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Not all Fridays — let’s face it — are fun, games, leisure, and license. Some suck. Not unlike a very recent one, a several-day visit to what I will call Palomino Hospital in the horse country in North County, where your columnist has found himself spending more and more time. Now some criticism has been leveled at “T.G.I.F.” for being sometimes a tad depressive. I have an explanation: my thyroid. It’s shot out, like much of the rest of me, and that is why (in part) I found myself in the care of the sinister Dr. W.

But this is about a patient next to me — quite mad, as it turned out. He was attempting to call 911 from his hospital bed. Darren, we’ll call him, suffers from multiple liver problems and alcoholic dementia. Wet brain it is sometimes called. He is maybe 32. And, oh, yes, this was a Friday night.

Darren was convinced that Dr. W., a tall man of some Asian descent (not suggesting anything here), was intent on cutting out his very compromised liver. The good doctor seemed to mistake bullying for reason and upbraided the poor loon for his “social irresponsibility in drinking to excess.” Naturally the M.D. had no intention of surgery. His suggestion was a locked mental ward. It was, in fact, his first suggestion, instead of, say, sedation.

Darren, a diminutive and pudgy young man, was easily bullied by the tall and well-built Eurasian physician. Doc W. upbraided him for his moral failure at sobriety. “This is the second time I’ve seen you in here this week! What’s wrong with you?” It would seem this was a question the good healer himself should be considering.

W. went on in this vein for some time before he called security. While no threat from the patient seemed evident, it appeared that the doctor had missed the meeting of the AMA where it was determined that alcoholism was a disease, considered much like diabetes or, say, psoriasis. To W., it was a moral failure, such as pederasty or kleptomania.

A beefy, pleasant security man was posted next to Darren while the patient went on over the phone to his mother about how the staff was trying to murder him. At no time did Darren pose any physical threat. Still, two other security guards stood over him for some 45 minutes. Meanwhile the nurses tittered a little about the absurdity of calling 911 from a hospital room but were mostly far more sympathetic to Darren than his doctor-on-call.

The nurses said that your narrator’s blood tests had come back indicating a badly functioning thyroid. This, they said, would account for much lethargy and depression — if, in fact, I were experiencing any such thing. It was agreed that this was the deal.

Not to dwell on my case, but I too received a ration of much the same kind of thing as Darren from Doc W. “Why do you suppose you’re depressed? Hmm? You haven’t taken your L-Thyroxine, have you? What did you expect?”

“L what?”

“Hah!” was his only response, his head thrown back in contempt.

“So. You get depressed and you drink. Is that right?”

“Well, yeah. Not always, but, you know...”

“That doesn’t help, does it.” It wasn’t a question.

“Well, at first, a little, but then, you know. I guess I take it too far.”

“I guess you do.” And then he repeated himself in a contemptuous tone, “I guess you do.”

The doctor also suggested a mental ward for me. A locked facility to prevent any further folly on my part. The bedside manner of a pissed-off tarantula was a phrase that occurred to me.

Darren spent much time on the phone to relatives, declaring the homicidal intent of his caregivers. Beyond this he did nothing threatening except express a will to leave. Nurses, security, and Dr. W. all stayed him with warnings about leaving, which Darren took to be some sort of legal charge. His message to relatives then became “I’m being held against my will!”

A nurse I had not seen before (of the Nurse Ratched type) appeared at my bedside and accused me of smoking in my room, threatened me with discharge, and calling security. I had done no such thing, though I wished I could have. I had nothing to smoke anyway.

Spending much time in hospitals might lead one to think that the subject enjoys the experience. Angiograms? Stress tests where one is forced to remain conscious but unmoving for six hours? Quadruple bypasses? Pacemaker implants and replacements? Hour-long attempts at IV implants and blood samples when one is a hopeless “stick,” as they say? The only enjoyment involved may be watching the television show House, which sometimes airs on Fridays — or used to.

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Comments

NotQuiteADiva April 10, 2009 @ 8:55 p.m.

A little dab’ll do ‘ya!

Happy I am to see our TGIF hero return, and sorry I am to see where he has ended up, yet considering the ultimate doom scenarios I had envisioned, all is well as could be! Glad to see that you are not… um… dead!

For the record, my own brother has the substance abuse disease – or what ever you want to call it. He is basically a non-functional human being, and in my efforts to help him through his ordeal I came to discover the blocks and blocks of recovery homes located around “Palomino Hospital” – as you call it. It is a sobering testimony to the massive and pervasive impact of this disease that threatens to cripple our society and how the public is so reluctant to acknowledge that it exists.

Yet in regard to sinister Dr. W, consider this a wake-up call! Many of those who staff our health care system are inadequate to deal with the real and incredibly difficult problems our society throws at them. You blame him for his inadequacy, but perhaps you and your room mate present problems far beyond the training he has been provided. Who is truly to blame in that circumstance???

I leave that question for all to ponder…

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MovedOn April 12, 2009 @ 2:19 p.m.

I think that the fellow writing this article ought to shadow a substance abuse doc for a week or two. It would make a good story.

It's pretty easy to push all the responsibility on how a person ought to act onto Dr. W...and yet not accept any responsibility for the choices the author or Derrick makes. Seems like it ought to work both ways, at least a little bit.

No, being an addict is not a moral failing. But addicts make choices every day. Too often, those choices hurt the addict and the addict's friends and family. And even SOB docs like the one in this article are trying to save lives---including the fellow's who wrote the article. It must get frustrating to have people making choices that undo all the attempts to save a person's life.

Yeah, Dr. W. ought to go to charm school. Is that the point of the article?

How dare the doc be rude? Who the heck does he think he is? We know a lot about the life of the guy who wrote this. We even know some stuff about Derrick. What about the doc? Maybe he has a moral failing.

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EricBlair April 13, 2009 @ 6:56 p.m.

I don't know if the criticism is entirely fair. Mr. Brizzolara is expressing his own frustration, and is not shy about expressing that emotion toward himself and his own actions.

There are no winners in all of this.

Yes, it is frustrating to be a physician trying to save lives, and have one's patients making choices that undercut that effort. But it is not as simple as freedom of choice for a substance-abuser.

I just want Mr. Brizzolara to do better physically, and emotionally.

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SDaniels April 21, 2009 @ 12:38 a.m.

I would second your thoughtful sentiments, Mr. Blair, and though we're glad to see JB not out in the cold--the last time I posted here, it was a reality for him--the present digs seem a mighty cold and nightmarish place to be ill.

I am still youngish, but have spent over a decade dealing with a chronic condition requiring many hospitalizations, surgeries, and outpatient treatments. You could say I've had my fair share of experiences with doctors. My current doctor's bedside manner is still kind, but distracted, and the level of care has diminished in direct proportion to the growing weight of his caseload. I’ve had both good and bad experiences with nurses, in-hospital too, and find that one is treated far better as an outpatient, regardless of the health problem.

Frustrating stuff, but nothing compared to what JB reports.

My disease does not carry the kind of stigma alcoholism or any addiction apparently does, but I have noticed that when there is nothing to be done, some doctors become brusque--no doubt in part because it is frustrating for them, too. The saddest I've seen is in the ER, where stage-four alcoholics limp in on diabetic feet--and worse.

Addicts suffer terribly, as JB has attested time and again. Why add insult and threat to injury, whatever the etiology? Dr. W. sounds like he needs a refresher course in patient relations.

NotQuiteADiva presents the tautology:

"You blame him for his inadequacy, but perhaps you and your room mate present problems far beyond the training he has been provided."

I'll respond by rephrasing:

Lack of training is no excuse for lack of training.

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