Unilateral facial pain with some subjective fevers, diaphoresis, and numbness/tingling in the same region. “So what medications are you taking?” I noticed the disproportionate opening of his mouth as he answered.” While we joked about random current events, I thought I saw a discrepancy in his eyelid elevation. And then it hit me. “Sir, close both your eyes as if you’re sleeping.” – one remained partly open. “Okay, now smile really big.” – a facial droop became evident on the same side. In my mind, I had just diagnosed Bell’s palsy, a very well known condition but not one seen everyday (or rather, at 4 AM). 🙂
My two weeks in the emergency center at Ben Taub showed me the unification of Internal Medicine, Psychiatry, and OB/Gyn in a vast variety of manifestations. Vaginal bleeding. Chest pain. Metastatic small cell lung cancer. Abdominal pain of every kind. COPD exacerbations. Blood glucose values over 800. Hemoglobins less than 6. Altered/violent patients secondary to drug use. Gun shot wounds to the head. Stabbings to the flank. Completed abortions. Proptosis secondary to hyperthyroidism.
And all that could be seen in just one night.
All the attendings I worked with were absolutely fantastic and empowered me to suture, place catheters/lines, etc. I learned so much about the “emergency” aspect of medicine, what constitutes an emergency, and what it feels to be on the “giving” rather than the “receiving” end of IM, OB/Gyn, and Psych consults.
In roughly six hours, I’ll begin another two week journey, only this time it’ll be at Texas Children’s Hospital on the pediatric surgery team. While I hope to continue seeing interesting cases, I expect to learn about another demographic of patients I have yet to deal with consistently on the wards – adolescents and children. Here’s hoping for a productive two weeks! 🙂