Patient: “So, my feet have been swolled up for like five whole days, and I think they’re infected and they hurt real bad, and this cut’s all angry looking and I just can’t hardly get around and I’ve been running a fever and I vomited once yesterday, and sometimes the pain shoots all the way up my leg and I just got out of Providence House and I’m out of my meds but I don’t think I really need them my moods are just fine without them but ohmygawd I’m worried about this cut on my foot and look, both of them are turning BLACK on the bottom!”
[AD examines foot and finds no swelling or signs of inflammation, no heat, negative Homan's Sign, no signs of cellulitis, no history of gout, strong distal pulses, one 2 cm superficial cut to the top of the foot, scabbed over and healing well, no tenderness to palpation, able to flex and rotate her foot through all planes without visible signs of pain, but liberally coated with dirt and toe jam.]
AD: “Well um, it’s kind of hard to quantify pain, Ma’am. Might be something going on there that we can’t see. So tell me, how did you get here? Did you walk?”
Patient: “Yeah, I live down at XXXX Fydallo Ho Expressway. I ain’t got no cell phone, so I had to walk all the way up here to use the pay phone!”
AD (mentally counting to ten): “But, but, but, that’s like… five blocks from the hospital. You walked fifteen blocks to call an ambulance, just so we could take you to a hospital five blocks from where you started from?”
Patient: “Yeah, but I figured there might be something bad wrong! Did I do the right thing, calling the ammalance?”
AD: “Certainly, Ma’am. That’s why we’re here.”
Patient (sympathetically): “Bug fly up your nose?”
AD (confused): “Huh?”
Patient: “Well you got this really bad facial tic all of a sudden…”
* Hand to God, this conversation actually happened.
