29 yo F with chest pain-
Had a history of panic attacks with chest pain when riding the subway. She started having a panic attack when I was on the subway and had some chest pain...wanted to make sure it wasn't a heart attack. Her panic disorder remains untreated.
34 yo M with fever and L testicle pain/swelling-
Bostonian: Do you use any drugs?
Dude: Officially, no. This isn't going in my medical record is it?
Bostonian: I need to know because certain drugs can cause fevers and infections. Unofficially?
Dude: I dunno, just little bit of Meth.
Bostonian: What happened on your arms there? (Pointing to the relatively fresh track marks)
Dude: Ok, I use a little bit of heroin too. But only a couple times.
25 yo F with BRBPR-
Bostonian: Any change in bowel habits?
Chick: Well...not really. I just moved in with my boyfriend a few weeks ago and I can poop with him in the apartment. I hold it, sometimes all weekend.
Bostonian: Honestly, I didn't know that girls poop until medical school.
Preparing for DRE
Chick: I usually don't let guys get to this point unless there are dinner and drinks first...
Me: Um...does that mean I owe you a drink?
23 yo F- with classical migrane and possible seizure D/O
Her- OH MY GAWD...I THINK I'M GOING TO HAVE A SEIZURE!!!!!
Me- Do you always have seizures when you feel like this?
Me- So why do you think you're going to have a seizure?
Her- Because I have a headache!!!
Me- How many seizures have you had?
Her- Like 15 since 2006. But no one believes me.
Me- Have you seen a doctor for them?
Her- I just started seeing one last month. He didn't believe me until my roomate yelled at him and made him order an MRI. He started me on Keppra a month ago which I didn't start until 3 days ago. And he gave me perscriptions for an MRI, EEG and CT scan, but I missed them all so they have to reschedule them.
Me- So you had 15 seizures and didn't see a doctor for 3 years and then you didn't follow up with your appointments or take your medication. Did you tell your neurologist about your headaches?