Code 3 for the unknown.
A woman in her early 30s is in her office, where her co-workers called because she just “isn’t herself.” It is clearly a reliable and professional environment, with drama and malingering quite unlikely. She isn’t in any severe distress, but she clearly is not normal. She can answer some questions, and keeps saying she doesn’t “feel good.”
“She reminds me of people with brain bleeds,” I whisper to my partner.
“Yeah, I know.”
The ones I have seen were all vague and difficult to describe, and they behaved somewhat similarly, if they were awake at all.
Not much history available, but her co-worker finds her primary care physician’s number. For some reason, I call him after I take care of all my business. I don’t know why, but I guess I just want to know about her medical history and psychiatric history, if she has any, not that I really think she does, but more unexpected things I have seen. If there’s anything House teaches anyone, it’s that every aspect of a patient’s history is important, especially if you don’t know any.
Surprisingly, her physician picks up the phone before we arrive at the hospital. I explain to him that we have his patient here ALOC without any obvious cause, and I just want to ask him a few questions about her prior history. Somehow that leads to him babbling on and on for 3 minutes straight about absolutely nothing important, and finally I have to cut him off.
“Doc, I just need to know what her medical and psychiatric history is, and whether or not she has had similar events in the past.”
“Well, there’s nothing I can think of that would lead to this. Did you check her blood sugar yet? Because that’s what I would be thinking. If her blood sugar is low, that may cause her to behave differently. You guys can do that right?”
What a waste of time.
I am never calling anyone’s physician again. Ever.