ALLERGIC TO INCARCERATION

The uniformed and armed guards walked on either side of the patient. The patient, a felon, was handcuffed and ankle shackled. He had long white hair past his shoulders and a dramatically weathered face, wrinkled and mapped by the sun. The paperwork said chief complaint: Body rash, no improvement despite 4 days of Benadryl and Prednisone.

The ER physician was a sharp young guy not soured by burnout or tainted by the older Docs cynicism (yet). Refreshing actually. He came with me into the room, the guards removed a handcuff and the patient peeled off his shirt.

Now any ER nurse will tell you, even the ones with 12 years of Catholic school... you "gots to admire the prison body". You know the one. Nothing else to do for 12yrs but lift weights and do
sit-ups. The Doc and I met eyes. It's a special ER glance. No facial expression. It means "get a load of this". Used in a multitude of situations involving patient assessments.

The Doc asked the typical questions including "Has this ever happened before"? Sometimes the answers catch you off guard, sometimes in a funny way. The prisoner answered "Yep it happened two other times but they were at different penitentiaries. Obviously I didn't have that filter on....the one my father told me should be between my brain and my mouth. Because
I burst out laughing and said "Ha...your allergic to incarceration"! If looks could kill...maybe I should say that differently. The prisoner shot a glare at me, the Doc looked at his shoes.

Continuing with the assessment the Doc asks "and how long have you been this facility"? The prisoner answers "16 years and a lot more to go". I guess the Doc didn't have his filter on either because it rolls right off his tongue "Jeez, what did you do"? The prisoner gave us a serious "you've got to be kidding" look and answered "I guess enough".

Now the game was on. I was given the assignment..find out what he did. I tried to be slick and pass it on to the summer ER tech. He said "No way! I'm not getting killed, I have to finish college". Come on. I pushed. Practice your H&P skills. It may help you some day. He was quick to point out "Being dead is not going to help me some day".

While starting the IV a registration clerk came in to verify information. He gave her his birth date. I was stunned. As old and beaten as he looked, I was 3 yrs older. Again, no filter. I said "Wow, your younger than me! Catching myself I scrambled with "but I mean that in a good way. You've been outside a lot" It didn't fly. The guards were now howling and the prisoner was just shaking his head but he had a little smirk on his face.

The IV meds brought him relief. He was re-shackled and escorted out. But before he left he stopped, turned around and said "You have a nice day mam and thank you kindly. Please thank the physician for me". We never did get the answer.