Maybe you are tired of hearing stories about drunks, but I am afraid any blog about emergency patients is going to be full of stories about drunks. We see so many drunks it takes a pretty amazing drunk to be remembered many years later. Here is a sad one I will never forget.
An elderly woman was found in her home, intoxicated, with a half-empty vodka bottle at her bedside. It was not clear who had called the paramedics. She had no complaints and said she was in no need of medical care. She had been verbally and physically abusive to the paramedics before she arrived. She had to be restrained in the emergency department to keep her from striking our staff.
She was very thin, half naked, intoxicated, disheveled and wet with urine. She was very uncooperative and refused examination and treatment. She demanded to be let out of the restraints. When I pointed out that she was too drunk to be trusted out of restraints, she adamantly denied being intoxicated, saying she was a Mormon and didn’t drink alcohol.
This was an interesting defense to use on me. Though she obviously had no way of knowing it, I am a practicing Mormon. This makes me very aware that most Mormons live by health standards that forbid the use of alcohol. Using Mormonism as a defense for her present situation might have worked on someone else but was clearly not going to work on me. Also, as an emergency physician, I am very familiar with signs of alcoholism and am very good at telling who is drunk. It was obvious to me that she was both an alcoholic and acutely intoxicated.
I then did what I usually do with such people: wait. I checked on her frequently, expecting that, with time, she would sober up, allowing me to be assured she had just been drunk and not in need of medical care for some other problem.
As she sobered, she admitted she had been drinking but she denied being drunk. Every time I tried to talk with her, she got upset and threatened to “cut (my) balls off.” She refused to call for anyone to come take her home.
It took all night for her to sober up. When she was ready to leave in the morning, she continued to refuse to call for a ride. She was provided with dry clothes and allowed to leave. As she was walking out, I couldn’t resist the temptation to say to her, “Have fun reading your Book of Mormon.”
She stopped, angrily spun around and flipped me off before turning on her heels and walking out.