X. Things Patients Say — A Coding Reference

Saint Rectory Memorial Hospital System has, over decades of operation, accumulated a remarkable archive of patient statements. Some are funny. Some are gross. Some are so outrageous that the only appropriate institutional response is to document them, code the encounter, and bill accordingly.

This memo is a mandatory reference for all staff. It is also, frankly, the only training material anyone will actually read. Each entry below is a verbatim patient quote. Each is real. Each has been said to a member of our team, possibly to you, possibly today.

A. The Arrival Quotes

• "I drove myself, it's just a little seizure." — Said in the lobby, mid-seizure, holding his own car keys like a trophy.
• "I don't need a wheelchair, I can walk. I just can't feel my legs." — Arrived via Uber. The Uber driver is now also a witness.
• "Is the ER open? It's an emergency but like a small one." — It was not small. It was a small intestine. Out.
• "My wife made me come. I feel fine. She's the one who's dying, probably." — He was, in fact, the one actively dying. She was fine. She was right to bring him.

B. The Symptom Quotes

• "It only hurts when I do the thing I came here for." — "What thing?" — "All of them."
• "I've been constipated for nine days but I didn't want to bother anyone." — You bothered everyone. You are now Memo III-G coded. Billable.
• "The pain moves around. Right now it's in my phone." — Psychiatry consult requested. Psychiatry declined to elaborate.
• "I think I'm allergic to water. Every time I drink it I have to pee." — Nephrology was consulted for the joke. They billed it.

C. The Treatment Quotes

• "Will this IV hurt?" — "A little." — (needle enters) — "I FELT THAT IN MY SOUL."
• "Can you give me the good stuff? You know, the one celebrities get." — "We have fentanyl." — "No that's basic. The celebrity one." — We billed the fentanyl.
• "I don't want any fluids, I'm watching my water weight." — Patient was actively dehydrated and also 300 lbs overweight. We hydrated. We documented. We billed.
• "Can you make sure the student does it? I want the cheap one." — The "cheap one" was an attending. The student watched. Everyone billed.

D. The Discharge Quotes

• "So I can leave? I never even pooped." — See Memo III-A. You may leave. We note your disappointment.
• "Can I get a ride home? My Uber is here but he won't come inside." — Your Uber will not enter the ED. This is wise. We discharge you to the sidewalk.
• "Will my insurance cover this?" — "We'll find out together, in 90 days, by mail." — Billed regardless. Optimism is not a covered benefit.
• "Thanks doc, you're the only one who ever listened." — We listened for 4 minutes. The other three providers listened for 4 minutes each. All four billed the listening.

E. The Legendary Quotes (Do Not Post To Social Media)

These are restricted to internal training. Sharing externally violates the CONFIDENTIALITY NOTICE at the bottom of this memo and, more importantly, is a firing offense. We are including them because they are the reason this memo exists.