Working triage on a busy Saturday night, I called for the next person to sign in and watched a young guy drag himself up to the desk. Obviously in a great deal of pain, he grimaced even while I placed the blood pressure cuff on his arm. As I entered his information into the computer, he explained that he had kidney stones in the past, but this one felt like the biggest yet. I handed him a urine cup, which dipped positive for blood when he returned it later, and watched him shuffle back to the waiting room. Given the number of traumas and critical patients we had that night, it would be a few hours before he would be seen.
Here's what I later found out actually happened:
Looking for a fix, a young guy decided to score some narcs for the weekend by visiting a new ED for the first time. Putting on a well-rehearsed act, he successfully conned an ED tech and triage nurse into believing that he was suffering from a bad kidney stone. When handed a urine cup, he headed to the bathroom, pricked his finger, and dripped blood into the sample.
Assured that it would be hours until his chart reached the top of the pile, he left the waiting room and drove over to Nearby Hospital, where he performed a similar routine. There, he received a dose of IV pain meds and a script for narcs. Mission accomplished, he returned to the Big City ED, claiming to have been outside on his cell phone when we called him up for re-evaluation.
Once brought back, he received a second dose of IV pain meds for the evening, but this time decided not to wait for a script. Rather, he attempted to rush out the door with his IV still in place. When approached, he ripped out the lock and ran down the street.
Here's what I learned:
I was played, pure and simple. I won't forget his face, and both the Big City and Nearby Hospital EDs are now wise to his act. But there are plenty of other hospitals out there for him to scam.
It's sad when successful con artists push healthcare providers ever closer to cynicism, and increase the suspicion towards people in legitimate pain. But it's sadder still to see the lengths addicts will go to get a fix, and to watch the destructive and all-consuming power addiction has over their lives. I only hope he eventually gets the help he needs.