Part
Thirty Four
"Doctors"
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Tuesday 26th May
"Good morning Tammy, take a seat. I have your results."
"Oh? Is there a problem?"
"You're borderline diabetic, right on the boundary in fact."
Tammy wasn't expecting this.
"How long for a referral?"
Dr Adelaide Sutherland laughed, "it's not as bad as it sounds."
"It isn't?"
"Look, do you skip lunch?"
"Once or twice a week?"
"Drink coffee, coke, fruit juice?"
"All of the above."
"Exercise?"
"Self defence on a Tuesday, you've seen the bruises!"
"Okay, try to have something for lunch every day, even if it's just a banana. Cut your coffee intake and try to avoid carbonated drinks, especially those full of sugar or artificial sugar."
"Even the diet ones?"
"Especially the diet ones! Try drinking water instead, no calories! Now, once a week keep fit is good start but you can do better?"
"Our swimming pool and gym are now up and running at home so I've been in the pool several times over the past few days."
"Better, with a little effort on your lifestyle you can improve your blood sugar. why don't we do another blood test in two week's time and review a week after that?"
"Sounds good to me, apart from the fasting - that is what you want isn't it?"
"Yep, nil by mouth from 8pm the previous evening!"
"Now, Doctor, I have Jeri Anders in the waiting room and I believe Helen McPherson is due to see you next?"
"I can't discuss other patients."
"I had to deal with Jeri when she came back from her initial Jill Davison appointment on Friday very distressed and I've had enough of Jill."
"You've been asked not to become in other people's issues."
"When someone runs up the stairs, hysterical, and comes straight to you for support then do you push them away?"
"No, of course not."
"And my mother, who was also in the room with Jeri was also distressed, she needed my father for support; how she drove home is beyond me. So, do you see my point?"
"Are you making a complaint?"
"Probably, our solicitor will write to the hospital trust. In the meantime we are seeking a referral elsewhere."
"Do you want me to find someone, the local NHS trust will only let me use Dr Davison although you can go private. If you choose to go private I can't provide any information to them unless I know they have your authority, nor can I accept your word regarding any other patients."
"We're in touch with Dr Hall in Inverness."
"He's a private practising psychiatrist."
"Yes, and gender counsellor. Professor Roberts suggested him."
"I see."
"Obviously my sister Angela Small will also be seeing Dr Hall and we'll talk to Lori Jenkins about her intentions. As I said, Jeri is in the waiting room for a blood test and urgently needs too see someone she can trust. "
"Okay, I can spare her a few minutes after my next appointment."
Tammy thanked the GP and went back to the waiting room, Helen was called in after a minute's wait, Tammy assumed Dr Adi Sutherland was updating her records when Helen queried the delay.
Jeri, meanwhile, had just come out of the nurse's room and had a sticking plaster on her arm.
"I'm not keen on that! I managed to avoid blood tests for over a year and end up with two in a month."
"At least you've not been told you could be diabetic?"
"Oh, sorry Tammy."
"It's not the end of the world and I might be able to do something about it."
"Like what?"
"More exercise and better eating habits."
"Oh, so it's not the end of the world?"
"Not yet, that's next week!"
They sat waiting for Helen, others had now arrived in the waiting room so their conversation was minimal. Eventually Helen re-appeared and Jeri was called straight away, returning a couple of minutes later. Helen wasn't happy when she sat down but didn't say anything, she was clutching a prescription.
She still wasn't happy when they reached the car. "Can we go to the pharmacy?"
"Sure."
Tammy managed a glance at the prescription as Helen handed it over to the pharmacist's assistant and wasn't certain what one item was, although she definitely recognised the other.
"She put you on the pill?"
Helen blushed. "I'll tell you later."
It took ten minutes but eventually they were on their way back.
Once indoors Helen went to find Joan, except she was at the school catching up with paperwork. Desperate to discuss the appointment with someone, she invited Tammy into her room.
"I've been having problems, when I'm on."
"This isn't one of my areas areas of expertise."
"I guess not, but I've been feeling awful, and my flow is heavier than normal. Dr Adi reckons the pill will help me, she's also given me iron tablets as I'm anaemic."
"Oh dear."
"It's fixable, she thinks my diet had alot to do with it as well, mum did mostly microwave meals, or I did as she was in meetings almost every day." Helen stopped as she recalled her mother, she sat on her bed and her eyes filled with tears. Tammy sat next to her and took one of Helen's hands.
"Why, why? I hated her because of what she did to me, but I never wanted her to die."
"We don't know the reasons, but life's not always fair."
"What did Angela think when she lost her dad?"
"You can ask her, but it's not something she talks about."
Tammy released Helen's hand and went to get a tissue to dry Helen's eyes.
"Thanks Tammy."
"Any time. Do you want to start the pills now?"
"Might as well. What was your thing at the quacks?"
"I'm borderline diabetic, I have to exercise more, cut down on my sugar intake and try not to skip lunch."
"We're a right pair, aren't we?"
"Sounds like it."
The rest of the day slipped past. Tammy spent half an hour on the exercise machines before jumping in the pool with Helen, who was gaining confidence in the water.
Angela decided she would go to the self defence class that evening and Jeri joined in for the first time. Fortunately her mother had the forethought to provide a letter authorising Jeri's attendance. One surprise was seeing Lori there, they talked during a break.
"Sarah suggested I came, we had an incident yesterday."
"Oh?"
"We were doing the bank run and a guy came up looking like he was going to grab the money, he must have been watching us. Anyway, I saw him and suggested to Sarah we went a bit faster, we went around the corner and walked straight into two police officers! The guy had just about caught up when we got to the corner but didn't see the officers until the last minute, he turned and ran."
"You must have been frightened?"
"Absolutely."
"Did the officers recognise him?"
"They said his name was Jimmy, or James."
"Didn't they go after him?"
"No, they said they'd find him a bit later when they had a van to collect him."
"Hang on, could he be James Dougal?"
"Might be, do you know him?"
"He was trying to break into my car on Saturday and tried to rob me and Sarah in December."
"I didn't know about that,"
"It's why Sarah doesn't like going to the bank on her own."
"She didn't give me a reason. One of the officers came into the shop today to take our statements, they found him last night apparently. There's been other bag snatches so they suspected him for those too."
"Maybe he can be kept inside for a bit longer than one or two days?"
"Hopefully."
They were called back by the instructor, Vance, for more self-inflicted pain.
Friday 29th May
"I'm sorry I'm late, Dad"
"You've missed all the work."
"I couldn't help it, Hilary asked me to go over to Wick Harbour again, after I'd been to Scrabster and Thurso."
"I thought Wednesday was a one-off?"
"Apparently not, but I couldn't see anything out of the ordinary there."
"How would you know what you were looking for?"
"I suppose I wouldn't. Anyway, how are the girls?"
"Upstairs moaning who got which room!"
"Their first domestic argument?"
"Yep."
Tammy took a look around the cottage, she'd last been here when Angela and Joan had moved out four months earlier. It looked a bit different now, the school maintenance team had redecorated and it seemed lighter than before, the lounge curtains were flowers and lace, rather than the plain drapes previously hanging there.
Helen had spent a few days with the Smart's cook, Julie, being taught the rudiments of cooking, she'd actually picked it up quite quickly but her food hygiene skills needed brushing up when she'd used the same chopping board for meat and vegetables. After Julie finished forcibly explaining the issue, Helen was near tearful but had learned something.
Jeri's sister, Claire, had sat with her while Jeri practised make-up, Another time Joan had taken the Anders family to improve her wardrobe and pick up things for the cottage.
Jeremiah Smith had been to visit and Jeri was now legally Jeri Marie Anders, all of the relevant authorities had been informed, although some would insist on her being Mr Jeri Marie Anders, much to her dislike.
How that was going to work in school was another matter. Joan had spent some time with Jeri and Deputy Head Thompson on the practical aspects of Jeri's attendance and there was a grudging acceptance that she could use the female toilets but Jeri was not to wear obvious make-up as the male students were forbidden from doing so.
This meant no lipstick, mascara and eye shadow. Apparently this was so that certain teachers, who were likely to have difficulty accepting Jeri's quasi status of almost legally female, would not find a reason to cause disruption in the classroom.
In practice, Joan suggested keeping it to powder for the first week and gradually adding. When it had been put to the Deputy head that Jeri might come into school fully made-up as not having an opportunity to clean her face, or not have a bottle of nail varnish available, what could she do?
With that question, the policy was dropped and she could do as she wished, within reason, a pointless exercise of common sense over bureaucracy if ever there was one.
Once the girls were settled into the cottage, Jeri's mum and sister had left. They declined use of the helicopter on the grounds Livvy hadn't been comfortable, although she hadn't said anything at the time. Richard ran them over to Wick Airport for a flight to Birmingham, they would get the train to Stratford on Avon from there.
Once the solicitor had dealt with Jeri, he'd sat down with Helen. The inquest into Veronica Salmond's death had opened in London but that was just a formality. Helen had no wish to attend the actual inquest when the main hearing was held and Richard was concerned for her security.
A few cars had been seen going slowly past Dunbankin' so additional cameras had been put up to cover the road. The number plates were logged but were identified as hire cars which had been obtained with forged documents.
The risk to Helen was reduced once she was within the school grounds but not eliminated. Hilary had assisted where she could but could do nothing overtly. The police, again, said they couldn't provide a security detail but would assist if an incident happened.
The solution was for the school to employ a gate guard, this was achieved by Helen making a generous donation to the school from the fund her father had created, now moved to a variety of accounts.
The donation paid for a simple barrier and a guard, plus a shelter. Once Helen left the school the guard would be dispensed with, although the barrier would remain in case it was needed. No-one had an issue with it, indeed several parents claimed they had thought the open gate policy of being slack security for their offspring.
"Tammy, there's some mail on the dressing table."
"Thanks Pru."
The letter was from Dr Hall's secretary, he'd happily see her the following Friday. Tammy's need was minimal, Professor Roberts had already stated Tammy could have her GRS, but a second opinion was needed and Jill hadn't already given her approval.
The complaint against the local NHS Trust had generated a flurry of correspondence with the Trust's solicitors claiming the allegations were vexatious. Elsie had submitted a statement by fax from Singapore which covered a few incidents, backing up the girls' own words. There was a separate fax addressed to Tammy:
I'm truly sorry for challenging you when you saw Jill, you had reason not to see her but I ignored your feelings; I put you in a position where you weren't comfortable and possibly could come to harm. I'm also sorry that I did not believe you. I hope my statement for the solicitor will make some amends, I have been able to think again what happened in my own house, why I insisted Helen and you saw her just a short while ago and previous occasions you and Angela suffered at her hands. Please forgive me.
Elsie
Dr Jill Davison had been suspended by the Trust and was said to be considering her future, the Trust had been forced to arrange for an inquiry board to examine the evidence. As news of the inquiry leaked, other patients of Jill came forward; Richard instructed Jeremiah's firm to handle a group case, although this was passed to another of the partners.
Jill's father, Harry Davison, notified the school of his resignation from governing body of St Andrews, citing ill health. As he had also been the Chairman, a governors meeting would be held in two weeks to elect a new chairman, Elsie was considered to be the favourite. The vacancy on the governing body would be advertised locally, but was a voluntary post without renumeration.
By 4pm Tammy was sat in the offices of Caithness Marine, Dave Brown was in town to review Hilary and Tammy's work.
"Now, what do you think was the point of your harbour visits?"
"To see if I could see something suspicious? To see if there was something out of the ordinary?"
"It turns out some intel was generated, and has been passed to HM Customs to follow up, but that wasn't the reason."
"So what was it?"
"Training, an exercise in following instructions and adapting to new circumstances, building confidence and appearing to be someone you weren't."
"But I wasn't using a fake identity?"
"No, there was no need, but you were in an environment that was new to you and we needed to see that you could handle it."
"I see, how did I do?"
"You passed, you didn't make a spectacle of yourself and in a week all of the staff will have forgotten you'd been there."
"So I was hiding in plain sight?"
"Something like that, no-one would see anything that was worthy of a closer look."
"Okay, What's next?"
"Your exams."
"I know, but is there any more work for me?"
"Not yet, and you're due some additional training, classroom based probably."
Tammy laughed, "Can you at least tell me where?"
"Not yet, you'll be sent instructions nearer the date."
"Fair enough, but I don't like being kept in the dark."
"That's the nature of this business. Now, we have some concerns with your security."
"Mine?"
"Yes, it's come to our attention that your former psychologist has been offering certain patients' records for sale."
"Namely?"
"Your's, Miss Small, Miss McPherson, Miss Anders and Miss Jenkins, amongst others."
"Damn."
"As far as we can tell, no actual records were passed on. We were told an hour ago that the police have searched her and her father's houses and taken computers for examination, Hilary will be informed about anything relevant so you can be briefed."
"What do I tell the others?"
"Nothing, the police will be in contact directly."
"What's Jill's problem?"
"I can't say, but it seems that a psychological evaluation has been ordered."
"How ironic."
"Indeed."
Comments
Not sure about GB laws
Not sure about GB laws regarding Jill's current actions in attempting to sell patient records; but I do know, at least in Washington State, a person doing so would garner themselves a 1-5 year sentence in prison. If it was serious enough, meaning actual sale/s, and who exactly the patient/s were, the time could increase. Also EACH record would be worth the same 1-5 or more sentencing.
What you need is a judge to sentence consecutively, (one right after another); rather than combining all sentences into one. (concurrent)
Then using Tammy, and the other four girls as the example, the perpetrator could be looking at 25 years if max sentence was mandated.
Hope Jill gets something like this, because I have a real feeling that Tammy, et al, are not the only ones she has done this to or against, during her years of practice.
In the US, it's a HIPAA
In the US, it's a HIPAA violation, which has a stack of other penalties. One problem that I don't believe has been tested is that HIPAA is a Federal law, but shouldn't come into play unless there is inter-state transfer of information. (State vs Federal powers. As there is no specific 'right to privacy' in the Constitution, it's a grey area as to whether it would be a State issue, or a Federal one. As most states, if not all, have their own version of HIPAA, it could get interesting in the US)
I'll get a life when it's proven and substantiated to be better than what I'm currently experiencing.
It doesn't have to occur
It doesn't have to occur across state lines to be a federal crime, bank robbery and kidnapping are both federal crimes yet don't have to involve crossing state lines to do so. Health Insurance Portability and Accountability Act(HIPAA) doesn't cover her notes though,Jill would be able to lie and claim she was selling her notes and get off without punishment.
I believe the UK equivalent is the Data Protection Act or something along those lines.
One thing I have to ask- are patient records considered to be the property of the patient in the UK like they are here in the US? If so, that woman is just asking for multiple theft charges.
I'm told STFU more times in a day than most people get told in a lifetime
Bank robbery is handled by
Bank robbery is handled by the FBI because all banks are operated under the aegis of the US Treasury Department and the Federal Mint. (FDIC, etc) Kidnapping is handled on the state level by the FBI, because it ended up that huge amounts of kidnappers immediately crossed state lines to specifically make it difficult for the police to pursue them. (There's also a mess of other reasons, and some kidnapping is handled through state groups, and I don't know, understand, or care about a lot of the exceptions to the rule) It's like robbing a post office (or even a mail box) is a federal crime, even if the robbers live right next door.
In the US, the notes belong to the doctor, but the patient has a right to a full copy of it. In fact, the doctor has to KEEP copies of records for a certain number of years (Paediatricians have it the worst, because they have to hold copies for the.. 10 years? or until the patient is 18, whichever is longer. )
HIPAA isn't just for insurance, despite the name of the act. It's any documentation dealing with a patient.
I'll get a life when it's proven and substantiated to be better than what I'm currently experiencing.
I suddenly recalled....
I suddenly recalled a scene in Cannonball Run with Burt Reynolds and Dom Deluise. They are trying to find a doctor to ride in the ambulance to help with their cover and Dom till him that the doctor they were going to use wasn't available anymore.
"Who is he," Burt asked.
"He's my shrink," Dom says the frowns, "he got suspended. He was smoking bananas."
quidquid sum ego, et omnia mea semper; Ego me.
alecia Snowfall
by the pricking of my kudos thumbs
another baddy brought into the light - be interesting to see what particular axe she had to grind against our blooming collection of gender benders, and Elsie - stupid to have a go at her, I am sure Jill will reap the revenge of the clan McPherson!
Hmm...did Harry resign in
Hmm...did Harry resign in disgrace or in solidarity with his daughter? I'd like to know if she lost an ally or an enemy.
It stinks that Tammy has to be forced to slow down and be forced to eat lunch for her own health but this is what is best for her. Sophie and Heather are going to run her ragged again(literally!) but it does help her out to be in better shape before she sees them again. They care about her, so the complaining and teasing will be for her benefit.
And I am glad that her training went as expected, Hilary and Dave are sly but it did give her both experience and a sense of purpose before the real training starts. The fact that some folks were caught and the government benefited is beside the point but did make the security expenses reasonable to their boss ;)
I'm told STFU more times in a day than most people get told in a lifetime
I knew Jill had a bitchy streak....
But I really didn't see all that coming.
Thank you Shiraz,
Jill's chickens have most certainly come home to roost ,she is in a heap of trouble ----the family motto of Mc Pherson is "Touch not the Cat" , --- you may get scatched but when Elsie gets home she may get ripped apart !!
ALISON
"How ironic."
I agree
another uttering!
The school board of Governors meeting reminds of the Wizards meetings in the "Unseen University", the creation of the sadly demised Terry Pratchett. Lots of pompous exchanges of hot air but getting to the obvious solutions eventually
They Do Say All Shrinks Are Mad
And it certainly seems as though Jill was mad or criminal(or both). My, My. Tammy can really attract trouble.
Oops....
I got my Master's Degree but never went on for my doctorate - does this mean I'm half crazy?
Love, Andrea Lena
half crazy? no, less than that...
It's an exponential thing based on the number of letters in the degree.
I wouldn't worry, you're in good company with the rest of us.
Anesidora
gotta
make you think for a town the size of Thurso theres a lot of troubles around, Hmmmm and it does seem Jill gone off the deep end. and that Thief still around and causing trouble, makes you wonder if he targeting Tammy and co on purpose for getting him locked up before, and I do wonder if theres more to things than a simple gambling debt? despite the amount ? not good theres a lot of traffic and all hired with false documents ?
Matt
How ironic
Sums it up nicely. I really didn't expect Jill to be this wacko. Looking forward to seeing what her problem was.
Ooooops
The psych needs to be psyched!
Defining the deference
Borderline diabetic isn't as bad as being diabetic. Coffee seems to be served everywhere Tammy goes, so reducing her intake, or quitting, may be difficult. And knowing how well Tammy's taken advice in the past, she may continue.
Adi told Tammy the same thing Alison and others have told her, don't get personally involved in another's life. Support, okay, but not personally involved. Trouble comes in that to Tammy there is no difference between support and personal involvement. She told Joan they can't sit on the fence when someone needs help. Joan said she could but knows Tammy can't.
Tammy sitting with Helen and listening to her talk about her recent doctor visit is offering support. Questioning the doctor about the care of a patient, and friend, is getting personally involved. These differences are what Tammy needs to learn before she gets it a position which gets her or others hurt.
So others have had problems with Jill but afraid to doing anything. Tammy taking the initiative to go against Jill caused others to come forward, something which should have been done long ago. A doctor can subscribe to a particular philosophy based on observations by other doctors, but must check their own personal views at the door. When their own personal views rule their practice then it's time for something to be said to the right agency.
Dave gave Tammy a pass for the photos taken at the harbors, explaining why she was given the assignment. But upset her by not providing more information about further training. She said she doesn't like to be kept in the dark, but has been keeping things from others for security reasons. Tammy needs to learn that she is not immune to the "need to know" phrase, that being kept in the dark, as she put it, may help keep her and others from harm.
Others have feelings too.
Jill
Given complaints from others and the (mercifully unsuccessful) attempt to sell medical records, it's feasible she'll be prohibited from practising. Given her father also resigned from his position as the chair of governors, I wonder if there's some personal or family history we're not aware of contributing, and / or if she has a connection to any of the other cases Tammy's been mixed up in...
As the right side of the brain controls the left side of the body, then only left-handers are in their right mind!