19 January 2009

Repeat business

Walking into the hair salon this weekend, my stylist commented to another, "Look, I am so good she doesn't even look like she needs a haircut!" She was joking of course, but that brought us to a conversation about never actually wanting to be that good because it would kill the bread-and-butter of repeat business. If hair didn't grow, there wouldn't be a steady line of customers every 4-8 weeks looking to have her make their hair look exactly the same as last time.

In itself, repeat business on the ambulance is not notable. Some folks are seriously ill and we see them often enough to know a bit about them. Others have a variety of reasons for calling that have little or nothing to do with their medical conditions. We have a large set of "frequent flyers" who should earn free trips for the amount of business they give us, if only they paid for trips in the first place. I was recently on-duty for 3 calls to the same address in less than 48 hours.

The original call was in the late morning for an overdose/unconscious person. We arrived to find a sobbing woman who pointed us to a bedroom. On the bed was a man laying on his back, snoring loudly. Not "snoring respirations" (a somewhat bad sign where a person is not keeping his airway open and possibly not getting enough air). Just snores. I walked in and shouted his name, to which he immediately awoke. After a long series of questions to both the patient and the woman, it turns out he "overdosed" on his sleeping medication and "passed out" the night before and her mom told her to call the ambulance. Stupidity discovered, we leave the happy couple with the police and move on.

Second call to the same address the following evening for overdose/unconscious person. Again, on his back, in bed, snoring. Again, wakes to verbal stimulus, but this time is substantially sluggish. We check his prescription bottles and one of them is a couple dozen pills lighter than yesterday. Off to the hospital where the fine doctors and nurses monitor him as he snoozes the medications away.

Next day, another call to the same address, same problem. Unusual for me to be working this many days in a row, but a shift swap leaves me in the station for too many days. This time, the call isn't for my truck, but I update the responding crew on the prior days events. Catching up with them at the hospital, I discover that this time there was a disagreement in the house with no overdose involved and the patient is now at the other hospital in town being evaluated for some other random complaint unrelated to any recent or potential overdose.

If we were ever good enough in medicine to prevent this sort of repeat business, the ambulances might have very little business at all.

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