
They had some great stories to tell. The guy who was making moonshine out of mash in a trash bag who dumped it all in the loo when he heard they were doing a “sweep”. But couldn’t bear to let it go, and was shitfaced and dripping from drinking what he could out of the commode - which apparently looked like a punch bowel, sort of pink, with all the mash floating around - before he had to flush it.
And there’s a fascinating “museum” in the entrance hall of “shivs” - murderous looking home made knives - ropes made from paper, a garrote made from strands of electric cord and even a gun one of the inmates somehow managed to make.
Now if only all this ingenuity could be put to good use. . . . . .
Maybe if you move in those circles all the time you get a bit cynical, but the P.O.’s seem to have an unbending conviction about the con’s, that “if their lips are moving they’re lying”.
There is a woman friend of Mrs. Gagg’s son who was being monitored by the Drug Court, and came up with positive for marijuana, though she swore up and down she was clean - but still finished up in jail.
“Is it possible a drug screen can be wrong?” I asked, in my naive way.
“No way” was the uncompromising answer - and the chemistry of the urine drug screens is pretty good these days (ibuprofen used to give a false positive - but that’s been fixed, except for possibly very high doses of several “non-steroidal-anti-inflammatories”). But that doesn’t effect the possible collecting and processing snafus. And this friend claimed the collection process was very lax.
And Mike tells me P.O.’s think doctors “can be suckered in to doing anything” - referring to the ability of patients to get their doctor to prescribe whatever pain med’s take their fancy. And this was definitely the hottest button issue they wanted to talk about.
It is a bit of a mind-field, this algology (the field of treating pain). There’s no test you can do to measure the pain level. You are reliant on the patient’s subjective assessment - and many of these patients are the most manipulative. Like the ex-cheerleader with pelvic pain syndrome (many of them have these rather vague diagnoses, and you really wonder are you treating an illness or feeding the habit) who, my nurse pointed out, always dressed very seductively whenever she came for her prescription of oxycodone (and I, like a dog in heat, pandering to her every wish).
Then I had this insight, that here was I, spending hours of my time, bullshitting about something I know virtually nothing about. The P.O.’s were right about it being possible to sucker doctors - Mike had done a good job.
