It is 4 AM in the morning and a 50 year-old male is next to be seen in the emergency department. You think to yourself, what can possibly compel this patient to leave the warm comforts of his bed to come to the ED in the dead of night? Chest pain? Belly pain and vomiting? Either way, you have your treatment algorithm ready in your head until he throws you a curveball. “Hey doc, I got these hiccups I just cannot get rid of…”
A 25 year-old male is brought into the emergency room after an argument about whether Tom Brady is the “Greatest Of All Time” turned into fistacuffs. He is alert, oriented, slightly intoxicated, and has visible injuries including a black eye, a missing tooth, and abrasions throughout his arms and legs. You ask him how he is feeling. He flashes a toothy smile, raises his fist (revealing a few small cuts), and replies, “You should take a look at the other guy.” (more…)
New year, new beginnings, and new resolve. A 31 year-old slightly overweight male visits the emergency department a week after New Years with a chief complaint of muscle soreness. He had recently attended a soulcycle session with his girlfriend as part of his new year’s resolution to lose some of his winter weight. The next day he was extremely sore (more than expected) and started to have dark urine (not expected). Our enthusiastic exerciser has rhabdomyolysis.
You scan the board for your next patient in fast track when you see the chief complaint: hand laceration. Great! You grab your suture set and lidocaine (without epinephrine of course) and prepare for another quick “treat and street” and head to see the patient. Wrong. You realize there is a deep laceration to the palm side of the fingers and this may not be as simple as you once thought.
You are polishing off the sweet remains of a fruitful Halloween weekend when the paramedics burst through the door with a very sick looking patient. You throw away your candy wrappers and rush to the stretcher where they present you with a 58 year-old ill-appearing obese male who’s been in sub-acute rehab after a knee replacement. EMS tells you he had been found altered with episodes of vomiting, diarrhea, erratic behavior and movements.
You ask for the admission history and are handed over tomb of papers.
A-FIB, CHF, COPD, BIPOLAR, ETOH ABUSE, PEPTIC ULCER DISEASE, CAD w/ stents…
A medication list that spans the page…
As your mind is flooded with a large differential of CVA, sepsis, C-diff colitis, ETOH withdrawal-you begin to wish you could go back to eating twizzlers and kit-kats.
Your wise attending calmly walks over and reminds you can order one test that can pull together these disparate symptoms.
It is another long Saturday night in the emergency department and you are entrenched in the general chaos of discordant sounds, noxious smells, and inconceivable sights. You are notified by the nurse of a disheveled regular of your ED who has a history of alcohol abuse and pancreatitis and today Read more…
It’s another long night in pod A, but luckily there is a break in the unending stream of patients. You head to your favorite green delicatessen and feeling adventurous, you pick up a bag of sour candy. So sour! Your brain instantly flashes back to the last time you prescribed sour candy as your memory-sensory axonal connections are triggered. The image of that 45 year-old man with 5 days of recurrent pain in the lower right of the mouth that was worse with eating is as clear as day. Who knew candy can be medicine? (more…)
You have just come home from an exhausting 12- (really 13) hour shift and left with the final two perpetual decisions residents must face before sleep:
Both choices are easy. As the water begins to boil for your ramen, you turn on Arrested Development and are greeted with your favorite never-nude, analyst and therapist – Tobias Funke. His blue legs reminds you of a DVT you saw earlier this month that seemed especially concerning…
You’re finally going to do it. Become the very best. Like no one ever was.
Become a pokemon master.
As you search along the mountain trail for the elusive EKANS with your eyes fixed on your phone, you step backwards onto a SNAKE. A sharp pain suddenly starts in your leg reinforcing how much better virtual animals are compared to those in real life.
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