A Slow Day in the Emergency Room

Patient, a 42-year old male in mild distress, presents to the E.R. with newspaper glued to his ass. Vital signs -- all normal. B.P. getting up there, but not too bad under the circumstances. Ditto, pulse. No apparent disorientation, although patient appears to be something of a nincompoop, and refuses to explain how he came to be in this predicament. The cockamamie story he told about a botched rescue of a parrot stuck up a tree just didn't wash, and he seems to be covering for someone or something. He claims that his chart has a DNTMW order. (Taber's gives the following definition: "Do not tell my wife.") Upon examination of the area in question, the solution to yesterday's crossword was detected, as well as the results of the junior bowling league final -- 2nd division -- (Camp B'nai Jeshrun edged The New Young Rascals in a thrilling tie-breaker). Patient was started on a saline I.V. drip -- not because this had anything whatsoever to do with his condition, but just because. He was also given a mild sedative and sent to radiology as he was starting to fall asleep. (He was gone a long time, and was covered with goose pimples upon his return, so he must have been parked in the freezing corridor for a not insignificant spell). X-rays of the posterior (five posterior views) confirmed the initial diagnosis (newspaper-stuck-to-ass). CT scan was inconclusive and an utter waste (as, for the record, were all the other tests), but patient's HMO is pretty generous and never scrutinizes the bills. Upon patient's return from radiology, a turpentine salve was appliquéd to the skin for approximately 40 minutes until the patient happened to mention that he is allergic to turpentine. This seems to have been borne out by the rapidly-developing rash originating on his right thigh and running the length of his backside. After the patient was stabilized with Calamine lotion (120 cc) he was sent for a surgical consult. Admissions telephoned approx. 1 hour after patient left the E. R. to report that patient had claimed that his watch and shoes had been left behind and misplaced during a nursing shift change. The staff conducted a thorough search, but found only one left shoe, which was promptly bagged and sent for a blood gas. Results pending.

Dictated (but not read) by Mandelbaum, P.M., M.P., M.D., D.M.