Once in a rare while I get a sick call slip that sounds pretty benign, only to find the inmate has had a severe clinical depression that went untreated for months at the sending facility. It's challenging to know how to triage these referrals when you have to factor in the magnifier-minimizer effect. The exaggeraters are easy to work with but I worry about the stoic tough guys. They're the ones who quietly stay in the background and won't seek help until they're really really desparate. And then they don't want you to know how desparate they are.
The only thing you can really do is work as quickly as you can and see as many as you can so you don't miss somebody who shouldn't be missed, similar to a paramedic working at the scene of a car crash. And to make sure they have a good enough experience talking to you so that when they do have a serious problem sometime down the road they can feel safe getting in touch with you. A good clinical reputation can go a long way.
The best way to find out where you stand with the inmates is through what I call the "hallway quality assurance program". That's where the inmates hangout in the hallway as a group while waiting for an elevator or waiting to move to somewhere else that they're being herded to. You hear the things that inmates say among themselves and get the 'real scoop' about your reputation. It's an oblique version of Questions For The Doctor----it's Comments About The Doctor. Here's what I overhear about my reputation with inmates (all real and unedited, even the negative ones):
- "You gonna see that lady? It's OK, she real nice."
- "I'm here to see the social worker."
- "What a waste. She talks to me for five minutes and tells me I'm OK." (from an inmate irate about not getting sleeping medication. And it wasn't five minutes.)
- "She actually listens to you. She seems to care."
- "She's the only one who does any work around here."
- "Yo, check out those legs. She a speed skater?"
That kind of balances out the leg comments. And by the way, it's all muscle.