Coldicidal

"Coldicidal"* (adjective)--to falsely state that you are suicidal on a cold night in order to secure a warm bed in the ER and possibly an admission to the psych unit, where you will receive blankets and 3 square meals a day.

A middle-aged man walks into the ER gripping his chest and complaining of pain. That combination of moves immediately buys him a gurney.

The standard chest pain work-up is started--EKG, IV, labs, vital signs, chest x-ray.

The doctor enters the room and does a history and physical:

How long have you had chest pain for?

A couple of weeks, off and on.

Did you drink anything tonight?

I had a couple.

Okay. Did you do any drugs tonight?

No.

Have you used cocaine?

Yesterday.

Tell me about your living situation. Where are you living right now?

Nowhere.

Are you living on the street?

Yeah.

About an hour later all the tests come back normal. We're not going to do any exploring for blood clots or what not. All signs point to one thing. He is discharged "home."

You got a bus pass?

No, we don't give those here.

The other hospital gave me one.

Well we don't do that. You can call someone to come get you or you'll have to walk.

The obvious question is "why do you have money for cocaine but not for a bus pass?", but I bite my tongue.

He gets dressed and comes out to the nurses station, casually leaning on the counter.

Anybody here got change for the bus?

No sir, we don't give change here. You can go back and ask registration if they have it.

A minute later the phone rings.

Why did you send him back here to get change? We don't have money for him! He's asking for a dollar sixty.

We meant you could MAKE change, not give change.

Unsuccessful, he ends his short-lived conquest for money and exits to the waiting room.

All is quiet in the ER now. It's the middle of the night--just a few patients with tests pending--time to relax, break out the magazines and suck on popsicles stolen from the patient food stash in the break room, check email on Blackberries. The phone rings again. It's registration.

This patient you just discharged says he's suicidal.

There's a camera in the waiting room, and we can see him on the monitor pushing buttons on the vending machine. And even more interesting to note is that he has somehow found change for the vending machine.

Here is the precise point where his new diagnosis changes from "atypical chest pain" to "coldicidal":

1. It's 30 degrees outside.
2. He's homeless.
3. He's both hungry and suicidal.

Security proceeds to escort him through the exit door.

Better luck next time sir. By the way, this incident will be dictated into your permanent record, so you won't be getting any paper psych scrubs to wear anytime soon.


*Full acknowledgment and credit belongs to "Officer Frank the Tank" for coining his entirely original term "coldicidal." I promised I'd make him famous. Ha ha. Are you happy now? ;)