Authors: J.M. Redmann
“Two patients have dropped out of care,” Lydia started.
Ron cut in. “First things first. Everything said in this room must be confidential.”
“Of course,” I said. “That’s standard procedure.”
“And I mean everything,” he emphasized. “This is sensitive information.”
He was pushing a little too hard. “Everything is confidential. Even private eyes have a code of ethics. I won’t cover up criminal activity, but if you’re cheating on your wife, I won’t be the one to tell her.”
They looked at each other for a moment, Lydia said, “Look, we didn’t do anything criminal.”
“Argue that in front of a jury,” Ron said sourly.
“Oh, good Lord,” Lydia said. “That’s not going to happen.”
“No, probably not, but all the more reason for us to do the right thing,” Brandon said. Again, the glance around the table as if making a decision.
I let the silence stretch out.
Brandon spoke. “We were all part of other practices that fell apart after Katrina, so we’ve only recently started all working together and in a new space.”
“Cut to the chase,” Ron interrupted. “I have patients to see.”
“We had to have some work done, a pipe burst, and we canceled a number of patients. We left messages saying we’d contact them to reschedule. Most people did. But we had a change of receptionists during this period—”
“Missing oxycodone,” Lydia put in.
“So two patients we really needed to keep in care got lost,” Brandon said.
“They have medical issues that need follow-up,” Cordelia added.
“And you’re concerned that they might sue you if you don’t go out of your way to fix the scheduling snafu,” I summed up.
“Our first concern is they need to be in medical care,” Lydia said. “But avoiding a malpractice charge isn’t bad either.”
“That’s not going to happen. We’re not committing malpractice here,” Brandon said firmly.
“What attempts have you made to contact them?” I asked.
“Phone calls and e-mail,” Brandon said.
“That’s it?”
“Three phone calls with messages, a reminder postcard, several e-mails, the last one which asked that they let us know if they’re in care elsewhere,” Lydia said. “That was a week ago. No word.”
“So about six or seven attempts,” Brandon defended. “I know it might not sound like much, but we have a patient list of several thousand people. And like I said, we’re still struggling to get everything in place.”
I nodded. For their resources, these were probably reasonable attempts. “No one has gone to their house or attempted to physically track them down?” I asked. “Any idea if the e-mail addresses are still valid?”
Brandon shook his head sadly as if guilty. “No, I don’t guess we even thought to do that.”
“It’s not like we can hunt patients down,” Ron answered. “Lord knows we have enough to do as it is.”
“Yeah, Ron, you’re so overworked,” Lydia said.
“I pull my weight,” he retorted.
“And leave every day by five, unlike me and Brandon.”
“I’m here every day by six thirty a.m.,” Ron said.
“Let’s focus on these patients,” Brandon said. “What can we do?”
“What outcome are you looking for?” I asked.
“To locate them, make sure they understand they need to be under medical care and that if they don’t want to come to us, they are at least going somewhere,” he said.
“Or if they’re not in care, that they have been informed that they should be, so whatever happens is on them,” Ron added.
“Okay, so someone needs to locate them and actually talk to them or somehow communicate in a way that gets a response,” I said, trying not to get annoyed with Ron.
“That’s pretty much it,” Lydia agreed.
“Can you do that?” Brandon asked as if this might be difficult.
“Probably. It’s possible that for some reason they don’t want to be found; that makes it harder. It might also depend on how much information you’ll let me have.”
Again they looked at each other.
Cordelia spoke, “Micky can sign a HIPAA compliance form and confidentiality statement. Finding them might be part of their medical care.”
“I don’t want to set a precedent here,” Ron said. “Micky is just doing a favor for her girlfriend, we’re not hiring her and this is a one-time thing. We can’t chase every patient who misses an appointment.”
“I’m doing a favor for my partner,” I answered, wondering if he’d notice my correcting him.
That seemed to satisfy them, as this time they nodded.
“Good thing I have the forms with me,” Lydia said, sliding several sheets of paper in my direction.
Cordelia took a pen out of her pocket and handed it to me.
“Should I read these things or can I trust that I’m not signing away a kidney?”
“You can sign safely.”
“Can I go now?” Ron inquired.
Both Brandon and Lydia waved him away. He left without pushing his seat back in.
“Lydia, do you have the files?” Brandon asked. “They’re both Tamara’s patients, right?”
“If you know me, you know I have the files. I think they’re hers.”
“I hate to run, but I’ve got patients waiting. Do you need me for anything else?” he asked.
“We’re good,” she assured him.
So the men left the women to finish up
, I thought. Although to be fair, maybe it was just they had people waiting and Lydia and Cordelia didn’t.
Lydia produced two folders from the pile of paper she’d brought with her. I wondered if she traveled with that huge stack all the time or just brought it to this meeting to make an impressive show.
She opened one, placing it between us. “Reginald Banks. He’s twenty-four and has sickle cell anemia. It’s gotten bad for him and he’s on medication. The problem with that is the meds have some pretty serious side effects, including increasing the possibility of infections. He came in last time with a bacterial illness. We gave him antibiotics and made an appointment for a week later for follow-up, and to come in sooner if he didn’t get better. That was about six weeks ago, and that was the last we saw of him.” She left his file in front of me and opened the second file folder.
“The second patient is Eugenia Hopkins, thirty-six, formerly Eugene, but transitioning. She’s infected with HIV, was struggling with side effects of the treatment and then tested positive for TB. We started her on TB meds, again an appointment a week later and it got lost in the shuffle. Again, six weeks ago.”
I appreciated that Lydia used layman’s terms; I don’t think Cordelia could have explained it as clearly, and she usually remembers not everyone has had a medical school education.
“Can you make me copies of all the contact info?” I pointed to one of the sheets I wanted. “Don’t worry, I’ll keep it as confidential as you do and shred it once it’s served my purpose.”
“We can sic the DIS on Eugenia, but that’ll probably make her distrust the system even more.”
“The what?” I asked.
“Disease Intervention Specialist,” Cordelia answered. “People who work for the Office of Public Health and do contact tracing and find people out of care. But with the budget cuts they’re probably overwhelmed anyway.”
“Let me make you copies,” Lydia said, retrieving the file folders. “Do you want the whole thing or just those few pages?”
“Just the contact info.” I didn’t need and wasn’t interested in their medical histories. With just what she was giving me, I’d hit a bonanza—not just address, but date of birth, Social Security number, emergency contact info, the things that I almost never get when I have to track people down. We hadn’t mentioned a fee and we’d already said that I was doing this as a favor to Cordelia, so I wasn’t going to bring it up. Given the info I had, it shouldn’t be too hard to find these patients.
Assuming that they were alive. Sometimes that was why people went missing.
I didn’t want to think about that.
“Do you get a lunch break here?” I asked Cordelia.
She totally missed my hint and answered, “Mostly we do. It depends on the patients, if there is something complicated that eats time, part of the time it eats is lunch.”
“How about today?”
Light dawned. “Oh.” She smiled. “Let me check.” She got up and left.
Cordelia came back before Lydia did. Maybe they were still waiting on the good copy machine to be delivered.
“My eleven thirty canceled—and was kind enough to call and let us know—and my next scheduled patient is at one. So, yeah, if we can do it in that time frame.”
We could probably manage lunch. Other “do its” would have to wait.
Lydia returned with a stack of papers—and mercifully took a much smaller slice off the top and handed it to me.
“Hey, Lyd,” Cordelia said, “is it okay if I sneak out for lunch? I don’t have anyone scheduled until one.”
“Stay within beeper range—I mean cell phone—just in case something comes up. But it should be fine.”
“Can we get you something?” Cordelia asked her as I secured the papers in an inside pocket in my briefcase.
“Nope, brought my lunch today, but thanks.”
I followed Cordelia, first to her office, so she could shuck the lab coat and stethoscope and get her purse and sunglasses, then out the labyrinth of turns to the elevators.
“Thank you,” she said as the elevator doors opened and we stepped in.
They shut and I took advantage of the privacy to lean in and kiss her.
She kissed back long enough to let me know she appreciated my being here. We broke off in time so we were blandly standing next to each other as the elevator doors opened to let other people in.
“Where would you like to go?” she asked as we exited the building.
“What’s around here?” I asked. This area wasn’t my stomping grounds.
She shrugged. “I mostly bring my lunch.”
We settled on a bar/burger joint just down the block.
After we placed our orders—me a decadent blue cheese burger and her a virtuous salad—I asked, “So, who are Lydia, Brandon, and Ron?”
“I’ve tried to stay out of the politics and personalities,” was her preamble.
“But you still know more about them than I do,” I prompted her.
She smiled agreement. “Lydia is a nurse practitioner and probably the mainstay of the group, with the major planning and organizational skills. Ron and Brandon are both doctors. They and Tamara, the doctor on maternity leave, form one section of the group practice. There are two other sections with about four doctors each. I’ve only met them in passing.”
“So about twelve doctors all together?” I asked.
“Yes. I think about four of them were here before Katrina; several of their colleagues left, so it’s been pick-up sticks in personnel for the last few years. Newer doctors get stuck together, so the older doctors don’t have to deal with constant change.”
“So why have a group practice?”
“Sharing of resources. We have the same clerical staff, phone systems, file space, copy machines. That sort of stuff.”
“Guess that makes sense.”
“Brandon and Lydia have worked together for a while and I think they joined this group as a team. Ron used to work out in New Orleans East and none of his partners came back. I think he’s a good doctor, but people skills isn’t his strong point.”
“You think?”
“It took me a while, but I finally noticed.”
“Think he’s not cool with gay folks? He seemed pretty taken aback that I turned out to have a vagina and not a penis.”
“Hard to tell, his usual style would make most people think he hates them. But…he is a straight white man and he got his undergrad at Ole Miss before coming to LSU for medical school.”
“Thank the cosmos for Mississippi,” I said. “It keeps Louisiana from always being at the bottom of everything.”
“It doesn’t really matter, Tamara will be back from maternity leave in about a month and I’ll be somewhere else.”
“So how legit is this finding patients thing?” I asked.
“We can’t make people keep their appointments, and a fair number do just not show up. Most of the time, it’s on them to reschedule. But because this is sort of our fault—or at least we can’t put it in the category of the patient deciding not to show up—we brought them both up at our last case conference meeting. I mentioned that my partner was a private detective and a lot of what she—I did say ‘she’—did was find missing people and maybe she’d have some ideas.”
“And ideas turned into me coming here and agreeing to find them?”
“I wasn’t really expecting you to say, ‘yeah, I can do that.’ Just give us whatever the magic trick is that you know.”
I laughed. “It’s not that big a deal. The PI equivalent of what you did for Andy,” I reassured her. “And there is no magic trick. Some experience, some knowledge, but it’s mostly doing the things you could do if you have the time and resources. I’ll go knock on their door. If they don’t answer, I’ll go knock on the neighbor’s doors and see if they know when the person might be around.”