Last week, I shared some interesting complaints with which some of my patients presented to the emergency department. Here are a few more:

35-year-old-man complained of excessive salivation after eating bad meat.

37-year-old man complained of excessive salivation after drinking milk.

20-year-old woman was hit on the thigh by a lime that was shot out of a homemade gun designed for that very purpose.

“This is a 15-year-old female who was struck with a can of Pringles potato chips and a water bottle by her 10-year-old sister tonight. This caused her to fall over and land on her elbow. The paramedics were called and she arrived here by ambulance.”

A daughter, speaking of her 67 year-old mother: “I woke up and found her on the floor unresponsible.”

Think Emergency Department means “emergency?” Check out some of these ED patient complaints.

26 year-old female presented at 6:00 in the morning complaining of being weak and tired after being up all night drinking whiskey at a party.

20-year-old man presented with a chief complaint of uncontrollable farting when he gets nervous.

An adult woman came in complaining of a “virginal infection.”

18-year-old woman smelled blood in her nose for three minutes, fifteen minutes before arriving at the emergency department.

Young female claimed to have complete amnesia for everything in her life up until she saw the “emergency” sign out front.

21-year-old man came in with a self-inflicted laceration in the middle of his forehead, which he caused trying to remove a “computer chip” from his brain.

19-year-old man complained of feeling funny after taking LSD.

I cared for a sixty-one-year-old lady who was brought to the emergency department by her daughter and brother. They brought her down from the intensive care unit where her son who was on life support. She was hollering hysterically and was inconsolable. She wailed as she told me her story.

She said her son had suffered from depression for many years. She had grown tired of it and had become angry with him. They had argued earlier in the day. The argument ended with her hollering at him, “Get a hold of yourself and get over this depression!”

The son then went straight out to the back yard and hung himself on a tree. Some time later, she discovered him hanging there. She couldn’t get him down so ran off to find neighbors to help. By the time they cut him down and got the ambulance to bring him to the hospital, he was brain dead.

As she recounted the events to me, she moaned about wanting to turn the back the clock, how she was not there for him when he needed her and how she should be dead instead of him.

A forty-year-old man was brought in my medics. They had been called to the Greyhound station to pick up a drunken man. They said he got on the bus in San Francisco with a ticket to Los Angeles. By the time they made the stop in San Jose, he was so drunk the bus driver didn’t feel comfortable going on with him. He was found with a quart of Bacardi rum, about two thirds consumed, on the seat next to him. The medics put the bottle in his backpack and brought him to us.

As is my practice, I examined him and considered whether there might be something more serous the matter with him. Finding no reason to be worried, I decided to closely watch for his expected sobriety.

A few hours later, as the end of my shift approached, he was awake and passed his walk test. He confirmed that he was an alcoholic and had, in deed, consumed too much rum as he started his bus trip. He asked how he could get a cab back to the Greyhound station as family members expected him in Los Angeles. He was directed to the waiting room where there was a phone and information about calling a cab.

About forty-five minutes later, my attention was called to this patient as he was being rolled back in from the waiting room, again unconscious. He had gone to the waiting room and, rather than call for a cab, drank the rest of the Bacardi. I had to turn his care over to the incoming doctor to watch for him to, again, sober up. I wonder if he ever made it to Los Angeles.

“My Jaw is Already Locked”

In the south, people frequently referred to a tetanus shot as a “lockjaw shot.” One night, the nurse told our patient she was going to give him a lockjaw shot.

When he refused to take the shot, the nurse asked him why. He had recently broken his jaw and had his jaw wired closed. He refused to take the shot, because, he said, “My Jaw is already locked.”

“My Marriage is Going Downhill”

A seventy-six-year-old lady was brought in by her daughter who had noted the patient’s prolapsed uterus for the first time. This is a condition where the structures supporting the uterus in the pelvis become lax, allowing it to slide down into and even protrude from the vagina. Though the patient said the condition had been there for years, the daughter was startled by it and wanted to make sure there was nothing that needed to be done.

The patient denied any symptoms but said her “sex life is terrible” and “her “marriage is going downhill” because her uterus was filling and sticking out of her vagina.

Here is an image I plucked off the Internet:

and here is the Wikipedia link:

http://en.wikipedia.org/wiki/Uterine_prolapse

A man came in saying he had been having painful urination and a drip from his penis. He claimed it all started when his horse bit him on the penis five days earlier. He said he doubted it was a sexually transmitted disease because he and his girlfriend had been together for about six years and didn’t “fool around.” He’d know if his partner was unfaithful.

He ended up having gonorrhea. I have heard of people claiming to have gotten sexually transmitted diseases from sitting on a toilet but I never before heard of someone getting gonorrhea from a horse bite.

This is the third of a series of emergency coincidences that were interesting to me.

Double Achilles’ Trouble

The Achilles tendon is the largest tendon in the body. It hooks the calf muscles to the heel.

There is a risk that it will rupture or tear during athletic activities, especially with jumping or sudden movements of acceleration or deceleration. It is more common in athletes and people who have conditions that lead to less-than-healthy tendons, like diabetes, vascular disease or certain rheumatologic conditions. About 7 people in 100,000 with suffer a ruptured Achilles’ tendon.

One day, I took care of a 50-year-old obese diabetic woman who was running to catch a bus when she tore both of her Achilles’ tendons at the same time. That is a coincidence for someone with very bad luck.

Two Self-Inflicted Stab Wounds to the Abdomen

During one shift, I took care of two people who both tried to commit suicide by stabbing themselves in the abdomen. I will tell their stories by using the exact words I wrote in their medical records that night:

“This 46-year-old man with psychosis became despondent and injured himself at some hour during the night. He was found on the floor of his board-and-care facility with a laceration of the left neck and a laceration of the abdomen with viscera (guts) coming out if it. The report to us is that he was actually pulling his intestine out of the hole in his abdomen. The patient is either unwilling or unable to give a more specific history about what is going on.”

The patient was taken to the operating room to put his guts back inside him.

“A 32-year-old man got upset when his mother tried to stop him from smoking so he decided he wanted to kill himself and stabbed himself in the abdomen. He arrives in the emergency department by ambulance with a complaint of abdominal pain secondary to the stab wounds.”

The patient was found to have two stab wounds into his abdominal cavity. He also was taken to the operating room to make sure none of his internal organs was injured.

Bible Open to Different Page

A 66-year-old woman came in by ambulance after waking up and feeling her eyes irritated and flushed. She believed another occupant of her apartment complex had sprayed her with something. No one else lived in her apartment and she saw no one. The only evidence she had of anyone having entered was that her Bible was open to a different page when she woke than when she went to sleep. She said she has no enemies and no reason to think anyone would want to harm her. Still, based on how her eyes felt and the Bible being open to a different page, she was sure that was what happened.

Blood from Eyes, Ears and Nose

A 16-year old said she felt something in her brain “pop” earlier in the evening. She came in saying she had blood come out of both of her eyes, her nose and both ears.

One her exam, she was found to have a little dried blood on her face and ears but no blood inside her nose, mouth, throat, eyes or ears.

She was completely calm and seemed to be not the slightest bit worried about what might have happened to her. She was unable to explain how she might have blood on her face but no blood inside any of the places from which she said she had been bleeding.

This is one of those cases where I wondered what the heck was really going on but will never know.

Here are some Emergency Department coincidences that were noteworthy to me.

Three T’s

I did my internship in emergency medicine at Milton S. Hershey Medical Center in Hershey Pennsylvania. One shift, I worked with an attending physician named Ted and a senior resident named Todd. So, we had Ted, Tad and Todd on duty at one time.

Where Is My Son?

The mother was called to the emergency department after her son had been injured in a car crash. On arrival, she found the patient was not her son but had the same name. She was very relieved but wondered where her son really was.

Elderly Couple with Matching Injuries

An elderly man was driving his car with his wife riding in the front seat next to him. They were struck from the rear by a school bus. The bus hit them with such force that the bench seat in their older car was knocked back flat onto the rear seat.

When they arrived in the emergency department, she was complaining bitterly of neck pain and her neck was very tender. He was quite comfortable though he did have some neck pain and tenderness.

X-rays showed they both had fractures of their second cervical (neck) vertebrae. They were both admitted to the same room in the hospital for care of their fractures.

A Sad Super Bowl Party

A fifteen-year-old girl was at a Super Bowl party at a friend’s house just up the street from where I live. She took the friend’s go-cart out for a ride on the street with another kid on the back. She lost control, ran the go-cart up under a parked car and died in the accident.  What a tragedy for this young girl, her friend, and her family who thought she was safe watching football.

A Seizure or Not?

A twenty-two-year-old-man came in after crashing a go-cart into a wall.

He made it back to his home where someone called 911. The medics arrived and found him at home having a pseudoseizure (a false seizure.*) In the emergency department, he reported having seizures since childhood but said he was never treated for them. This seemed strange to me, as most people with life-long seizure disorders have been on medicine at some time.

He seemed to be uninjured in the go-cart crash.

He would not cooperate with our efforts to help him and he refused the CT scan I ordered. When his parents arrived, he would not talk with them or even allow them in the room.

I finally discharged him and he walked out, though it was unclear if he joined his family in the waiting room or left by another route, avoiding them.

It made me wonder what was really going on in his life and brain.

* http://en.wikipedia.org/wiki/Psychogenic_non-epileptic_seizures