When we treat people, it is our duty to do it using as much science as possible. I still remember the woman who came to the hospital in the middle of the night for chronic headaches. Her pain was terrible, she said. She had already taken the powerful narcotics she used daily, and yet her "chronic pain" was worse. She said to me, with slurred speech, "You haave to helppp zzzzzz." And with that, she drifted off to sleep. In a person with a sudden, new onset headache, that would have been cause for alarm. It would have been reason for a CAT scan of her brain, maybe even for a lumbar puncture (spinal tap) to look for a bleeding aneurysm or meningitis. In her case, however, this was just another normal day. I looked at her husband, who said with a sigh, "Why don't I just take her on home." [continues 629 words]
Hurricane Frances had an unforeseen effect on a patient I recently saw. It forced him to flee Florida without bringing any of the narcotics he chronically took for back pain. It was so ghastly a storm that he drove all the way from Florida without so much as a driver's license for identification. Even if I had given him a narcotic prescription, he would have needed some form of picture identification to purchase them. The fear inspired by a hurricane is a terrible thing. But then, so is prescription drug abuse. [continues 675 words]
