Do drug abusers ever get sick?
There is a particular posture that can be attributed to healthcare providers of any level when confronted with these types of patients. Maybe it is anger, or disgust. Perhaps it is mistrust or simply exhaustion from all of the shit that smells the same way coming through our doors. Signs and symptoms aside, if you, your chart, or your mannerism stipulates that you are a drug abuser: you will be mistreated.
This week, I watched an ER physician withhold ventilations from an opiate overdose with a respiratory rate of six. "He shouldn't have shot up" was the justification. The kid was cyanotic and looked like shit. When the narcan went in, they slapped him in the face in order to help revive their still unresponsive patient, and when he woke up denying drugs, the doctors told him that the narcan would kill him if he wasn't honest about his drug usage.
Same day, same hospital, I brought in a patient with profound right sided weakness, obvious right side facial droop, and a blood pressure of 180/100- all an acute onset 30 minutes before our arrival at the hospital. The patient was obviously frightened, and perhaps by some lapse of judgment she let loose through her slurred speech that she had used cocaine the night before. Hearing this, the triage nurse rolled her eyes. She got a bed in the hallway and I had to make a scene at the hospital in order to get some attention for my patient.
Impose whatever judgment you will upon these ED providers, but I have personally seen these same people provide absolutely top notch care. I've witnessed them go above and beyond to provide emotional support, and I've watched as their expertise illuminated acute pathologies that only great experience and skill could have possibly recognized. I've seen these people as shining stars within their departments, and even thought to myself that if I were ever injured on the job, these are the people I would like in charge of my care.
But then again, I don't do drugs.