Request: Emergency Room Procedure


Aggelakis

 

Posted

Here is the scenario:

A young woman, apparently in her 20s-30s, normally dressed, with no apparent injuries, enters a hospital emergency room one morning.

She is an albino.

She writes her name on the signup sheet as "Jane Doe".

It being a big city hospital, she waits a few hours for her turn, and when it comes up, very calmly reports that she has no memories beyond waking up this morning in a hotel room where she had paid with cash and registered as "Jane Doe" the previous night.

She has less than $10 on her and no identification.

What happens next?

EDIT: I am writing a horror story that may one day become part of a novel or webcomic or something: this is part of the research. No money will change hands based on replies to this thread, but if there are acknowledgements some day, names can appear in those.


Story Arcs I created:

Every Rose: (#17702) Villainous vs Legacy Chain. Forget Arachnos, join the CoT!

Cosplay Madness!: (#3643) Neutral vs Custom Foes. Heroes at a pop culture convention!

Kiss Hello Goodbye: (#156389) Heroic vs Custom Foes. Film Noir/Hardboiled detective adventure!

 

Posted

I'm not a medical profession, but that's very simple...

She's going to invited back to an examination room. The doctors are likely going look in her eyes with the light... I forget exactly what it does but it might give "clues" to what is going on and then she is going to have an MRI or CAT scan then she's gonna be left in a room for a while as doctors debate what's going on. They most likely will call the police at some point during the previous events and have the police try to take her fingerprints to identify her... As soon as the doctors can they'll likely give a diagnosis explaining to her what they think is going on and what they can do...

if they can figure out who she is, family will be called, and explanation of what's going on will be give and then she will be handed over to their care, telling them to have her have a follow up visit to doctors at some later point

if they can't find out who she is I believe they will keep in the hospital for a few days, but i think they'd send her to assisted living or some such and her face will likely be on the news..

Again not a medical profession, but that's roughly what would happen probably I think.


 

Posted

Make sure she bleeds red and does indeed have a navel. Does she give off any weird magnetic signals that interfere with the hospital equipment? Do telephone/PA speakers start squealing static when she's near?



 

Posted

Does she have odd cravings for stuff that wouldn't normally be considered "food"? Like say, drywall or markers or gas station burritos?



 

Posted

Okay let's roleplay a little.

This is from my phone, so please cut slack on formatting.

She has no sign of concussion or recent injuries.
She asks to be checked for sexual assault which shows that she us a virgin.
She has a navel. No wing scars though.
Her fingerprints are in fact missing. Looks like someone removed them with acid weeks ago.
Cat scan shows signs of fairly extensive brain damage but no obvious cause. She does not show any obvious sign of mental impairment, in fact she seems unusually bright.

She is hungry, but no specific wired cravings per se. She does mention that the smell or sight of blood makes her hungrier. She thinks this might be wierd but is not sure.

Please continue.


Story Arcs I created:

Every Rose: (#17702) Villainous vs Legacy Chain. Forget Arachnos, join the CoT!

Cosplay Madness!: (#3643) Neutral vs Custom Foes. Heroes at a pop culture convention!

Kiss Hello Goodbye: (#156389) Heroic vs Custom Foes. Film Noir/Hardboiled detective adventure!

 

Posted

Is this a setting with widespread supernatural, superhuman, super-tech, or otherwise extranormal stuff? It doesn't sound like this is set in CoH specifically, but being able to call in, say, a psychic could dramatically alter how this would be handled. Or does this story take place in basically the real world?


 

Posted

Quote:
Originally Posted by Aggelakis View Post
Dental records?
Addendum to that...does she have any evidence of ever having had a filling or other dental work? If there were none, I'd find that highly suspicious.

Do her mannerisms seem natural or are they just slightly...off?

Any sign of a double heartbeat or lack of a heartbeat? Higher or lower than normal body temperature?



 

Posted

Are there any tags on the clothes she was wearing?

Does she have any memory of current events? IE, "Who is the President?" level of questions. May have to dig a little to get past stuff she heard/read in the waiting room.


 

Posted

In my local area the flow would be something like this assuming she went to one of the larger regional hospitals (the smaler ones woudl typicaly send her to one of the larger regionals after the first few steps).

She woudl be seen by an ER physician and her medical "history" taken (in this case, she only has this incident.)

She would be visually inspected for injuries.

She would be given an MRI/CAT Scan (and since she has extensive brain damage she'd likely be subjected to several including fMRIs over the course of several hours or days).

They would run any tests she requested (in this case, she'd be checked for sexual assault).

With the brain damage she would be admitted and the local police called.

Local police would take her data (description, anything she recalls, fingerprints and so on). Should that data be useless they may later request dental x-rays as a last resort. She would be assigned a police psychologist and a DSS social worker. Police would file a missing person's report on her, slowly expanding their search from the local, to county to state to region and eventually to the federal level. Odds are they would eventualy get most newspapers in the state to run her picture with a "fluff' story, that would be picked up sporatically in other areas and on the internet. If all efforts in the irst month or two failed, she'd be issued a temporary identification that, assuming she doens't recover her memories, woudl become somewhat "her" inclusing a SS number, ID card and such.

The hospital would remand her to the psych ward for evaluation. Given her complete lack of memories, it woudl most likely recommend she be remanded to the state's care in a nearby mental health facility.

The hospital would assign her a patient advocate. The patient advocate would normally act on her behalf due to the extensive brain damage detected under the sssumption she could and likely does have some sort of impairment.

The patient advocate would get her into the DSS system. She'd be issued whatever state assistance was avaliable, likely Medicade and food stamps and usually she'd be placed on the rosters for utilities assistance. There is a very good chance with her medical conditions the Patient Advocate woudl also try to get her on SS Disability (she'd be turned down at least twice and likely a third time even with legal assistance from the sounds of your description).

She would be held in a "waiting tank" for anywhere from a few days to a week. During that time she would be under hospital and psychiatric doctor's care. This would last until a place in a state run facility opened up.

She would stay from two weeks to three months in a "short term care" facility. Length of time would depend on her cooperation and her mental state and if she showed any memory recall of the past. She would not enjoy the experience as most of those places are described as "the waiting room for hell."

After she'd stayed her limit in that facility she would either be determined to be no threat to herself or others and remanded to a half-way house for the functionally mentally ill (limited to a 6 months or so stay), tossed out the front door on her keister if the half-way houses were full (VERY likely) or remanded to long term care in another state (the east coast likes to send people to a facility group in Virginia for some reason but it takes some serious mental illness or several hospital stays to get sent there).

After that, she'd likely drop out of the system if she didn't establish herself in some way. She'd need a job, an adress, utilities and all the "stuff for normal living" even though she'd be at least partially cared for by state services like food stamps and welfare. Her missing person's file woudl be anywhere from a month or two old to a year old by the point and be quickly slipping into "cold case" turf. If it reached a year without any leads coming up, it would be converted to the cold case files and revisited MAYBE once a year.


 

Posted

Quote:
Originally Posted by Durakken View Post
I'm not a medical profession, but that's very simple...

She's going to invited back to an examination room. The doctors are likely going look in her eyes with the light... I forget exactly what it does but it might give "clues" to what is going on
Basically it's a test for pupil response and to check the size of the pupils themselves. This helps rule out concussion or other forms of conditions affecting the person's brain. Things like blown-out pupils, or pupils that don't respond (or respond slowly) to light (normally a light will cause almost instant contraction of the pupil) will indicate that there's either been head trauma or some disorder is affecting the person's brain.

Quote:
and then she is going to have an MRI or CAT scan then she's gonna be left in a room for a while as doctors debate what's going on. They most likely will call the police at some point during the previous events and have the police try to take her fingerprints to identify her... As soon as the doctors can they'll likely give a diagnosis explaining to her what they think is going on and what they can do...
Maybe yes, maybe no. If there's no proof of insurance, they'll likely do preliminary testing but expensive procedures like MRI and CAT scans will wait until the police investigation unless the person is obviously in some sort of medical danger.

Quote:
if they can't find out who she is I believe they will keep in the hospital for a few days, but i think they'd send her to assisted living or some such and her face will likely be on the news..
Again, without insurance, they'd turn her over to the police unless there are extreme medical contraindications that would mandate a hospital stay. What the police would do with her? Not sure. Possibly drop her at a shelter (or wherever she woke up (her apartment?) and make an attempt to check in on her over the next few days.

Quote:
Again not a medical profession, but that's roughly what would happen probably I think.
I was, for about a decade.



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Posted

I am on my phone at work. Apologies for brevity and delays.

No static or electrical wierdness.

Her mannerisms are a bit off in that other than having a snarky sense of blqck humor, she seeme too calm ajd rational for a person in her situation.

Normal pulse and temp.

Her clothes are all branr new with normal tags.

The world is somewhere between mystery men and the grudge and unbreakable in terms of wierdness. You can't call up a friendly psychic for a reliable believable reading, but the cops in a big city might employ someone to help when they are stumpe on an important case.
There are a few spandex wearing do gooders, as in real life, but some ro have surprising levels of competence. A cop of emergency worker with more than a decade of service has probably seen traumqtising things they cqnnot explain.

She has fairly poor eyesight and very good relexes.

All of her teeth are implants a few weeks old. Har canines are a little longer and very sharp. Looks like hollywood quality high dollar work.


Story Arcs I created:

Every Rose: (#17702) Villainous vs Legacy Chain. Forget Arachnos, join the CoT!

Cosplay Madness!: (#3643) Neutral vs Custom Foes. Heroes at a pop culture convention!

Kiss Hello Goodbye: (#156389) Heroic vs Custom Foes. Film Noir/Hardboiled detective adventure!

 

Posted

Quote:
Originally Posted by Kitsune9tails View Post
Her fingerprints are in fact missing. Looks like someone removed them with acid weeks ago.
Dental imprints. Or, barring that, prints from her feet and checked against birth records.

Quote:
Cat scan shows signs of fairly extensive brain damage but no obvious cause. She does not show any obvious sign of mental impairment, in fact she seems unusually bright.
How "extensive". Depending on how severe it really is, they could admit her for observation and wind up doing more scans of her head.

Quote:
She is hungry, but no specific wired cravings per se. She does mention that the smell or sight of blood makes her hungrier. She thinks this might be wierd but is not sure.

Please continue.
Chalked up to the brain damage. But if she starts exhibiting any sort of dangerous behavior she'd be restrained and sedated.



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Posted

Quote:
Originally Posted by Dark One View Post
Addendum to that...does she have any evidence of ever having had a filling or other dental work? If there were none, I'd find that highly suspicious.
I have never had any dental work done and I'm - as far as I know - a normal, natural human being. :x


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Quote:
Originally Posted by Dispari View Post
I don't know why Dink thinks she's not as sexy as Jay was. In 5 posts she's already upstaged his entire career.

 

Posted

Quote:
Originally Posted by Aggelakis View Post
I have never had any dental work done and I'm - as far as I know - a normal, natural human being. :x
That makes you have above average dental hygiene or whatever... Or a really bad dentist that doesn't care about money or your actual health.


 

Posted

Quote:
Originally Posted by Kitsune9tails View Post
All of her teeth are implants a few weeks old.
And that's hte ID right there. Dental implants are fairly specialized and the higher the quality of the work the fewer places that can produce it. Implants take about 3 to 6 months for the bone matrix to set and produce stable enough bone for implantation and after implantation they take 3 to 6 months to heal to the point of being able to be used to chew properly.

The posts for implants are specialized and only produced in a few places (IIR there's only 3 companies in the US making them and only 1 or 2 in Europe). The crowns that go on top of them can be produced all over the US, but again, the higher the quality the fewer places and the mix used in the caps will pin it down very quickly to a smaller number of places that use it.

Those aren't devices that can be made in your back yard. The posts alone are highly specialized requiring some pretty specific metalurgy or they won't seat and set properly (the bone has to accept and bond to the surface or they slide out easily). Most implant posts have markings that can even be read on a dental x-ray (my one implant can easily).

Implant quality materials are not somethign you can knock off easily unless you have an eccentric millionare with about 50 mil to spare and the capacity to hire a dozen specialists on the sly.

Quality caps are the same way. The material is fairly twitchy since it has to be strong enough to withstand chewing but not brittle. Again, that takes some pretty specialized equipment to manufacture and the materials in it aren't purchasable at the local Home Depot.

Then there's the bone matrix itself. Again, very specialized and there's only a few types avaliable on the market with a very limited market to sell to on the high end. Again, the matrix used for my implant could be pinned down to ONE manufacturer and given it's age, only about a dozen dentists.

Even the local yokel cops here can track down a person's identity from a single implant in about two weeks (and it just happened a few months ago with an unknown body that was nothing but rags and bones when found).


 

Posted

Footprints will likely be partial due to heavy calluses consistent with a lot of barefoot actvity.
Missing persons reports are as normal for a big city.

Blood toxucology shows recent exposure to "she ought to be dead" levels of a neural paralytic. This could account for the brain damage, I am guessing.

The dental work once traced would lead to an extremely wealthy and uncooperative surgeon who is known, Er, alleged to be in the pocket of organized crime.

On the subject of social security. Per Wikipedia there is a guy known as 'benjaman k' who was found behind a burger king 6 years ago. He has yet to be assigned a number and is still unidentified and unable to legally work and still homeless.


Story Arcs I created:

Every Rose: (#17702) Villainous vs Legacy Chain. Forget Arachnos, join the CoT!

Cosplay Madness!: (#3643) Neutral vs Custom Foes. Heroes at a pop culture convention!

Kiss Hello Goodbye: (#156389) Heroic vs Custom Foes. Film Noir/Hardboiled detective adventure!

 

Posted

RedBone and Hyperstrike seems to have medical profession experience and have completely different and opposing ideas of what will happen... This seems to me that this means regardless of what you do you'll be realistic...

So considering this is a horror story I'd go with the more frightening and the more jostling and the more kinetic... which will result in the reader not able to get their baring helping them to relate to the character...


Also acid burned fingers to get rid of fingerprints would be indication of foul play as they look different than, say, the device from Men in black which removes finger prints because acid is imprecise.

The big problem with the story is that it sets up a problem of identity being stolen and someone spending lots of money to do it... but assuming that's the case then they'd obviously want them never to be able to recover it and as such is more or less murder. If they are going that extent and have that much money they'd more likely go with murder as it's cheap and there is no risk of memory returning.

If it's something like that it's a big plothole. If it's not, then it becomes obvious that this person isn't someone that has been altered but someone that has been made to look like the were altered and seems more in line with aliens or "others" trying to sneak into human civilization. They'd have the tech and the motive to do it... Mobsters or something like that would never waste the time and very few people would have the wealth and/or stupidity to risk doing that to someone and try to get away with it.


 

Posted

Quote:
Originally Posted by Kitsune9tails View Post

The dental work once traced would lead to an extremely wealthy and uncooperative surgeon who is known, Er, alleged to be in the pocket of organized crime.

On the subject of social security. Per Wikipedia there is a guy known as 'benjaman k' who was found behind a burger king 6 years ago. He has yet to be assigned a number and is still unidentified and unable to legally work and still homeless.
The surgeon gives a general location (IE where she's a local) from there widely circulating an image would lead to identification. People, even in big cities, normally have enough interaction that someone has seen them even if they don't know the name (the guy at the gas store, the girl at the coffee shop). Every positive ID would narrow down her local area, so keep that in mind and have a work around if you want to keep her ID unknown. One of the great truisms of police work is it's easier to find a living person's ID than a dead person's because they can be photographed as they are now and someone, somewhere has interacted with them recently.

As for Social Security, yep, there are some isolated cases of "John/Jane Doe"s staying off the grid for years despite trying to get back on it. They're vanishingly rare though since there's systems in place to "reidentify" people with new IDs in the case of unknown individuals (especially in big cities) that are similar to the methods used in New York at the turn of the century (LOTS of name changes then). Most will be RE-IDed in under a year, often under 3 months.

Fact is, a patient advocate and DSS social worker WOULD pin her with some identification even without her real ID being known just to keep her in the system and identify her case. The folks who fall through the cracks in the system are the rarity, not the norm. That's a minor point though since it doesn't lead to IDing her just gives her a "name" to go by. It's still a common joke to name people after the hospital where they were initially sent and the doctor or a nurse that worked her initial admittance.


 

Posted

Quote:
Originally Posted by Durakken View Post
RedBone and Hyperstrike seems to have medical profession experience and have completely different and opposing ideas of what will happen... This seems to me that this means regardless of what you do you'll be realistic...
What is "realistic" is going to come down to WHERE it is. Regions have different proceedures and states in those regions will have variations. What I've said is pretty much SOP up and down the east coast (call it east of the Mississippi) with some regional or state variation on the same theme. It is as close to accurate without variation as you can get without being very location specific for pretty much anywhere on the east coast south of the Mason-Dixon Line. This is due to the combination of the involvement of SLED (South Carolina Law Enforcement Division) in not just training but also in loaning out their people and resources to most Southern states and also a quasi-unimind politically for decades which effects hospitla policy (the south is pretty much a block vote red state area these days whereas 40 years ago it was a block vote blue area).

For instance, almost none of what I've said except some of the general police proceedures will be accurate for Las Vegas (Vegas has a LOT of unidentified individuals thanks to its history) because of the sheer volume of people who aren't who they say they are.

If you're talking the upper mid-west, like North and South Dakota the proceedure flow is completely different because of the low population density. If you're talking Utah, one of the first places the police will look is the Mormon Church even before they get full reports back on prints. If you're in California, DSS services will generally be more aggressive in taking part but the hospitals will be a bit more lax in deeper testing unless it's seen as necessary or ordered by the police (thank you Keiser medical services).

If you're in Louisiana the DSS will generally suck. They're still covered up with Katrina fallout.


 

Posted

Quote:
Originally Posted by Aggelakis View Post
I have never had any dental work done and I'm - as far as I know - a normal, natural human being. :x
I'd be checkin' you for fast clone growth or otherwise alien/robot/golem tendencies...

-.-



 

Posted

I have a good reason for the circumstances, so no worries.

For the initial story it is best if jane stays a jane doe for a couple months or so.

If I end up committing trilogy I may or may not need her to remain thoroughly mysterious. Even if she is identified she will still likely have amnesia. Assuming she even survives the horror stuff.

Next question. I would like a nurse from the hospital to take her in as a roomie. Is that unbelievwble? Illegal?

I gather feom the above that her hospital stay will a week minimum up to a couple weeks tops if she presents no or few symptoms.


Story Arcs I created:

Every Rose: (#17702) Villainous vs Legacy Chain. Forget Arachnos, join the CoT!

Cosplay Madness!: (#3643) Neutral vs Custom Foes. Heroes at a pop culture convention!

Kiss Hello Goodbye: (#156389) Heroic vs Custom Foes. Film Noir/Hardboiled detective adventure!

 

Posted

I can't see any reason that it would be "illegal" (just my opinion). It might be against hospital policy to fraternize with patients though.