Sunday, March 30, 2008

The Suitcase Sign

The Suitcase Sign.
It's when a patient presents to the ER with, literally, a large suitcase or two. Usually occurs at the start of a weekend, or holiday. Usually negatively predicts the severity of illness. Almost always an ominous sign. Patients coming to the hospital lugging a suitcaseful of clothes either expect this to be a hotel stay, or expect to have an extended hospitalization, or both.
The outpatient version of this that we dread, is when the patient brings a suitcaseful of medical records. Though sometimes they do this to be helpful, sometimes it can also hint at 'doctor-shopping', or obsessive-compulsive traits.The other day, as I started my day, Dani, my clinical assistant half-giggled as she handed me my patient list.
"Your patient brought his medical records with him", she gestured towards what I thought was a box of printing paper.
I kid you not.
A box.
And not just a box. A full box. And the patient actually brought it with his own cart. Yes, you heard me. A cart. The kind grocers use to transport wooden crates of tomatoes.
It was a Monday. These things always seem to happen on Mondays.
800 pages of outside records, 4 days and a half-dozen tests later, I provided him with the diagnosis I had suspected all along: No endocrinologic disease.

(for a nice sum of money for 'health supplements' , some health practitioner had misled this poor guy for the last several years)

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