One of the docs I was working with (who is much more “cerebral” and well-traveled than I) made an interesting comment as we watched a noncompliant epileptic patient being wheeled past us into the room on a stretcher.
“We are such a country of enablers,” he said. “In this country if someone doesn’t take their medication and has a seizure on the side of the road, we send a big taxicab with lights spinning and sirens blaring to go pick them up and bring them to the hospital. We put them in a nice warm bed. We give them a meal if they are hungry. They get to watch cable TV. Several well-educated servants in scrubs tend to their every need. We even give them the medicine they should have been taking through an IV so they don’t have to swallow it. We then send them home with a prescription for more medication in their pocket and give them a survey to make sure that they enjoyed their stay. And if they don’t have a ride home, we get another big taxicab to take them home and tuck them into bed. Two days later when they don’t fill the prescription and have another seizure, the same big taxicab goes out to find them and we repeat the same process all over again.”
I smirked at his pointed cynicism. Then he continued.
“In Mexico if someone doesn’t take their medicine and has a seizure on the side of the road, they wake up on the side of the road … with no sneakers and with no pesos in their pocket.”
I wonder what the rate of seizure medication noncompliance is in Mexico.
For an example of a different kind of enabling, see this post on ER Nursey’s blog.
One patient I saw was too large to be taken out of their home through his front door. The fire department had to remove a window and take the patient out of the second floor with a crane. Then the paramedics had to bring him on the back of a pickup truck and drag him into the ED on blankets because he wouldn’t fit on a stretcher. At some point will society agree that if you allow yourself to get this big that you are acknowledging no one may be able to treat you in the event of an emergency?
SEE ALSO this post and the comments on a separate discussion of enabling medical patients.