Nursing home sends the standard "altered but more altered than usual" via EMS at 3 AM. Yeah, okay. I do a quick head to toe and find that yes, the patient is still altered. I'm trying to decipher the paperwork these fools sent over when I realize the name is someone I recognize- she was a former street person who would occasionally find her way to our ER, usually agitated due to some combination of crack and mental illness. Both had clearly taken their toll-she looked about 20 years older than her actual age and was basically obtunded. Pretty depressing stuff, really.
I'm going about my business when the patient's sister calls to check up on her. I talk to her for a while about what she was normally like and she gave me a brief history of what had happened over the last few years and how she had declined after an inpatient psych stay. At some point it came up that I remembered her from her previous visits, which somehow seemed to comfort her. She was obviously a pretty nice lady. "I'm glad you remember her. Yeah, she was on drugs there for a while." "I remember", I tell her. "She was doing crack then, wasn't she?" "Uh huh. That was her." She paused for a while after that and then chuckled a little bit. "You know, the funny thing is, she was good and strong when she was smoking that crack rock! She just started going bad when she quit!" I laughed a little bit without thinking, but by this point she was laughing hysterically. "I'm sorry", I told her, after I'd regained my composure. "No, that's okay", she said, still stifling laughter or tears, I couldn't tell over the phone. "That's just how things worked out. Will you call me when you guys know something though? I know I'll be up all night worried about her."
Sure enough, she was wide awake when I called her back a few hours later to tell her all the tests we'd run were negative. It makes me feel a little bit better that we aren't the only ones who do this kind of thing.