“Gol,” he simpered. “G-O-L.”
“And your first name?”
“Smea. S-M-E-A,” he answered, baring his rotted teeth in an obsequious grin. He grimaced and cleared his throat painfully.
Eeeeewwww. Somebody has the meth mouth.
“So what brings you to the ER today, Mr. Smea Gol?” I ask absently, looking over his shoulder at the gathering horde in the waiting room.
Jesus, it must be a Malingerer National Holiday or something. Every drug seeker in three parishes is out there.
“My handses,” he whimpers. “Oh, the pain in my handses…”
“Did you recently injure them somehow?” I ask, examining his long, gnarled fingers. He smells vaguely of fish.
“No, nobody hurtses,” he assures me, shaking his head vehemently. “Nobody hurtses us! Chronic, it is!” Again, he swallows and clear his throat painfully.
What is it with this guy and the repetitive swallowing? And what’s up with the drool?
“Something wrong with your throat, Sir?” I ask. “You seem to be having some trouble swallowing. We can swab your throat and run a quick test, maybe see if it’s strep…”
“No!” he snaps, then swallows again. “My handses hurt! Fibromyalgia, it is! It’s Vicodin we needs, yes Precious! We mussst have Vicodin!”
I fucking knew it. Do these people think we’re stupid?
“Vicodin, huh?” I grunt skeptically. “Who’s your doctor? Do you see a pain management specialist?”
“Dr. Simmons it is, Precious – gollum! – Dr. Simmons! Always, always he gives us Vicodin! We wants it. We needs it!” At the mention of Vicodin, his eyes took on a feral gleam.
“Uh huh,” I grunt noncomittally, “and Dr. Simmons prescribes Vicodin for your chronic pain? Are you out of your pain meds?”
“No more,” he moans mournfully. “Someone stole it, they did. Filthy, tricksy thieveses! Baggins stole it, he did, and leaves poor Smeagol to suffer… no more Vicodins we has – gollum! – no more Somas, no more Xanaxes…”
Riiiight. It’s always someone else’s fault.
“No problem,” I say cheerily, flipping the chart closed and sticking my pen back in my pocket, “all we have to do is call Dr. Simmons, and see about getting your prescription refilled. We don’t do that in the ER, you see.”
“Nooo!” he cries in desperation, “Mustn’t call Dr. Simmons – gollum! – Mustn’t believe Dr. Simmons lieses. Wicked! Tricksy! False! Gollum.”
“You look awfully familiar to me,” I muse. “Have you been here before?”
“No! – gollum! – Never been to nice hosspital before! We just needses Vicodin for our poor, aching handses…no one cares about usss – gollum! -no one knowses what it’s like having fibromyalgia,” he whines pitifully.
“I have seen you before!” I accuse, remembering the exact occasion. “You were in here a couple of months ago, trying to score Lortabs for your kidney stones! Smea Gol…Smeagol?? I gave you 50 of Demerol and 25 of Phenergan in good faith, and your fucking renal CT scan was negative! Oh yeah buddy, I remember you.”
“Wassssn’t usss,” he hisses, eyes darting shiftily.
“Sure it wasn’t,” I sneer. “Well, have a seat in the waiting room, Smeagol. We’ll be with you as soon as we can.”
“Smeagol wants Vicodin now,” he hisses threateningly. “Complain on you, we will! Fuck up your Presss-Ganey scoreses, we will! Oh yes we will, Precious!“
“That’s spelled D-R-I-V-E-R,” I furnish helpfully, holding out my name tag. “As in Ambulance Driver. Be sure to spell it right on the complaint.”
“Massster will not be pleased,” he snarls. “Smeagol needses his Vicodin. Smeagol wasssn’t supposed to come back without his Vicodin! Master Sum-” Too late, he guiltily claps his hand over his mouth and stares at the floor.
“Master who?” I demand, grabbing him by the throat and pinning him against the wall. “Who sent you? Tell me!”
“Smeagol doesn’t know what Fat Paramedic isss talking about!” he whines in protest. “Smeagol just wants his Vicodin! Gollum!“
“Sumdood sent you, didn’t he?” I demand. “I want an answer! Where is he?”
“No one can find the Massster,” Smeagol sneers spitefully. “Fat Paramedic is too late! And Smeagol brought friendses, yes he did!” he gloats, eyeing the waiting room.
I look at the bloodthirsty horde in the waiting room, and from the corner of my eye I catch a glance of my trauma shears in the pocket of my scrub top. They’re glowing with a pale blue light.
Shit, that means fibromyalgia orcs, and now we’re surrounded. Sumdood has changed tactics and caught us unprepared.
“Bar the doors and call the ambulance!” I yell desperately to the bewildered clerk as I fling Smeagol bodily through the ER doors into the waiting room. “We need reinforcements now!”
I turn and sprint back into the ER nurse’s station. Dr. CandyMan and the Ex Missus both look up from their charts.
“We have a problem,” I tell them grimly. “Sumdood has recruited an army. They’re massing on our doorstep as we speak.”
“Sumdood doesn’t work that way,” Dr. CandyMan yawns, unconcerned. “He’s strictly a solo act.”
“He’s using surrogates now,” I insist. “One of them as much as admitted it, right out there at the triage desk!”
“Let me tell you how Sumdood operates,” CandyMan smiles condescendingly. “Sumdood jumps people with no warning, and for no reason. Sumdood plants drugs on innocent citizens. Sumdood steals -“
“He knows how Sumdood operates,” Ex Missus cuts him off. “He was thwarting Sumdood when you were still memorizing the cranial nerves in gross anatomy class.”
“Oh- Oh- Oh- To- Touch- and- Feel- a- Virgin- Girl’s- Vagina- and- Hooters,” Dr. Candyman quotes automatically. “It’s a really good mnemonic for – “
“Shaddup, Doogie,” Ex Missus says dismissively. “We have a real crisis here. How many are out there, AD?”
“Company strength, at least,” I answer, my eyes betraying my concern. “Mixed forces. Toothaches, fibromyalgia, migraine patients. Maybe a dozen more wanting work excuses. Throw in maybe thirty with viral gastroenteritis, and probably a good twenty-five more involved in minor fender-benders a week ago that just want to be ‘checked out.’ And four cave trolls wanting free pregnancy tests.”
“Shit, we’ll be overrun,” Ex Missus breathes. “We need reinforcements. They outnumber us 10:1. We’ll be like the Spartans at The
“I’ve got the clerk calling the ambulance service, and I’ve barred the doors. Can we get the sick patients transferred out? We need everyone here who can wield a Foley.”
“All the other ERs are on diversion,” Ex Missus says, fear and realization dawning in her eyes. “There’s no place to send them. And the ambulances are all tied up on calls. Medic One is bringing in a combative meth head, and Medic Two is on scene with a frequent flier with toe pain.”
“This is not just a probing attack,” I confirm. “He’s massing an all-out assault on all fronts. He’ll stop at nothing short of the total collapse of our emergency health care system.”
“Now we don’t know that,” Dr. Candyman admonishes. “I’m sure they’re all just simple sick people, in need of prompt and professional relief of their pain and suffering. We should welcome them in. That’s why we got into health care.”
“You make a move toward opening those doors, and I’ll strangle you with your fucking stethoscope,” Ex Missus warns. “I’m not so sure you’re not a collaborator. I’ve seen how they tend to come around when you’re on duty.”
“I am most certainly not!” he huffs. “Besides, how do we know Sumdood sent all these people?”
“They come bearing the Mark of the Beast,” I inform him. “A Medicaid card. And several of them were asking for you by name,” I accuse.
“That proves nothing!” he cries desperately, looking at Ex Missus for support.
“No, it doesn’t,” she agrees, looking at him appraisingly. “But there’s one way to prove your loyalty. Go out there and use It.”
“No, not that!” Doc CandyMan shakes his head vehemently. “It’s…it’s too drastic!”
“Desperate times call for desperate measures, Doc,” I inform him. “Sumdood has shifted tactics. We have to adapt.”
“But surely there’s a better way!” he whines, desperately seeking an out. “People will complain! Our patient satisfaction scores will suffer! I’ll risk my bonus!“
“Sumdood has gotten inside your OODA loop, Soldier,” I tell him flatly. “He’s dictating the terms now. We have to take back the initiative. You have to go out there and tell them that we require a $50 copay for all non-emergent cases.”
“I won’t do it,” he says obstinately. “You can’t make me.”
“You’re the doctor,” I retort. “You’re supposed to be our leader.”
“You must understand, AD,” he whines. “I can’t do it! I would use this Copay out of the desire to do good, but through me it would wield a power too great and terrible to imagine!”
Pussy. We need a tougher
“Do it,” she orders. “I’ll keep an eye the traitor.”
I pull a document from the file cabinet, march out to the ER entrance, and gird myself for battle. The ER clerk, fear and desperation etched into her features, stands with her back to the barred door. Outside, the howls of the fibromyalgia orcs herald their thirst for blood.
Stout heart, AD. And if you go down, go down swinging.
I heft the six-foot, carved rosewood caduceus adorning the ER hallway off of its hanger, and hold it before me like a scepter. Taking a deep breath, I nod for the ER clerk to clear out, and I fling open the doors.
The patients charge.
Standing resolute, I plant the caduceus on the scarred linoleum at my feet and wave the piece of paper in their faces. Taken aback, they screech to a halt and eye my paper suspiciously.
“YOOUUU SHALL NOT PAAASSSS!”I bellow fiercely, eyes glinting with the light of battle.
This is my moment of truth.
“Gah! Get it away!” Smeagol recoils in horror. “It freezes us, it burns! It aggravates my herniated discs, it does!”
Behind him, a murmur of fear and disquiet ripples through his comrades. What seemed to be certain victory only a few seconds before, now doesn’t look so sure.
Emboldened, I stride forward and sweep the crowd with a piercing glare. Smeagol cowers in abject terror, and Sumdood’s Army quails before my wrath.
“Let it be known from this point forth, all throughout Middle Earth, or whatever part of it is our catchment area! Those who would utilize the Emergency Department of this fair hospital as their 24-hour free clinic or personal pharmacy shall now be required to remit cash payment in the amount of $50 at the time of services rendered for all conditions deemed by the medical staff to be of a non-urgent nature! At most, you will receive your medical screening examination as set forth by the Emergency Medical Treatment And Labor Act, and be given instructions to follow up with your Primary Care Provider!”
Blank looks abound as I glare triumphantly.
Shit, forgot who my audience was.
“Yo yo yo, that mean if we think yo problem is bullshit, homey ain’t gonna be gettin’ no free drugs or pregnancy tests up in here! This be a cash bidness, bitches! Noamsayne?”
And just like that, Sumdood’s Army runs squealing into the night, leaving only empty coffee cups, Doritos bags and mangled copies of last year’s Time and Newsweek to mark their passing.
“Get thee gone, hirelings!” I shouted at their retreating backs, “And tell your Master Sumdood that I’m coming for him! And Hell’s coming with me!”
“…and that’s when I woke up,” I tell Ex Missus as I thumb quarters into the Coke machine. “Pretty freaky, don’t you think?”
“I think you need to stop reading Lord of The Rings to unwind after work,” she answers, shaking her head. “Call Babs or something. Oh, and about you talking to the hospital board in support of the copayment plan?
“Yeah, this Thursday at 1:00, right?”
“Never mind. The last thing I want i
s you speaking to the hospital board. Thanks, but no thanks.”