Generation that gave all and the generation that takes all

I met an older gentleman in clinic today. He was hunched over and walked with a cane. You could tell that he was in pain. Even though, he helped another gentleman into the exam room and held his coat. I looked at his chart, he was not on any pain mediations, only a daily aspirin. He put down that he takes an occaisional motrin for back pain. He was blind in one eye and had partial paralysis of his left arm. Talking with him, he has a farm and has worked there all his life. He apologized because he felt he was late for his appointment. One of his cows was having a calf and he had to help pull it out. With all his problems he was not on disability. I apologized to him because I was late. It turns out that he lived on the farm all his life except for the years in the Army and in the Japanese POW camp. The paralysis and the limp was from the shrapnel that is still in his spine. He lost his eye when he was tortured.

When I left his room, I went to the next. There was a 30ish year old woman on full Social Security Disablility for "chronic fatigue syndrome, fibromyalgia and interstitial cystitis". She was on Oxycontin, Lortab, Xanax and Adderall. At least that is what she put on her new patient intake. She did not have a referring doctor which is always a tip off that she is making stuff up because they dont want to have us check up on their records. The disability was real though. She had the magic money card. We got lucky though, she had some xrays at the hospital and we can access their file system. She had been doctor shopping to generate the paper trail to get her disability and then jumping to try to get each doc to refil her fake "home medications". I was in the room no more than 30 seconds when it came "I wont see my family doctor for several months, he is such a bad doctor, can you call in or give me refills for my home medications." I quitely explain that it is bad medicine to have multiple doctors writing for multiple prescriptions but I would be happy to call her doctor to see what can be arranged. I got the standard answer "My doctor is so bad, I am not going to go to him anymore, could you please refill my mediations?" The game goes on. "Do you have your prescription bottles with you?" "No, I left them at home." "What pharmacy do you use? We can call them?" "I dont remember." Now that this had wasted about 10 minutes, we get to the reason that she is there. She had been to the ER in the middle of the night complaining of severe pain and I was the lucky sod on call with whom they had set her up to follow up with. She did not like the diagnosis of musculofascial pain and the offer of motrin and demanded that I give her dilaudid for this pain that she did not have when she went in the room and all the questions about her home medications. On her way down the hall she literally walked into the first patient who could not get out of her way fast enough. She called him an "a--hole" and yelled "watch the F+++ where you are going, cripple!" even though she was the one who walked into him. Once she was out of the office she got in her car that was parked in one of the handicapped spaces and sped off. We helped our fist patient back to his feet and asked if there was anything we could do. "He said, I've seen worse." When he left we saw that he was parked about as far away from the office as ou could get. He held the door for several patients coming in as he was on the way out. There was a Corvette in the handicapped space and I saw a young kid hop out.