THE SECRET HOLLYWOOD ELITE

According to Dr. White, he’s “seen just about everything.”  Despite his peppered hair and ever crinkly smile lines, he doesn’t look as old as he suggests.  Dr. White is also inextricably woven into the hospital’s politics, which is a good thing considering he’s a founding member of our little group of reservoir docs.  

Anyways, I happened to walk in on him talking about his early days back in California.  Apparently the hospital where he trained at was a popular one with the Hollywood elite.  Actors, models, VIPs, would be checked in under false names.  Paparazzi would sneak in wearing doctor’s coats (and would be subsequently arrested).  The names he mentioned were of an age long gone – Sammy Davis Jr., Liza Minelli, Bronson, Eastwood and many others I forgot.

When he finished residency, Dr. White was offered a job in an elite circle of “doctors of the stars.”  These docs would make housecalls at any moment for their well-compensating but unwell patients.  If they were in the office and “got the call,” they’d have the secretary “cancel all my appointments for the next two hours.” 

Dr. White declined the lucrative offer.  Hollywood VIPs are often difficult patients – fussy, petty, and dramatic by definition.  When the docs in the circle got together, they’d drop famous names like comparing trading cards, Dr. White chuckled.  “Well, I’ll top your daytime drama star with a supermodel and a two-time Academy Award nominee!”

“… It just seemed kind of dirty,” Dr. White explained the choice of his lifetime with a timeless smirk a couple of decades far from innocence.

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(These pictures have nothing to do with these entries.)

THE THREE REASONS

One morning, not unlike many others, I walked into our cramped hospitalist office to print my day’s list of patients.  The pepper-haired Dr. White happened to be talking to the overnight house physician who informed us,

“One of your patients expired last night. Mr. Whats-his-name, yours,” he pointed to me.

Expired.  That’s how we say “died” in the charts.  It’s less emotional, less laden with loss of life, dreams, and soul.  Sounds more like the end of a club membership.  Club Life, in this instance.

“Oh.  Thanks. I don’t think the family was expecting it this soon,” I answered with unease.  I thought my list looked a little lighter today.  Now I knew why.  

“Did the family come in?”

“Yep.  No autopsy.”

“Were they … mad?” I asked.

“I don’t think so.”

Dr. White interjected, “That reminds me.  We have sympathy cards and envelopes in this drawer for bereaving families.  … Or if a patient died unexpectedly and the family might be upset.”

“Upset” is only a phone call away from “lawsuit.”

It’s been said that man is ruled by the laws of God, the laws of man, and the laws of nature.

In today’s litigious world of medicine, there are always three reasons for anything you do as well.

You want to make the patient get better.

You want to make the patient happy.

You don’t want the patient (or family) to sue you.

These three motivations often have the same result, although occasionally one may conflict with another.  You can be an idealistic savior, a charming pushover, or a legalistic paranoiac, and you’re patient can still get good care.  At any given time, this troika can be involved in your daily decisions as a physician.  Sometimes you order a certain test with low yield so that some plaintiff’s doc-for-hire won’t accuse you of being “less than throrough” in some nightmarish alterna-future (or the front page of next week’s Medicolegal newsletter).  Oftentimes you weigh a patient’s quality of life and happiness against the benefit or risk of another inconvenient drug or test.  On the other hand, sometimes you summon a completely pointless consultation or scan just to placate the family, because a dissatisfied family once again, is a litigious family.

It’s a different world now.  Marcus Welby, M.D., would likely be disbarred and have to register as a sex offender just for doing breast exams the old school way – without a female nurse present, and in all these “suspect” positions that even I was taught in medschool.

“The family was nice enough,” I confess, “But I don’t know how they’ll feel about this. We weren’t expecting him to die this fast.  At least they weren’t.”

“I’ve even got sympathy cards made out for patients who haven’t died yet,” Dr. Blonde added his two pence of dark humour.  The funny thing with Dr. Blonde is, he's never just joking. 

“Sometimes a phone call is better,” Dr. White added.

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AMY LIKES PRISON SHOWS

AMY:  "You know when that big guy unzipped his pants in front of Al Pacino in that movie (Two For The Money)?"

ME:  "Yeah...."

AMY:  "I thought he was going to make him suck his dick."

ME:  "Haha!  Yeah, me too."

AMY:  "We've been watching too much of Oz."