I am outraged.
The patient Iโm seeing right now is Mr. Carpenter. He is in his late twenties, and he was shot in the spine while doingโฆ well, whatever got him sent to a maximum-security prison for life. It was bad, Iโm sure. I donโt want to know.
But none of that is my concern. What is my concern is that Mr. Carpenter is a paraplegic and uses a wheelchair. So heโs sitting on his bottom all day, and then heโs lying on a mattress at night that is paper-thin, and now he has a rather impressive sore on his coccyx that has not been addressed in God knows how long.
โWhat do you think, Brooke?โ Mr. Carpenter asks me. Heโs lying on the examining table on his side with his pants pulled down, waiting for my assessment. Unfortunately, I donโt have anything good to say.
โItโs a pressure wound,โ I say. โWe can put a dressing on it, but itโs never going to heal if you donโt keep pressure off of it.โ
โYeah, well, how am I supposed to do that? The cushion on my chair is halfway decent, but the mattress in my bed is terrible. Iโm basically lying directly on metal springs.โ
โSo you need a better mattress.โ
Mr. Carpenter snorts. โHow long have you worked here? Nobodyโs getting me a new mattress.โ
โThey have to get it for you if I prescribe it.โ โWhatever you sayโฆโ
Despite Mr. Carpenterโs skepticism, heโs going to get that mattress. Itโs medical neglect not to give a paraplegic a decent mattress with pressure relief. It might involve a stack of paperwork, but Iโm going to make it happen.
As soon as Iโm done with Mr. Carpenter, I confirm nobody is waiting to be seen and head down the hall to Dorothyโs office. Yes, she has anย officeย and I have a desk in my examining room. But I recognize she has seniority, so Iโm not going to say anything. Hopefully, I wonโt be working here long enough to get a desk.
I knock on the door to Dorothyโs office and wait to hear her say to come in. After what seems like five minutes, she calls for me to come inside. When I enter the office, sheโs sitting at her desk, a pair of half-moon glasses balanced on the bridge of her bulbous nose.
โIโm very busy, Brooke,โ she says.
โThis wonโt take long,โ I say. โI just need to find out how I can get a pressure relief mattress for Malcolm Carpenter.โ
She peers at me over the rim of her glasses. โAย pressure relief mattress?โ
She says it like I was speaking in an unfamiliar language. She knows very well what Iโm talking about. โHeโs a paraplegic, and heโs developed a pressure sore on his coccyx. He needs a decent mattress or it wonโt heal.โ
โBrooke,โ she says flatly, โthis is not the Ritz Carlton. We canโt get dream mattresses for all the inmates.โ
A muscle twitches under my eye. โIโm not asking for a luxury item.
This is medically indicated.โ โIโm afraid it isnโt.โ
โOf course it is!โ I burst out. โHe canโt move or feel the lower half of his body. The sore is just going to get worse if we donโt relieve pressure on it. Getting him a decent mattress is the least we can do.โ
โIโm afraid a new mattress just isnโt in the budget. Youโll have to come up with a more creative solution.โ She shakes her head. โDonโt you have any problem-solving skills?โ
I stare at her, too stunned to respond. The problem is that the man has a pressure ulcer. The simple solution is a decent mattress. What isย wrongย with this woman? Doesnโt she care about these prisoners at all? Theyโre human beings, after all.
The phone rings on Dorothyโs desk. She picks it up without saying another word to me. I stand there while she listens to the other person speaking. Finally, she says, โYes, Iโll send her right over.โ
Damn. She probably means me.
Sure enough, when Dorothy hangs up the phone, she raises her eyes to look at me over the rims of her glasses. โThere was an incident out on the yard. Officer Hunt is bringing one of the inmates over to see you for an injury.โ
Great.
My shoulders sag in defeat as I march back to my examining room/office. I havenโt given up though. Iโm going to figure out a way to get Mr. Carpenter that mattress if itโs the last thing I do. But first, I have to treat this guy who got injured in the yard.
I wonder how he got hurt. Was it a lock in a sock? Is that a real thing they do in prison?
Just as I reach my office, I catch sight of Officer Hunt coming down the hallway with one of the prisoners. It must be the guy who got injured in the yard. The inmate is wearing the standard prison khaki jumpsuit, and unlike most of the prisoners, both his wrists and his ankles are shackled, so heโs shuffling along slowly next to Hunt.
As he gets closer, I can see the bandage taped to his forehead, which is saturated with bright red blood. Whatever is under there, itโs almost certainly going to need stitches. Then my eyes drop to the prisonerโs face.
Oh. Oh no. No, no, noโฆ Itโs Shane.