Monday, April 20, 2009

"My Feet Are Bleeding From The Inside"

A middle aged black women came into the ER at about 4 am on a Wednesday night. Her chief complaint was "my feet are bleeding from the inside." I looked through her medical history, and she had been to the ER four times in the last week for the same thing.... so the "ok this lady is crazy" thought was going through my head.

When I went to go see her, she was a very pleasant but concerned smelly patient. She stated that her feet were bleeding from the inside. She knew this because they were getting darker and darker. She admitted to being seen multiple times for this....but no one had figured it out. Her symptom was accompanied with foot pain if standing too long at work.

I examined her feet. They were indeed very dark. So were her sandals though. So...being the astute young physician I am....I went to get some magic solution to get the "blood off." I grabbed some alcohol pads, and showed the patient that when I cleaned her feet with alcohol, her feet were no longer dark. She didn't quite understand this, so I had to tell her kinda bluntly that her feet were just dirty...not bleeding. After much teaching, I thought she understood. When my attending saw her was apparent that I didn't do much good.

I couldn't find a billing code for dirty feet. I think we should make one though b/c we see a lot of this. I also wish we could bill for being dumb.

-ER Doc


Anonymous said...

Mmmm hmmm. And I long to one day see the choices of "Personal Hygiene" and "Common Sense" when printing out discharge teaching materials for some of my patients.

LivingDeadNurse said...

You might be a nurse if you firmly believe that "too stupid to live" should be a diagnosis. ~Author Unknown~

lol yup its amazing what you run into...even more amazing in the mountains of va lol

loved ur post

Trust us....we're doctors said...

Once, I was evaluating an adolescent boy with basically teenage boy behavior gone to the extreme. I asked how I could be of service and his mom said "Can you give him a pill that increases responsibility?"

She was completely serious.

Psych Doc

Anonymous said...

The only thing that does that is dope slap therapy, Psych Doc.