Robbie's Memories

              The end started about a year and a half before my actual retirement.   I had no idea this would be the beginning of the end.   We had what is euphemistically called a “drug diversion”.   Someone was stealing narcotics.   One of the nurses noticed that a new card of narcotics had been signed out of the locked narcotics cabinet for a patient who almost never took his pain medication.   We had a double record system.   All the back up supply cards of controlled drugs were kept in a locked cabinet.   When new cards of controlled medication came in (there were individual cards for each patient, usually containing 30 tabs in bubble packs), they were signed into the narcotics book and locked in the cabinet.   Signing narcotics in and out took two signatures, a nurse with another nurse as a witness.   When a patient needed to start a new card, the card was signed out of ...

              I opened my private practice: Internal Medicine and Family Practice, in a small town of about 1400 people in southern Delaware, in October 1980.   The first cases of homosexual men with pneumocystis pneumonia and severely depressed immune systems appeared in the medical literature in 1981.               In 1982, I attended an infectious disease conference in Steamboat Springs, Colorado.   They discussed what was being called “gay bowel syndrome”, a term that was used then to describe a group of peri-anal and rectal problems seen more commonly in homosexual men.   The term is no longer used.   I don’t remember those patients with pneumocystis being discussed (of course, I did cut the lecture one day – it was a ski conference – ski all day, lectures from 3 to 8 pm – realized one day that I hadn’t had dinner in 4 days ...

In my 9 th year at SCI, Correctional Medical Services took the contract back again.               I’m not sure many people realize this, but the only population in the US that is required to have medical care is the inmate population.   Litigation has been the only way to change things in this system, and, as a result of litigation, the courts have decreed: when you put someone behind bars and take away their ability to access medical care, you must provide that medical care.   It must be medical care to the acceptable community standard.   The punishment of incarceration is taking someone away from home, family, friends; bad medical care is not supposed to be part of the punishment.               Contracting prison medical care out to private companies is basically an attempt to protect the state from litigation.   If something g...