self-delete

[NNguyenMD]

It was inappropriate for me to make the previous post. Although I did not disclose the identities on specific individuals, I will not discuss any of my interactions with other patients on DU anymore.

The gist of the post was if individuals who treat healthcare as a revolving door still deserved it. I apologize that the original post offended others on this message board.

[jillan]

1. I know someone like that, who is

midly disabled, by birth, not a vet.

He has it all figured out as well.
When he can't mooch off of the gov't, he
hits up Churches. Plays the disability to his advantage.
He is capable of working.

Unfortunately, there will be these people.
Just like the people from Katrina that abused the
$$. But overall, you can't punish everyone because of
a few that take advantage.

[Digit]

3. Great cartoon, thanks

I missed that one I guess!

[BlueIris]

2. HIPPA is a real law you know. An ethical provider wouldn't do this.

Shame on you. This is totally inappropriate. I continue to fear for the future if our providers feel comfortable abusing their access to our information in this way. Sick.

[Sgent]

4. This in no way

comes close to violating HIPAA or any professional code of ethics I'm familiar with. Case reports are used all the time in literature. As long as there is no PHI (which there isn't), it doesn't violate any national laws or code of ethics I'm aware of.

[Lars39]

5. .

[Sgent]

12. Of course he can

But even so you can't identify the patient w/o the OP's real name and address...

[Lars39]

13. .

[NNguyenMD]

7. thank you for that

[Maru Kitteh]

6. No. What makes him unmanageable and expensive is he can no

longer be involuntarily committed fro the VERY OBVIOUS mental health and addiction issues he suffers from. Thank Reagan for that. Of course it was couched in fuzzy lies that would appeal to the Democratic congress - like every mental patient was from One Flew out of the Cuckoos Nest. Truth is it was just another "deregulation" aka let's screw the people, let them die and get more money into the pockets of big business.

Were you here for the Reagan years? What if you had the power to protect this man from himself? What if he could be dried out and evaluated? Might that help?

[NNguyenMD]

11. without getting into specific cases

evaluating someone for compentency is a difficult job. Its not enough to act like a jerk to be deemed incompetent, you really have to demonstrate pretty marked cognitive impairment, or that you are in a state of psychosis or suicidality.

Without those, most providers would be reluctant to utilize the "2PC" law in which two physicians at a health care facility can commit a patient up to 60 days I believe.

So it is actually relatively easy for a providers to commit someone who they think is a danger to themselves or society, but I'm afraid that wanting to act like a jerk and refusing to take care of yourself doesn't fit that criteria for most of them.

[Cleita]

8. Thirty years ago this guy would have been placed in a VA

facility known as the Old Soldier's Home. They got shelter, food, their meds and a staff that could cope with their difficult personalities. They were given their social security checks and could come and go as they pleased. Most of them ended up in bars, but the bus drivers and taxi drivers knew where to take them and the staff knew how to patch them up until the next binge.

When Reagan became President, funding for the Old Soldiers Homes was suddenly dried up and they were greatly reduced in their capability. All these old guys got thrown out into nursing homes that were ill equipped to handle them and the streets. This was the first time we started to see homeless people.

I sympathize with you and hope you will know how to cope with this wounded soul the next time he comes around.

[Maru Kitteh]

9. two great minds that thought alike

fuckin' Reagan.

[Cleita]

10. You can trace all these deteriorations in our system of

safety nets back to that plaster of paris "saint".

[NNguyenMD]

14. I really would appreciate any advice you would have on approaching

vets with there very severe problems, or how to talk to them. The more experienced staff seem to think that the best approach is to take their emotional outbursts at face value.

I don't know. I guess I'm just baffled that people will respond abusively after you try so hard to help them.

[Cleita]

15. I have no help to offer you in a medical sense.

All I know is that these men need the specialized help they got at the VA and can't get anymore. I really hate that our government hasn't kept their promise to give them the help they need after fighting wars for us, no matter how misguided those wars may have been. That old man seems to have been thrown at a system that can't really cope with him.

Those nursing homes and assisted living facilities don't have a staff that is trained to deal with this man's personality disorders. It's a tragic thing in our society that people like that can't get the help they need. I guess he probably doesn't even have family you can consult with to help decide what would be best for him.

Sorry, I'm not much help, but I do sympathize with your problem.

[magellan]

16. Maybe anger's all they've got left

I have no experience in this area. But I immediately thought of young women who overeat, or starve themselves, because it's the only control they feel they have over their lives. Is it possible some vets lash out indiscriminately for similar reasons?

[Lars39]

17. Or self-esteem.

Something in him says he's not worthy of whatever help he gets, so he sabotages by alienating those trying to help him.

[magellan]

19. Could be

The situation you described could suggest he doesn't value himself. It's not uncommon for wounded vets to lose their self-respect considering the obstacles they face in a world that seems to no longer care what happens to them. Lt. Dan from Forrest Gump comes to mind.

Whatever the case, there's a lot of anger in there looking for a way out.

This is just my opinion -- I might feel different if I were a medical professional faced with this person -- but it seems to me that the onus is on you medical folks to accept that he's difficult, and treat him, literally and figuratively, with respect, to the extent he will allow at any one time. He obviously needs your care in more ways than one.

edited: sorry, lars, I thought I was replying to the OP!

[Maru Kitteh]

18. It's so hard to tell on the limited information that you yourself have

available. I would say take all direct THREATS at face value but emotional rants and outbursts without threats? No.

This sounds like someone who could be suffering from PSD, chemical and alchohol dependency, neurological disorders, who the hell knows what.

If/when he shows up again see if one of your particularly gifted hospice workers might be willing to pop in on him. The best of the hospice people are angels on earth.


I want to THANK YOU for being good enough to care. I will pray for you, that caring never leaves you.