SAFE Opioid Prescribing: Strategies. Assessment. Fundamentals. Education
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The Start of Something New by Thomas Das
As Mr. Rochelle fumbled with his new smartphone, he couldn’t help but feel out-of-sorts. He had been a hold-out, and a stubbornly proud one at that. For the past twenty years, his life had been a model of consistency: same family doctor watching his blood pressure; same 7:00am Sunday tee-time with his old college buddies; same mustard and pastrami sandwich for lunch. The only thing in his life that seemed to change with any regularity was the Rangers’ pitching staff, and that was stressful enough. Now, it seemed as if this phone would be another unwanted change.
“See, Sir,” said the salesman. “You don’t even have to punch in someone’s number to call them – you can just touch their name!”
“Humph,” muttered Mr. Rochelle under his breath. “I guess that might be useful.” Mr. Rochelle handed the phone back to the salesman, and unfolded a sheet of notebook paper from his pocket. “Can you get these numbers in there for me? That’s what this thing is good for, right?”
The first name was an old one, scribbled in messy handwriting. Jack Slidell, Doctor. He had met Dr. Slidell after moving to the city for work. He was much younger then, thought Mr. Rochelle, though he definitely had his head on straight. On their first meeting they talked about his hypertension, his medications, and his diet (he never did care much for that pastrami sandwich habit). They had even talked a little bit about baseball; Dr. Slidell had played college ball, and still had the calluses to prove it. They’d been meeting every few months since then, adjusting his meds and watching his vitals for any changes. In fact, he had just started him on some new pill. “Call me if you’re ever worried about anything - side effects, new symptoms, anything” the doctor would say. “Remember, we’re a team in this.” Mr. Rochelle watched as the salesman typed the name into his phone – Jack Slidell, Doctor.
Four hours later, Mr. Rochelle found himself clumsily thumbing through those names, his other hand holding his suddenly puffy face. His finger finally found what it was looking for, and pressed the name.
“Hello, you’ve reached the cellphone of Dr. Jack Slidell. I can’t take your call rig-”
Mr. Rochelle winced as he hung up. It’s still early, thought Mr. Rochelle. I can drive by and see if he’s in today. By the time he had driven to clinic and reached the receptionist, the swelling had started to engorge his lips.
“You’re lucky, sir - we’ve had a few cancellations, and can see you right now. Next time I’d start at the ER”. Mr. Rochelle nodded; before he knew it he was sitting on an exam table, answering a knock at the door.
“Hello, Mr. Rochelle. I’m Jackie, a Nurse Practitioner; I work with Dr. Slidell. How are you feeling?”
Mr. Rochelle cocked his head, momentarily distracted from the swelling. He caught a glance of the name on her white coat – Jackie O’Donnell, MSN. Hmm. MSN… wonder what that means. She offered him a reassuring smile.
“Good,” he stammered past his lips. “I mean, not so good - look at me! Dr. Slidell has been seeing me for a while, watching the blood pressure, you know? We just started some new drug that’s supposed to help. Do you know when he’ll be back?”
“He’s away at a conference this week, I’m afraid,” said the woman with a smile. “We do work very closely together though. As a matter of fact, I was just reading through his notes in your chart before coming in here. If you’d like, you and I could talk about what’s been going on.”
Mr. Rochelle sighed. Better this than try and work that phone again, he thought. “Well, you see, Doc, it’s like this…”
With a grunt of exasperation, Mr. Rochelle sat back up on the table, his story and exam complete.
“So what are you thinking, Jackie? Anything to worry ‘bout?”
“I’m thinking that I’m glad you came in, Mr. Rochelle. This angioedema is exactly what Dr. Slidell was watching for with that new medicine, but thankfully we’ve caught it early. Now that we know how your body reacts, we’ll be able to give you something to help with the swelling, adjust your blood pressure meds, and have you follow-up in a week. I’ll call Dr. Slidell and run through the plan with him – after that, I’ll put the order in to the pharmacy. Just in case, here’s my pager number; let me know if you have any trouble.”
She scribbled a few digits and handed them to Mr. Rochelle, along with some pills. He slid the paper into his front breast pocket and swallowed the pills. The swelling started to fade by the time he got back to his car.
As he pulled into his driveway, Mr. Rochelle heard his phone buzzing. “Mr. Rochelle! This is Dr. Slidell. I’m sorry I missed your call, I just got out of a meeting. How are you doing? I just heard back from Jackie.”
“Hi, Doc. Yeah, I’m feeling alright, just a little spooked earlier. Jackie got it all taken care of. I’ll tell you all about it next week”
“Can’t wait to hear all about it. Call me if anything changes before then. Glad to hear Jackie got to see you today though; remember, we’re a team in this.”
“You got it, Doc. Hey, did you hear about that new prospect that they’re gonna call up this season? Supposed to be a real hotshot; I heard he can throw 103.”
“I’ll believe it when I see it”
Mr. Rochelle laughed and said his goodbyes. As he finished the call, he pulled the paper with Jackie’s pager number and punched the name into his phone. Jackie O’Donnell. He put the phone back in his pocket and started to chuckle. New phone, new docs, new pitchers. What a life!
Thomas Das is a TXACP Medical Student at UT Southwestern.
Texas Chapter Annual Scientific Meeting
November 17-18, 2018, JW Marriott Austin
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