Friday, March 07, 2008
A good ER doc is a good Zebra hunter. A 'zebra' is a patient that has a bizarre diagnosis, often dangerous, that masquerades as a run-of-the-mill problem. You can't find zebras if you don't look for them.
A young woman with congenital deafness came in tonight after her sister ran into her at the local Wally World. The sister told me that the patient did not recognize her and was 'acting funny'. Then the step dad chimed in, "You know doc, I think she might have diabetes because she eats a whole lot of cookies, and even eats cookie dough." Hmmm.
The young lady knew the day, date, time, and place but obviously had problems talking so she appeared to be normal to me considering her deafness. The family was right though, they put me in a position where I had to do a big workup including CT of the head and I'm glad they did.
The patient has a brain tumor which is bleeding. She went off to the local tertiary care center by ambulance and the nurses looked at me like I had just derived the theory of relativity with a piece of paper and a pencil. The point of the "boy who cried wolf" story is that one day there's a wolf... or a zebra. The other point is that it's a very expensive sport.
Posted by 911DOC at Friday, March 07, 2008