In the Eye of the Beholder

In general, I have a very low tolerance for status dramaticus.  If a patient is brought in to the ER screaming and writhing in pain, and doesn't have a damn good story to back it up, we tend to assume BS.  Such was the case for my gentleman the other night, who arrived clutching his chest, rocking back and forth in the stretcher, all while pleading "Don't let me die!"  Normal EKG, negative cardiac enzymes, pain completely resolved with one GI cocktail.  Maybe if he had taken off the designer sunglasses at any point during his stay, the act would have been more convincing.

The same advice applied to the drunk vs. stairs that rolled in later that evening.  Sporting a broken pair of shades that were missing a lens, he emphatically informed me that there was no need to check his blood pressure, as he could feel that it was "seventy over one and a half."  Taking the patient at his word, I charted the BP and moved on.