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‘All ye who enter here abandon logic’

By Robert Brandt, M.D. | on June 1, 2013 | 0 Comment
Opinion
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Reason drives us as physicians. Logic courses through our veins and supports the choices we make. However, some patients lack our tenacious grip on common sense. One young lady, wearing thick, bedazzled sunglasses (despite its being 4 a.m.) demanded immediate care. She had a condition that permanently set her behavior to belligerent. She also lacked the ability to speak quieter than a jet taking off.

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ACEP News: Vol 32 – No 06 – June 2013

Me: “Hello, I’m Dr. Brandt. How can I help you?”

Her: “Like you don’t know.”

Me: “Well, actually, I don’t know.”

Her: Sighing (very loudly), “I am pooping all the time, and my feet stink.”

Me: “Alrighty. So you’re having diarrhea?”

Her: “No. My poop is fine. I just poop a lot. Does your wife yell at you when you’re pooping all the time? My boyfriend does.”

Me: “So is that why you’re here?”

Her: “And my feet are stinkin’!”

Me: “…”

Her: “You’re actin’ like you don’t even care that my feet stink!”

Me: “Um, well, no, not really.”

Her: “You’re the doctor. Fix it!”

I had a patient who tried to convince me that her brother was a Chupacabra, which I believe is Mexico’s version of Bigfoot. Her brother was in the room, and he looked more like a Yeti than a Chupacabra to me. Though, to her credit, at least she did not have crazy demands.

Have you ever had a patient demand testing? My patient believed that she had been poisoned. I have occasionally had patients who believe someone slipped something into their drink. Usually, the strange foreign substance is identified as “too much beer,” and they sleep for a while and magically become better.

This fine lady had a different agenda. She admitted that she had been injecting laced heroin (which was her norm). The problem arose when she felt different after using large amounts of her normal substance. So, logically, she concluded that her dealers put something abnormal in it.

Me: “So you have no pain, no shortness of breath, or any discomfort.”

Her: “No.”

Me: “You feel completely normal now?”

Her: “Yeah, now I do. But you gotta test my blood. I’m going to sue them!”

Me: “Sue who?”

Her: “My dealers!”

Me: “You plan to sue your dealers for giving you impure drugs?”

Her: “Exactly.”

I am not sure which part of the FDA regulates heroin and crack cocaine purity, but I wished her well in her pursuit.

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Topics: Brandt's RantsCommentaryEmergency MedicineEmergency PhysicianImaging and Ultrasound

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