On confidentiality, and trip to the Nebraska Supreme Court


She’s not the litigious sort

Her niceness comes by the quart

            But I stand by the side

            Of my loving bride

When her case is at the Supreme Court

This is the 21st century, the era of HIPAA.  I sanitize the information about my patients because I respect confidentiality.  But when I see patients, I see people.  I see someone with an age, a gender, a language, an ethnicity, a handedness, an eye color, who has an illness.  Each comes from the context of their families, at a particular developmental stage, as part of a community.  I don’t say to the nurse, ‘The toe in Room 9 needs an x-ray.’  I say, ‘Mr. (Ms.) 9 needs an x-ray,’ because I won’t say the patient’s name in the hallway. 

I won’t give identifying data on my colleagues unless he or she has given me permission to write about them.

I can, however, relate information that comes to me in a public place from a person who doesn’t know I’m a doctor.

Bethany’s court case came up before the Nebraska Supreme Court this morning.  We drove in the dark to Lincoln, about 2 ½ hours, parked next to the dirty, thawing snow banks, and sat on uncomfortable courtroom seats for an hour.  The arguments lasted less than twenty minutes.  The opposition didn’t have a case, and they didn’t even pretend very well.  After the proceedings, a representative of the Nebraska Education Association (the teacher’s union) and a writer for the NEA journal, the Voice, talked with Bethany.

While we walked away from the Capitol Building, I asked the writer, “So, how’s business?”

He got a grin on his face and told me how much better it was to work 40 regular hours for the NEA than to work 60 or 70 hours a week for a newspaper.  I agreed, and talked about how I am making a shift in my career.

Later in the day in Sioux City, I was waiting to see a colleague professionally when a family entered the waiting room speaking Spanish.  An older, bald man, a middle-aged woman in scrubs and a smock, and a boy about 11 who appeared to be completely bilingual.  The patriarch of the group sat down, and I started a conversation in Spanish.

Before I was called back for my visit, in the course of about five minutes, I learned that the man’s father was Sicilian, his mother was from Spain, they met on a boat on the way to New York, and he was born in New York.  He started living in Puerto Rico when he was 11 (about the same age of his apparent grandson).  He moved back and forth to New York for quite a while, he lived in Whittier, California, and he spent four years in the Navy in the Korean War.  In the Navy he cruised the Mediterranean. 

By the end of the conversation he was confident enough that he was throwing some New York accented English into his Puerto Rico accented Spanish.

I found the conversation far more interesting than any of the magazines in the racks.

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