Doctor’s Out
by
Marc J. Yacht
Time: Present
Cast: Dr. Sails 50 years of age
Mrs. Finklestein, 72 years of age
Nurse Diana Jenkins, 35 years of Age
Mrs. Swann, 25 years of age
Herb, 45 years of age
Fred, 45 years of age
Phil, 62 years of age
Dr. John Smyth, 35 years of age
(Doctor Sails is in his private office, he
sits behind a large desk with books behind
him and magazines and journals in disarray
on his desk. He wears a white coat; his
Stethoscope is on his desk. Panels separate three exam rooms SR of
Doctor’s office.
Curtains are drawn on each exam room. Stage
lights up. Nurse Diana Jenkins enters
SL.)
Dr. Sails: (looks
up) Is the next patient ready Diana?
Ns. Diana: (steps into office) Yes, but I better give you a heads up.
Dr. Sails: What’s
the problem?
Ns. Diana: She’s
got a sick baby with a high fever. I
could be wrong but you’ll probably
want to admit the infant to hospital.
Dr. Sails:
Sounds serious, anything
else?
Ns. Diana: No
insurance and black. That’s a sick baby,
Doc.
Dr. Sails:
The other rooms?
Ns. Diana:
Mrs. Finklestein in 2, the
usual complaints. Herb in 3, depressed,
with his little dog. Oh, and a drug rep
wants to see you.
Dr. Sails: A
dog, you shouldn’t let him in with a dog.
Ns. Diana: I
know, but the
Dr. Sails: The dog cried?
Ns. Dana: Whimpered.
Dr. Sails:
All right, all right, what
else?
Ns. Dana: The
hospital administrator called, he wants to bring the doctor over who wants to buy your practice.
Dr. Sails:
Not so loud, I don’t want the
patients to hear. (Doc crosses down
stage and across to 1st exam room with nurse, picks up chart, opens curtain
where mother rocks sick infant. Spotlight room 1, stage lights dim.)
Ms. Swann: My
baby’s awful sick doc, I think my babies goina’ die (weeps).
Dr. Sails:
(Doc gives comforting nod to mom but focuses on the chart. Now looks at
mom.) This baby is very sick. She has a 105º temperature and I can hear the
congestion from here. (Doc now places stethoscope on baby while
mom holds the infant). This baby is dehydrated and may have
pneumonia. Why didn’t you take her to
the emergency Room?
Ms. Swann: I
did, Doctor. They sent me away.
Dr. Sails: Who
sent you away?
Ms. Swann: The
lady at the desk, she said just to give her juice and a bath and she would be
fine, but she ain’t fine. She can’t hold
nothin’ down and she keeps getting hotter.
I put ice chips on her chest but that don’t do nothin’ and she ain’t
breathen too good. She goina’ die! (Mom rocks baby and hums.)
Dr. Sails:
The lady at the desk! What about the Doctor? (Doc
is agitated)
Ms. Swann:
I never saw no Doctor. The lady
at the desk asked about my health insurance.
I told her I don’t have none.
Then she asked me for $500.00 cash.
I told her that I didn’t have that neither. That’s when she told me that I should take
the baby home and give it some juice and it would be fine. That baby don’t hold nothin’ down, I knew
that weren’t no good.
Dr. Sails: Don’t
you have Medicaid?
Ms. Swann: I
work at Wal-Mart, I make too much to get Medicaid and Wal-Mart don’t offer no
insurance. My baby just kept getting’
sicker and my friend Mabel told me to come here. She says you was a carrin’ Doc. I don’t know where else to go.
Dr. Sails:
Diana, this baby needs to be
hydrated, start an IV with 250ml D5 ½ normal Saline. Give her a Tylenol rectal suppository and give
the baby 250mg of Penicillin IM. We’ll
watch her here. (Doc looks at Mom) Don’t
worry Mrs. Swann we’ll do all we can for your baby. That baby will be fine.
Ms.
Swann: I don’t get paid till next
week. Is that Okay?
Dr. Sails:
Pay me when you can. Anyway, stay here with your baby and Diana
will take good care of both of you. (Doc leaves room 1, shakes head, closes
curtain, crosses downstage to room 2,gets chart, opens curtain, Spotlight on
Room 2).
Dr. Sails: And
how are you Mrs. Finklestein?
Finklestein: Oye, Doctor such pain. I’m sure I should need surgery.
Dr. Sails: Where
do you have pain?
Finklestein: He vants’ to know where I have pain? If I knew, I vouldn’t’ be here. I vould’ be on an operating table. My pain starts in my toes and Doctor, even my
hair hurts. My blood pressure must be
through the roof. My head is pounding,
pounding, pounding. My stomach is
tvisting’, tvisting’, tvisting’. That I sit
here before you alive, is a miracle from God!
Dr. Sails: Is
your knee better, from your last visit?
Finklestein: Oye vey, the knee. (flexes
right knee.shakes head side to side)
It seems a little better, but it may be the same. All the other pain hides it.
Dr. Sails: (looks at chart and then to Mrs.
Finklestein) Your blood pressure is normal,
no temperature, and your pulse rate is normal.
(Doc listens to her heart and
chest.) Your lungs are clear and
heart fine. Your blood work is
good. Mrs. Finklestein, you’re healthy.
Finklestein: You curet’ me. You are a
very good Doctor, the best! You valk’
into the room and I feel perfect. Anyvay’,
I von’t’ need an operation?
Dr. Sails: Not
today.
Finklestein: I’m
glad to hear it. It’s my Bridge night.
If I went to the hospital, Zelda and the others vould’ never forgive me.
Dr. Sails: See
you in three months.
Finklestein: A
little birdy told me a story, but I said dat vas’ not possible.
Dr. Sails: What
was that?
Finklestein: I heard from someone, who I cannot mention, that you were
retiring, selling the practice.
Dr. Sails:
I am thinking about it. How could you know?
Finklestein: It’s true, vhat’ terrible news.
You’re young, my Abie worked until he was 70 and dropped dead in the
factory, fixing a sewing machine. He
vouldn’t’ vant’ it different. Ve’ put
the machine next to him, in the coffin, so he should still be able to fix
it. It vas’ a Singer.
Dr. Sails: It
won’t be for a while, but I’ll be taking a job in Public Health. I’ve wanted to do that for a long time.
Finklestein: (shakes head back and
forth, squints eyes, and puckers her mouth) Very high falootin,’ A big shot
Doctor in public health. And vhat’ will
happen to us?
Dr. Sails: You’ll
be fine. I’m seeing a Doctor today who
may be taking the practice. He’s
younger, better educated and much smarter than I am.
Finklestein: Aye, but does he care? You,
I can talk too, you understand. Will he
understand, Doctor?
Dr.
Sails: (Doc hesitates and looks at Mrs. F., then
smiles) He’ll be terrific, you’ll
see. I’ll see you in three months. (He leaves Mrs. F. and closes curtain, puts
chart back and goes to room 3, opens curtain, Spotlight.) And how are you Herb? (Doc
pets tiny dog)
Herb: Do
you see this, do you see this pimple? (Herb
points to his chest which he bares for the Doctor) It’s AIDS isn’t it? Tell me the
truth!
Dr. Sails:
Why do you think you have
AIDS? Did you have a blood transfusion?
Herb: Never
in my life!
Dr. Sails: Are
you injecting illegal drugs?
Herb: Are
you crazy, you know me for 10 years.
Such a question!
Dr. Sails: Are
you a homosexual?
Herb: What? My mother would turn over in her grave, rest
her soul. Of course not!
Dr.
Sails: Then, why do you think you have AIDS?
Herb: I
hear so much about it, and people where I work may have it.
Dr. Sails:
You don’t catch AIDS by
hearing about it. People at work are no
risk to you if they have AIDS or are HIV positive. Herb, you don’t have AIDS, but if you want
I’ll have a test done for you.
Herb: Please
Doctor, I’m worried sick. I haven’t
slept for a week. A test would make me
feel better.
Dr. Sails: Wait
here, Diana is busy right now but will come in and draw some blood. The test results will take about 10
days. (Doc writes some things on the chart and places it back in the rack,
leaves room three and closes curtain. He goes back to his office stage lights
up. All exam room curtains are drawn. Diana
enters Docs office. )
Diana: The
baby has cooled down a bit but is very congested. You know, she has to go to hospital.
Doc: (Doc scribbles a note and gives it to
Dana.) Give this to the mother for admission to hospital. They won’t dare turn her down with this. Tell her to call, if she has any
problems. Admissions will know to call
me for orders when they’re settled in.
Have the drug rep come back, and do an HIV test on Herb. This week, he thinks he has AIDS.
Diana: Right.
(Diana
exits, lights out, lights up on Docs office only. The drug representative stands in front of
Doc. He is wearing a loud Sports coat
and has a very large pill in his hand.)
Phil: (jovial and bombastic) It’s good to see you Doc. Look at our latest product. (shoves pill in front of Doc’s nose.)
Dr. Sails: Phil,
you’re nuts, nobody’s going to take that pill.
A patient would have to eat it, with a knife and fork. (Doc leans back in his chair and rolls eyes
upward)
Phil: I
tell you this is the pill of the future.
It’s glycerine coated, easy to swallow, and one pill with sustained
release gives a full 10 day course of antibiotics. Right now it’s available in erythromycin and tetracycline.
(Phil holds pill up for Doc to get a
better look.)
Dr. Sails: Phil,
a horse couldn’t take that pill. No
doctor in his right mind would prescribe it.
Who came up with this?
Phil: R&
D, there all excited about it. Compliance,
it’s all about patient compliance. No
body takes their full course of antibiotics. (Phil points to large pill he holds toward doc) One pill, 10 days of treatment.
There’s your patient compliance.
Dr. Sails: Good
luck with that one. Frankly, you’ve been
at this a long time. You were sick back
in January, I remember.
Phil: A
heart attack. I’ll be retiring in a few
months. This business is not what it
used to be. Many of the reps are gone. Generics have killed us. You know it takes millions to bring a drug to
market and the profit isn’t there. Then
there’s the government regulation. This
job’s no fun anymore.
Dr. Sails: I
know that problem. You know Phil, a lot
of antibiotics don’t work and I don’t see too much in the pipeline.
Phil: Everything
new is for chronic disease and pain, except for the Power Pill (Phil points to pill). There’s no money in antibiotics or
vaccines. You develop a drug and if
government regulation doesn’t kill profits, liability will. With antibiotics, by the time the drug gets to
market the bugs are resistant to it. If
that’s not bad enough, someone knocks it off as a generic at 20 cents on the
dollar. Look at the pharmacy stocks -
that will tell you what’s going on.
Dr. Sails: Hospital stocks too. Everybody wants service and nobody wants to
pay or can’t pay. It’s a mess. (Diana
enters)
Diana: Fred
Ward, the Hospital Administrator is here, with a physician.
Dr. Sails:
Send them back. Phil, take care of yourself. Good luck with that pill.
Phil: You
take care, Doc. I’ll leave some samples
up front. (Phil exits)
Dr. Sails:
Hi Fred. (Fred Ward Enters with Doctor Smyth)
Fred: This
is Dr. John Smyth. (they all shake hands).
Dr. Sails:
Before we get started, I sent
a black lady and her very sick baby to admissions. Her name is Swann. Make sure she gets in, please.
Fred: No
insurance, right?
Dr. Sails: What
can I say?
Fred: Only
for you, Doc, only for you. Do your best
to get some to me that can pay.
Dr. Sails: Promise.
Dr. Smyth: This
is a very nice office. I see the
potential for an extended hour’s clinic.
Yes we could open it 12 hours a day, 7 days a week. You’ll get the hospitalizations Fred. Yes, we could make good money here.
Dr. Sails: I
would want my staff protected. Diana is
a great nurse and nobody is better at billing and the front desk than Jan.
Fred: That
shouldn’t be a problem. With extended
hours they could make more money.
Dr. Smyth: I
could bring some part time Docs in here, do some marketing, this place has real
possibilities.
Fred: Please,
insured only, and work with us on our HMO contracts.
Dr. Smyth: I’ll
work with you but I’ll need some help from the hospital.
Fred: We’ll
work it out. But only paying patients go
to my hospital. Indigents go to
Dr.
Smyth: Indigents? Not here, not when I run it.
Dr. Sails: (very forlorne, looking down at his desk,
looks up to the two men.) I don’t
get it, don’t you two care about people.
I’ve never refused a patient in this office. I’ve done well. I’ll admit, its getting a bit harder with the
HMOs and Liability costs. Tell me Dr.
Smyth, why did you become a doctor? Was
it to care for people or make money?
Dr. Smyth: (looking uncomfortable)
Look Sails, it’s a different world out there. My father used to go to people’s homes. He set fractures, delivered babies and sat up
all night with sick kids. Five years ago
he had a heart attack and died. I am
convinced it was a lawsuit that killed him.
He took care of a family for 3 generations and got sued because the
daughter had a limp after a car wreck.
She was drunk. Another Doctor testified
against him. That patient never paid him
and claimed loss of consortium; she wasn’t even married, and a loss of her
career as a cheerleader. She got 1
million. Don’t lecture me about the
great unwashed. I worked hard to develop
my skills and I’ll provide them to people who can pay. There’re
government clinics to take care of the poor.
Dr.
Sails: I’m sorry about your
father and maybe things are tough for us these days. However, we took an oath, and it wasn’t to
get rich, it was to heal. If we forget
that, what have we become?
Fred: This
is getting to heavy for me. I need to
get back and get your non-paying patient in.
You two can solve what’s wrong with medicine but I have to work. Dr. Sails, can you get Dr. Smyth back to the
hospital?
Dr. Sails: Sure
Fred. I’m sure this will work out. But I need to know my patients will get a
caring physician.
Dr. Smyth: Maybe
we got off to a bad start. You’re
patients will get good care here. I
promise, no one with a chart in this office will be refused. Your staff will be
protected, as long as they do their job.
You have my word on that.
Dr. Sails: It’s
a different kind of medicine isn’t it John?
Dr. Smyth: When
all is said and done, it’s a business Sails, just a business. (stage lights out, curtain.)
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