Neal Little, MDBack to back encounters, almost. “So, how many steps did you fall down? “ “I don’t know.” “ Did you lose consciousness?” “I don’t know.” “Was anyone around?” “I don’t know.” “ How long have you been on donepezil, and mematine?” (No, of course I used the brand name- I can’t remember the generics- quick, what are these meds, without looking them up?)You get the picture. Trying to see how much of a workup the patient needs. Then, a key question- “Why were you going down the steps to the basement?” “To un-jam the shotgun shell in my hunting rifle!” “How were you getting to the field to hunt?” “Drive” ( the “you idiot”  was more of an unspoken part, but just as clear- it’s all in the inflection)

Or, while shouting into the squealing hearing aid so that EVERYONE in the rest of the ED can hear, except him, “So where were you going when you drove off the road?” “Right here.” “Where are you now?” “ Right here” Each answer it its own way somewhat correct- partial credit on those, but you get the picture.

And of course, nursing then says “ if you want to take their car keys away in the ER, then how are you planning to send them home?” “ What’s your daughter’s phone number?” “I, don’t….”

So, when people fill their prescriptions for these meds, should they have to turn in their car keys? But then, how will they get home from the pharmacy?