Monday, January 31, 2005

Problem Solved



It’s just an unfortunate truth that patients tell lies. In this month of night float I’ve seen at least one or two patients who complain of chest pain every night. A common cause of chest pain, especially in the area I serve, is Cocaine. So, it’s just a fact of life that when someone comes to the Emergency Room complaining of chest pain one of the most important questions is how many white lines they polished off that night?

Of course, a patient-doctor relationship is based on trust and I do my best to establish that trust while ate the same time verifying truth. Unfortunately, to do that requires betrayal as I send their urine for a toxicology screen. On the average, once every other night, one patient who vehemently denied drug use shows up positive. But fear not, all is not lost.

It is said that everything in the universe serves a purpose. With a little help from the chemistry lab I believe that I’ve found a great benefit to be derived from such patients. Currently, all we’re missing is a little research money and a sharp mind.

I often blog about the amount of loans medical students assume to pay for their education. Actually, I mostly blog about my debt and how it’s effecting my wife and I and the decisions we make. Through the wonderful talented minds here at the Mad House we’ve found a way to repay everyone’s loans in one year. Actually, we’re hoping to cut that time estimate to half a year, with a little promotional scheme.

If we were able to crystallize Cocaine and Heroin from the urine of patients who test positive than we can repay our loans in no time, maybe even buy a nice mansion or two in the rich sector of town. Here is how it would go.

A patient comes to the Emergency Room complaining of squeezing type chest pain. We’ll send a tox-screen. He’s positive. Now, a few ethical violations have to be committed, but as my grandfather says “Ethics Shmantics”.

We ask the nurse to stick a Urinary catheter (Urine catheter) in the young man (Completely unnecessary). Then, we hang IV fluids at 300 ml/hr (A mega dose). Proceeding to step three, we give him 100 mg of Lasix through his IV access (Enough Diuretic to dry up an elephant) and all that’s left to do is watch as the money slowly trickles in, our pure yellow pot of gold.

Judging by the amount of patients who currently test positive I estimate we could have one to two tons of Cocaine and Heroin ready for consumer distribution in less than three months. Some advantages:

1. Technically, our patients will be our suppliers and dealers. They, thus, will be subject to drug trafficking charges and, viola, one less drug addict on our streets.
2. If somehow we happen to "misplace" a dime bag or two, the poor, unfortunate Crack smoker will surely end up with chest pain and eventually return to our ED, only to be diuresed again. A never ending supply.

Now all that’s left is checking with the good folks over at the Drug Enforcement Agency how they would feel about such a project. After all, they stand to benefit if medical students are able to pay off their loans, this is federal money. With a little active promotion and advertising (ie: We got a great cocaine chaser here at the Mad House) we could really build a small Fortune-Five-Hundred company in no time.

The money of course would go for beneficial causes. Like paying off said debts and buying a few Ferraris for residents so that they’re never late for work again. Maybe even one or two mansions in the rich part of town so we can all sleep well.

My wife advises attaching a disclaimer: I am in no way promoting the use of Cocaine, nor, am I promoting the distribution of drugs of any kind to achieve any purpose including paying off outrageous student loans. This is for purely comical relief. Even if some genius finds a way to crystallize the metabolites found in urine and sells these, I am not taking any responsibility for supplying the idea. In reality, this is not real cocaine anyways, just metabolites, so if you want to pay off your outrageous student loans go work, you ass.