The Swan Neck, the Babbling Brook, and the Burning Ball of Styrofoam
What an atypical week. We had off for nearly 7 days, so it was a flood of patients today. I didn’t bear the brunt of it since I was with the Ob residents, but I got to see a few of the Family Med patients once those doctors were done.
Maria, our now volunteer MA, is chatting with the next patient and taking her blood pressure. When she asks her to rise so she can stand on the scale for her weight, the woman just can’t get up. She’s wincing and struggling to get a grip on the table and use it as leverage to hoist herself upright. Betty and I are looking at her– if you can imagine dogs suddenly turning their heads to a noise–and we watch as Maria helps her onto the scale. The pain isn’t new to the patient, she said she’s had it for the past 3 years. But she’s only 44.
She has her little kid with her who keeps mimicking what Paul, our resident for the day, does– pressing on her joints and squeezing them. Paul shows me her index finger and how it curves into a swan-neck.
We find out that there is a history of lupus in her family, so we’re fairly sure that it’s RA.
The next guy is someone who came in last minute before. Maybe I just look very approachable but he kept looking at me and giving this very long convoluted history. I felt like I was reliving my clinical skill exam…I had the talkative patient and I bombed the first time as she went on and on about her husband’s eating habits and her Air Force uncle. It was a little more awkward since I wasn’t the one handling the case. Paul was doing it so I didn’t want to steal the show from him. I picked up some more things from him (I love watching him), he touches the side of the Brook’s knee to get his attention and that seems to bring him back to Earth.
Last girl was …classic. She’s a little thing and has a big scab on the side of her face. We find the story is that she was with her friends at the river and had burning balls of styrofoam on sticks. Of course, you can imagine what would happen to a bunch of kids whirling around flaming balls of burning plastic. She got hit with a gob of it on the face, and it actually looked to be healing pretty well. Something that irks me is how people never use any medicine before coming to see us. Isn’t that common sense?