Sunday, January 24, 2010

Neuro Call

I was on Neuro call today. It consisted of arriving at 7am, seeing a pt we'd never seen before, then rounding with the head of the department. My partner, A, presented to him, but luckily he ran into another attending who my pt belonged to and I didn't have to present anything. Score! Thank you Jesus!!! Honestly, I'm grateful. I'm not just using the Lord's name in vane. Anywho, around 1:30 or 2 we got a consult from the ER:

"22 yo female c no past medical problems here for R sided weakness"

Sounded simple enough, especially since there aren't very many 22 yo females who actually have strokes. None of the tests had actually come back by the time we left around 3:15 this afternoon, so I don't know what was wrong with her..

other than the fact that she was 28 WEEKS PREGNANT!!!

Our residents spent a lot of time with her doing a very detailed neuro exam, asking about any meds she took, etc. and she neglected to leave that little detail out. Because she was already an obese woman it made it hard to tell on observation. Here's my favorite parts of the interview process:

Resident: "Have you had any surgeries in the past?"
Patient: "Just 3 c-sections, had my last baby in 2008"
R: How many pregnancies have you had?
P: "4; 1 miscarriage"
R: "Are you on any form of birth control?"
P: *bewildered look on face* "No."
R:(Moving along with the social history) What do you do? Do you work?
P:bewildered look again* "No."
R: Why not?
P: *in disbelief he's asking* I don't know.
R: How do you afford things?
P: I got people to help me out. My dad helps me. (And me, and you, and Uncle Sam)

And now for my favorite part:
R: "When did you realize you were pregnant?"
P: "Oh, about a month ago."

Seriously?!? She almost made it on that TLC Show - "I Didn't Know I Was Pregnant."

Also, just as an aside - when I have my M.D. in 1.4 years and am taking social histories (are you married? where do you work? kids? tobacco/alcohol use?) from my patients I plan on doing the same line of questioning. People who are able to work but just sit at home and con the welfare system should be guilt-tripped. My family/little old ladies from church/peers would have guilt tripped the hell out of me if I hadn't applied myself and gone to college, etc... so why don't these people deserve the same thing? I just want to fulfill my social duty as a friend:)

2 comments:

Laura said...

That is most excellent.

A. said...

Love it!!!! I did the same thing with an 18 y/o the other day with a GSW to the hand.
Me: Do you work?
Pt: I'm self-employed
Me: You are 18. What does that mean?
Pt: It means I work for myself.
Me: I know it means you work for yourself, but what exactly do you do? Do you work regularly?
Pt: I cut grass & stuff.

And stuff. That's my fav. And probably how you ended up with a GSW to the hand. Doing "stuff".