Acute Incarceropathy

The chest pain patient was escorted back to a treatment room by not only the triage nurse, but also by a police officer. The patient was crying in pain. Agonizing pain. As the officer removed the handcuffs, the patient slowly and deliberately climbed onto the cot. “I’m doctor WhiteCoat. What brings you to the emergency department today?” Through her tears, she rolled her eyes and tilted her head toward the police officer. “I see that, but why did the officer bring you here?” “I – I – I am having PAIN! Pain all OVER!” “The nurse said that you were having pain in your chest.” “There, too! I have a complicated case of Behcet’s Disease. Any time that I have too much stress, I get a flare and all the joints in my body become inflamed.” When she said that, the police officer rolled his eyes. I dutifully performed an exam. Everywhere I touched, the patient would yelp … except when I touched her chest with a stethoscope to listen to her heart. Complicated Behcet’s disease must only respond to the galvanic response to another person’s fingers coming into contact with one’s skin. None of her joints felt warm or inflamed, either. Just pain all over. No eye irritation. Between breaths, she stuck out her tongue to show me the ulcerations that had “just popped up in the past hour.” She definitely did have ulcers in her mouth. However, the ulcers had obviously been there for a long time and had obviously not appeared just since her stressful e...
Source: WhiteCoat's Call Room - Category: Emergency Medicine Doctors Authors: Tags: Patient Encounters Source Type: blogs