by Robert Lanz LCSW
It was another one of those patients who can lead to nothing but problems- of course we didn’t know it when he came in, unconscious and possibly on his way to death. All the docs knew was that he was flat lining and they couldn’t figure out why. You’re never too young to have a heart attack but there is a curve and this guy was on the wrong end of it for that diagnosis. His pupils were round, equal and barely reactive so it probably wasn’t a brain swelling event. His lungs were clear but he was barely breathing so it probably wasn’t a pulmonary embolism. Narcan had no effect. Nothing we did seemed to be working and that meant I would need to contact the family. Normal stuff.
Normal stuff except for the business card I found in his wallet announcing he was a high ranking officer at a local corporation not too far from our own business district in downtown Los Angeles-and I won’t say any more than that because about twenty seconds after I found that out, hospital security called to tell me there was a woman in the waiting room asking about him. Must have been his wife I thought, noting his wedding ring. I was going to have to get her into the family room and get her ready for some bad news.
I peeked out into the ever crowded waiting area and didn’t see anyone that looked like she might be his wife. There was the usual number of patients and families, a couple of heavy drinkers, a couple of other regulars, a hooker and a couple of guys from a bicycle crash with their lycra and funny shoes setting them apart from the rest of the crowd. But no one looked like the wife. I caught the receptionist’s eye and she gave me a nod towards the hooker, or the one that looked like a hooker. Don’t want to be judgmental, yet.
Oh no. Not the hooker. Not the one with the skin tight dress and overflowing breasts, looking a little disheveled. Disheveled in the sense that it looked like maybe she threw on her clothes while someone had a heart attack and called 911 while she was doing it. Not a street hooker. A street hooker might have called 911 but she would have disappeared, not come to the ER to see how her client was doing. If this was a hooker, she was a high end one. This wasn’t getting any better.
I went back to see how the patient was doing before I talked to her. He was already dead. Young, married, dead for reasons unclear, a beautiful woman who everyone assumed was a hooker and she has no right to any medical information. And there I was, right in the middle.
So I called the cops. I was trying to keep the ER docs out of the upcoming drama. We were too busy and we didn’t need to grieve and we hate having to lie to anyone, even hookers. We needed to uncouple ourselves and the hospital from all the bad energy. We’re a community hospital from a good community and the businesses were very supportive of our mission. Very supportive.
Luckily one of my friends was the watch commander and all I had to say was, Joe, I need a cop down here with bars right now. Not a street cop. Not a cop with stripes. I need bars or stars. Joe understood. Every call to the police is on a recorded line and as problematic as an upstanding corporate guy dying in the arms of someone not his wife. No use complicating things by adding unnecessary evidence or circumstances that could be blabbed around. This dead guy had enough problems. he didn’t need all the bad things coming his way to be spread around the community. I guess in the Everything Else list, this too was going to take some creative social work because I wanted to separate us from the circumstances as best I could. The patient was young and dead and that would entail police and the coroner. He was also prominent in downtown LA and the less the hospital was involved the less the circumstances would be somehow attached to us.
Pretty soon I had a cop with bars, a captain, another friend who I could explain our position to openly. He got it. He also got his own room and his own phone number and his own liaison (me) and was far enough from the ER treatment area that we would not be part of the ensuing flow of cops and family.
Pretty soon I had the real wife show up and I have no idea how she found out. Pretty soon I had a corporate officer from the patient’s business show up who also wanted information. How the cops kept the woman the patient was with separated from the patient he was married to is still a mystery but the less I knew, the better I liked it. The corporate officer was in the loop as he apparently was friends with the wife. I didn’t see the woman I assumed was the hooker, or a close friend who dressed like one anyway, so I assumed the cops took her back to the station as a material witness to whatever had happened and that’s the cop’s job to figure out. We’re medical people and all we need to know for our legal documentation is what happened after he got to the ER.
Luckily my intervention worked just like I hoped it would.
An hour later the doc who had been trying to revive the patient asked me if the cops had ever showed up on his patient.
“Yeah, they did.” I said. “You guys were really busy and I didn’t want to bother you. Remember, this is a coroner’s case so keep it legal.”
“OK Bob. Thanks. What was the story anyway?”
“Not sure. I was really busy too and left it to the cops. They’ll leave it to the coroner.”
And for the most part, the ER was left out. Just like I planned.