Rock Star

An honest-to gosh rock star has been staying in our hospital. Okay, he's no Mick Jagger. If I could tell you his name, it's doubtful that you have heard of him. It's unlikely you have even heard of his sub-type of dark, heavy metal music. But, he makes his living as a rock star. As proof, he showed me a magazine article featuring him. I also did an Internet search. He is who he says he is and actually has a loyal following.

Rock Star got sick while touring in Europe and was flown back to our hospital for treatment. That, in itself is really odd. Doesn't he know that celebrities go to Cedars or UCLA? HMO's like us, are for ordinary people. But he is a nice guy. Despite the tattoos and stringy long hair, he is handsome, well-mannered and even has a college degree.

The problem is that he is high as a kite and we are keeping him that way. He may be bright, it's hard to tell, but everyday that I visit him, he introduces himself as if we had never met before. Usually, people remember me, but I'm not taking it personally. Although wide awake and wired, Rock Star's eyes are glassy and he is totally focused on getting another hit.

We have had patients with high drug tolerances, but he is a record holder when it comes to drug dosages. I would die, if given his dose. You would probably die too. We could split his dose between us and still die of an overdose.

This is what he gets:

Dilaudid 134 milligrams by mouth every three hours PLUS
dilaudid 2 milligrams pushed into his IV line every hour.

The usual dose for severe pain is 4 milligrams of dilaudid by mouth every three hours or, one or two milligrams in the IV line every two hours. The first time I saw someone preparing his medication, I was sure she had made a terrible mistake. No one takes 33 and a half tablets of pain medication. She had to be off by a decimal point. (The last time a nurse was off by a decimal point, the patient spent some time in ICU on a vent.) But, 33 and a half tablets was what he needed to just barely get by.

Despite the high doses, Rock Star constantly complains that he is under-medicated. He was especially angry at one nurse who, instead of pushing the concentrated drug in his IV line, mixed it with a bag of IV fluid and infused it over fifteen minutes. That robbed him of the rush. If he really just needed pain relief, the slower infusion would have done the trick. Rock Star was sure that the nurse was just doing that to spite him.

Rock Star needs to get back on tour. We'll probably send him on his way with a big bag of pills, but he won't be getting any IV pain meds. That part is non-negotiable. We have another patient who is also addicted to dilaudid. He refuses to leave unless the doctor gives him X number of pills. It is worth it to us to give them what they want so that they will leave. It is odd that we have to negotiate with drug addicts who are holding our rooms as hostage. If I were in charge, I would have security escort them to the door and leave them by the curb. Perhaps that is why I'm not in charge.