Thursday, December 20, 2007

Phone Conversation: An Exercise in Boundaries

The phone rings at my desk.

"So," a voice says through the receiver. "Can I get my oxycodone prescription today?"

"Your oxycodone prescription?" I respond. "Is this __________ calling?"

"Yes, it's me. I need my prescription now! You've kept me waiting!"

"Now wait a second. You spent the whole weekend snorting heroin and I sent you to the ER in an ambulance because you were wandering your building naked and hearing voices," I say. "You also had a machete on the kitchen counter. I thought you were in danger. And now you want your oxycodone just like that?"

"Yes. I'm in pain and I need it and now you won't give it to me. Jesus Christ!"

"Listen." I try to be patient. "You were out of control this weekend. Even your son said so."

"But I was celebrating! Can't I celebrate like anyone else?"

"Well," I say. "You could have taken a friend out to a nice restaurant to celebrate. Or maybe gone to a movie and bought yourself something nice at the mall. Instead, you chose to go out on the street, buy some heroin, and then spent most of the weekend psychotic. How can we trust you with a bottle of oxycodone?"

"C'mon! I need my meds! You can't refuse to give me my meds!"

"Well, this is the story. I have decided that I will give the bottle of meds to your visiting nurse. She will keep the meds in the lock box and give you four pills every morning for you to take throughout the day. Then the next morning you'll get four more. That's the deal. Either you accept what I'm offering or you get no narcotics at all. No arguments. No bargains. Period."

"No, no, no. You can't do that. I need my fucking meds now!"

I sigh. "Look, _________. This is it. Take it or leave it. I have your prescription in my hand and I'm about to go find the doctor to have her sign it. I can just as easily shred the prescription and we'll talk after Christmas."

"OK. But I'd better get my meds!"

"I'll have the doctor sign your script now, as long as she agrees to my plan. But if you use any more heroin, take any street drugs, or do anything like that again, I guarantee you she'll stop writing those prescriptions right away."

"OK, OK," she grumbles.

"Merry Christmas, my dear."

"Yeah, yeah. Bye." She hangs up.

I hang up my phone and my colleagues applaud. An exercise in boundaries? Sure. And patience. And compassion. And insanity. Was I really on a leave of absence just five days ago? It seems like an eternity.
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