Every physician and every nurse in the country knows they type. Young, brash, frequently stoned, covered with gang tattoos and enough piercings to set off a metal detector at 20 paces. They show up in the ED with the same stories, the same injuries, the same attitudes. They have been stabbed, beaten, shot, or run over, and expect nothing short of an effort worthy of a Congressional medal to save their lives. Of course, we've all heard the same comments: "I got jumped by two dudes;" "I wasn't doing anything;" or, my personal favorite comment, "......" --- as in, "I ain't sayin' nothin', because I'm such a bad ass."
Of course, every physician and every nurse in the country knows otherwise --- the real bad asses are the cops tough enough to bring these jerks in, as well as the soldiers we are fortunate to have serve our country. My problem is that these frequent hospital clients get under my skin like botfly larvae and cause me heartburn worse than my teenagers. For years, I would just shut my mouth, take care of them, and send them on their way. But it always bothered me that while I could help with their physical problems, these young men were on a path to a place that no one ever dreams of ending up.
So, even though I'm sure I am rarely heard, I came up with The Speech™. This allows me to at least tell myself that I have given all of the medical warnings relevant to the situation. It goes something like this:
So, have you been in prison yet? No? Well, that's just great. Except that, given your present situation, with police officers in the emergency department than nurses on the night you decided to get my sorry butt out of bed at 2:57 AM, I would say that prison just might happen to be in your future. And, since I get the delightful opportunity to see young men just like you who are or have been in prison, let me introduce you to a few facts of your future life.Am I being judgmental? You bet your ass, and I'd say it's high time we all got a little judgmental with these guys. I know it falls on deaf ears. But, if it sinks in, then maybe I will have done something better than just patch them up and send them out the door.
Let's start with anal warts. What? Never heard of them? That's right, they sound pretty disgusting, and they are. And, no, they don't result from sitting on the john in a dirty cell. They are sexually transmitted ---- yeah, that's right, some other man is going to give them to you. Sort of a little gift, courtesy of yourself, that often results from prison rape. Let me tell you, when you do get out of prison, nothing says "Hey ladies, I'm back and I'm ready for a little action" like a few warts on your butt and your Johnson. And don't forget about the potential for a colostomy should you resist a little too hard and it gets rough.
How about Hepatitis C --- know anything about that? Well, the prison mambo is one way you'll get the opportunity to experience this little treasure. Cure? Uh-uh, sorry. And if you are planning on adding a few "prison tats" to that collection of ink on your skin, there's another little chance to roll the dice with your liver.
Oh, yeah, one more thing. I know how much you have enjoyed this little hospital visit for your stab wounds. Just remember, you are one wrong look, one mistaken word, one friendship with the wrong guy from being stabbed again...and again....and again.
I don't like having these little chats any more than you do. So, do me a favor. Cut the crap, get a job, and get a life, because right now, everything I have laid out for you is all you have to look forward to. And I don't want to see you here ever again.
Have a nice day.