"Do you have any burning when you urinate?" I asked a patient today.
"Yeah, it burns when I pee right around the pearl tongue."
"The what?" At some point while the words were slipping out of my mouth, the meaning became clear.
"Oh, I don' know what you all call it. But you know, its that part there on top like a little penis, the pearl tongue?"
I nodded. "Of course, the clitoris."
"The what?" I was pretty amazed that she had never heard the word clitoris before. I could write a pretty long list of slang terms for the penis and vagina. But until now, I'd never heard of a slang term for the clitoris before - unless 'clit' qualifies. Its great that, in addition to educating, we also get to learn from our patients.
December 2006 Archives
Wow, the amount of time I've had for blogging on this rotation has been amazingly ridiculous. Not going to say anything more about that - not that I'm superstitous or anything!
There's a drug rep dinner at a fancy-schmancy restaurant tonight. It's the kind of restaurant where Brazlian gouchos bring you meat until you turn your coaster to the red side. Then, when you want more, just turn it back to green. I skipped breakfast and lunch in preparation...muwhaha!
There's a flyer up. It's posted on the walls of the more discreete areas of the labor and delivery floor at our hospital - the conference room, the physician lounge, the little cubicle in triage where the intern (i.e. me) writes his notes. The flyer reads as follows:
Wanted
Jasmine Ramirez (pictured) and Matthew Orton are wanted by the FBI in connection with drug trafficking charges. There is a $5,000 reward for information leading the the arrest of these individuals. Jasmine Ramirez is pregnant with a due date of 12/16/06. If she presents for care at your facility, please report her to your local police department immediately.
That was the jist of it anyway.
Is this a problem for anyone else? I looked up Ms. Ramirez's chart (not her real name, incidentally) in our system. She did present twice to our hospital for care - once to triage and once for a clinic visit. Her alleged due date of 12/16/06 by last menstrual period comes from our records. I thought about what I would do if she came in:
Thought #1 - how much of the money do I have to give to my program in order to pay for lunch at our weekly conference and how much can I keep for myself without appering a greedy asshole?
Thought #2 - when a patient presents for care, aren't they reasonably entitled to the expectation that whatever information they provide - including their name and what they are being treated for - will be held in the strictest confidence?
"Well Ms. Ramirez, I can see on the monitor that your contractins are coming every 3-5 minutes now. Your cervix is almost four centimeters dilated and very thinned out. I think you're going to have this baby pretty soon! We'll move you over to a labor room. First we'll just have the nurse start your IV while I let the FBI know you're here."
I contacted the head of our hospital ethics consult service regarding the matter. She bumped the question on up to risk management. The reply I received:
Hi James. Great question! I went to the OB unit and saw the posting. Tom McDougal in risk did state that exceptions to HIPAA rules would include folks wanted by the FBI. If this is a legitimate FBI posting (nurses did say that an FBI agent escorted by hospital security posted the paper on the unit) then employees should comply.
The woman in question has yet to reappear. She was only about 8 weeks pregnant when we saw her; who knows whether or not she's even still pregnant? i will repost regarding the outcome if she does decide to deliver at our hospital. I personally have decided that I'm not ethically comfortable reporting her to the FBI if she were to come in. But, there are plenty of other staff members here. Undoubtedly there will be at least one for whom the urge to see justice served, evil punished and $5,000 in his pocket will be too overpowering.
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