45 C.F.R. §§ 164.510 — Emergency circumstances.
(i) If the opportunity to object to uses or disclosures required by paragraph (a)(2) of this section cannot practicably be provided because of the individual’s incapacity or an emergency treatment circumstance, a covered health care provider may use or disclose some or all of the protected health information permitted by paragraph (a)(1) of this section for the facility’s directory, if such disclosure is:
(A) Consistent with a prior expressed preference of the individual, if any, that is known to the covered health care provider; and
(B) In the individual’s best interest as determined by the covered health care provider, in the exercise of professional judgment.
“No Emergency Contacts”
I found them for you.
Your blonde little girls who grew into women
Then grew apart from you.
I found them.
You told us you were estranged from your children,
That the once happy home had been shredded
You told the social worker you wanted to find them
But you didn’t know how.
You told us when you could still talk
Before you couldn’t breathe.
Before your lungs filled with fluid.
Before the ventilator.
Before the only sound you could make was the beep, beep, beep of the heart monitor.
I’m sorry no one asked their names then.
I’m sorry we didn’t care enough to bother
Until the unit
Until decisions needed to be made and our only resource said,
“No emergency contacts listed.”
But still, I found them for you.
I should say we found them for you.
The clerk at the ambulance company who told me where they picked you up
Who gave me that address that turned out to not exist.
The lady at the insurance company who tried to help
Even though her supervisor told her not to
Even after I read her HIPAA chapter and verse.
The police officer who answered the phone
In the town
In the address that didn’t really exist.
She found your driver’s license.
The case manager at the homeless shelter, which was the address on your license,
The only man who recognized your name.
Who knew you.
Who gave me the phone number with no name attached.
The phone number that turned out to be your daughter’s.
We found them for you.
I don’t know if you knew they were there with you
At your bedside in the ICU.
They held your hand as you died.
They told the medical team your story.
They told us how you had been the best daddy
Before the drugs and alcohol stole your life away from you.
They didn’t let you die alone in anonymity.
I found them for you
And they found you for us.
Poetry Thursdays is a weekly newsletter that highlights poems by medical students and physicians. This initiative is led by Slavena Salve Nissan at Icahn School of Medicine at Mount Sinai. If you are interested in contributing, please contact Slavena.