Dx: Constipation - "I've been having abdominal pain for the last two months, and I've been to three different hospitals. My doctor won't even see me because she's only available on Mondays, and I was having abdominal pain, but I didn't have severe pain until today, and I knew that I couldn't wait until Monday, but then she wouldn't see me anyway because I always have to go see the nurse practitioner, and I never get to see the doctor." Why didn't you go back to the last hospital that saw you and has all your tests and records? "Well, I didn't like them there. They told me that nothing was wrong, and that I was just constipated and then they admitted me and then I felt better but then my doctor didn't work there so then I wouldn't have my own doctor, and this pain is so bad and I didn't want to wake up my brother because he sleeps in the room above me but he was so worried about me and what are you going to do to fix me?"
Dx: 4th metatarsal fracture - "Well I was fighting this girl and then she suddenly came out and stepped on my foot, and I haven't been able to walk on it ever since." Well, how have you been getting around? "I've had to crawl on the floor."
Dx: Overdose and suicidal ideations - "Well, one of my kids had a scratch so someone called CPS, and then they said because of the bruises that I would have to go to court, and then my husband said that (mumbles something incoherently) so then I decided that I couldn't live in a world without my children and I took all the pills."
Dx: Multiple stab wounds - "I was fighting with this girl and then all of a sudden I felt this pain, and then I realized that I was bleeding and I couldn't believe that she would do that."
Oh... and the Award for highest blood sugar I've ever seen in a fully conscious patient goes to my homeless man who presented with a blood sugar of 1048. Yeah, that's right! Four digit blood sugar.(btw normal is around 100, most doctors recommend diabetics keep theirs below 160).
And, in my "Art Imitates Life" section: Tonight's episode of Grey's Anatomy had a storyline where one of the doctors Callie suffers a broken nose after getting clocked by the elbow of a patient... during a code today, I was placing a central line in the patient's femoral artery (in the thigh) when I bent over to get something from the kit I had to place on a chair. I was just about to turn back to the patient when one of the nurses toward the head of the bed turned suddenly and clocked me with her elbow. Not enough to daze me, but I did have to suffer through CT and subdural jokes for a part of the shift.
You have to watch out... life moves pretty fast in the E.D. Oh. yeah!