More of the same?

As I mentioned in "Getting Started," the hiring office manager at The Company seemed completely non-plussed by my past. Their history of hiring addicts perhaps explains this. What is surprising is that they were so accepting of this particular foible when I was, in fact, replacing a drunk. And he was not a particularly well-hidden drunk. The doc who preceded me was a come to work drunk sort of drunk. He was a "that's not booze you are smelling, that's my cologne" type of drunk. He was big and loud and funny and charming, and could bluster his way through most obstacles. After a company party he was falling-down-loaded and had to be scooped into a car and sent home. At some point, someone had to have started complaining about him because the powers that be decided that he needed watching, so they began asking for his medical assistant, who was to become my medical assistant, to start reporting back on any suspect behavior in the field. I guess he had a lot to report on. Here are just a couple of the episodes he recounted to me: my predecessor (I'll call him Tyler) once, in a fit of anger, tossed a patient chart onto a porch roof then had to ask for a broom to knock it off. Tyler once made a housecall to a family member of a patient's homemaker from Catholic Charities. When he encountered a number of young men in the home, he at first became visibly nervous then started expounding on how the young men had to keep control of all their "little soldiers," apparently meaning their sperm. The man who told me this story made sure to tell me that he suspected that Tyler had a drinking problem. During my first few months, at least ten people--a security guards at a CHA high rise, patients, family members--after asking why Tyler left, went on to answer their own question by saying that they bet it was because he drank. There is a great lesson here. No matter how well we think we are keeping our dirty little secrets, almost invariably someone knows. It is only our own denial that allows us to continue on with impunity. But getting back to my original point, given all the havoc this man caused, it says a lot that The Company was willing to replace him with another alcoholic.

I could speculate that The Company differentiated between a drunk bolstered and solid in recovery and one who is still out there, and having knowledge and confidence in the power of 12 step work, knew that I was a much safer bet than Tyler. This would be the charitable view and I wish that I could assume it were true, but all of the evidence points elsewhere. They put up with Tyler's behavior for months before addressing it. And they did not address it by performing an intervention or referring him into treatment. They advertise until they are able to fill his post, then as soon as they have me, they push him out. In fact, on my first day of work Tyler also shows up because no one has yet bothered to tell him that he has been replaced. If they had told him before I made an appearance, they would have run the risk that I change my mind, leaving them with unseen patients and that many fewer billable visits. As I was walking out to the company car, I saw Tyler walking toward the building. The office manager who hired me, a rather imposing guy himself, intercepted Tyler and walked him away from me and around the block. Then I guess he gave him the axe, because I didn't see him again, at least not anywhere near The Company. I took over all of his patients, none of whom had been warned that he was leaving, of course. One month he was there, the next he wasn't. Though this was probably nothing new. Looking back through some of the charts, among the patients who had been using The Company for a while, Tyler was only one in a line of docs who came for a few months, to perhaps a year, year and a half, then were replaced.

So the transition was abrupt. All the more so because I hadn't made a housecall since my rather progressive residency days, and then only a few. Luckily, the medical assistant, I'll call him Lenny, knew all of the patients. He helped break the ice and provided a touch of familiarity to what would have otherwise been a very awkward meeting. More on that in the next entry.