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“Mrs. Olner,” you begin.
The old lady opens her eyes and inspects you through trifocals. The lenses of the glasses are smudged with fingerprints.
“What brings you to the Emergency Department?”
“My son, Ronnie.”
“No, I meant what kind of problem?”
“I guess they thought I needed to come.”
“Ronnie. And his wife, Rita. I stay with them. They take care of me.”
“What do you think? Is anything bothering you?”
“Are you hurting anywhere?”
“In my back.”
“When did that begin?”
“Oh, 10 or 15 years ago. I’ve got osteoporosis, you know.”
“Are you having any new symptoms?”
“My bowels aren’t moving like they should.”
“When did that begin?”
“I’ve had that all my life.”
“Not possible,” Able answers.
“They’ve fled the scene. Outa’ here. Adios, amigos. A classic case, I’d call it.”
“A classic case? What do you mean?”
“A Granny Drop. Also known as a positive Taillight Sign. When the family
wants a weekend off from caring for an elderly person, they drop the aged one
“Mrs. Olner’s family really left?”
“Yep. And in case you missed it, Mrs. Olner also has a positive Suitcase Sign
— the family packed her suitcase so she can stay at the Hometown Hospital
You shake your head in disbelief, yet recognize that Nurse Able speaks from
her thousands-of-shifts experience in the emergency department.
You proceed to examine Mrs. Olner. Physically, she is fine. Mentally, her
mind wanders. You cannot deem her responsible for her own self-care.
“Dr. Jones, I’ve got one of your patients here, 88 year-old Emma Olner. Nothing new with her, but her family dropped her here and took off. She’s unable to take care of herself. If we send her home, I’m afraid she might burn down the house or something. There’s no way we can get social services to find her a sitter at 9 P.M. on a Friday night. And, if we send her to a homeless persons’ shelter, someone might take advantage of her.”
A deep sigh emanates from the other end of the phone. “Her family has done this twice before,” reports Dr. Jones. “By the time social services finds a sitter or a nursing home bed, Mrs. Olner’s family shows up and reclaims the old lady.”
“Then you’ll admit her?”
“Yes, I will. Medicare may not pay, but we still have to think of the patient first. At least for now, we need to protect her by putting her in the hospital. I will ask social services to investigate the home situation, though. This is a form of negligence.”
“I agree. Thank you for putting the patient first, Dr. Jones.”
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