Thursday, August 2, 2007

A rash

3am in the ER~

"What brings you in this morning?"

"I have a rash."

"Okay, can you show me where?"

"It's everywhere," she says, pointing to her arms and legs.
I'm looking. I'm not seeing it.

"Okay, well I'm having a hard time seeing a rash here."

"Well you can't see it! It's under the skin."

"Oh. If you can't see it, how did you know it was there?"

"I woke up with this...feeling."

"What does it feel like?"

"A rash."

Eighty-five questions later and I still had nothing. I found the psych resident, handed him the chart, and said, "I've got a patient for you. She's got a rash...on the inside. Good luck."


The next four patients I saw had different complaints--chest pain, nausea, ear ache, hit on the head with a box. And all four of them just happened to have rashes. By 4am, the woman complaining of a rash was the only patient in the ER without a visible skin disorder.

8 comments:

Maria said...

Ok...I'm intrigued.

Delusional parasitosis?
Akathisia?
Metabolic/electrolyte abnormality?
Chronic Fatigue Syndrome?

Or maybe Ekbom's?

What did the psych resident come up with?

Did she have any other presenting symptoms? Any history of drug problems?

God, I hate it when I do this. Now, this will bug me.

Guinea worm disease??? :)

Vic said...

How about she's just a fruit loop?

dive said...

Yikes! I used to get that.
It sucks; you just want to tear your whole skin off to get to it.

Having said that, it only ever happened when I'd been on the road for a couple of weeks with no sleep and too much alcohol and weed.
Hey ho.

Susanlee said...

I have that rash too. Everywhere itches sometimes. It's not really a rash....I think the dog hair makes me itch when she's slept with me.

Terroni said...

Vic's diagnosis comes closest to what the psych resident said. He called it malingering.

Maria, given a vote, I'd pick akathisia in this case.

I went to college with someone who had Guinea worm disease...gives me an invisible rash just thinking about it.

Ms. Avarice said...

i would have felt like i was in the twilight zone! weird!

Anonymous said...

i am a hypochonriac, ergo i never ever, under any circumstances, go to the doctor. in my mind, doctors are for other people, and i'm not allowed.

one day, like jim henson, i hope to die because i have pneumonia but don't want to bother people with it. really, that is my hope. i mean, jim henson is cool ...

CS said...

Probably needs the kind of doctor I am!