A 42-year-old patient was unloading a truck when he developed sudden nausea and dizziness. He was found in a bathroom vomiting. When his co-worker approached him, he was unable to describe what happened to him. An ambulance was called 10-15 minutes later when the man complained of numbness in his right arm, his tongue, and the left side of his face. 
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Your patient is a 51-year-old male immigrant from Northeast Thailand who complains of recurring syncopal episodes. The nurse says the computer is reading this as an acute MI.  What is your interpretation? (choose only one) 
a Peer-Review of Expert Witness Testimony
 
The Case
A patient with a history of alcoholism was brought to the emergency department by ambulance after falling five days earlier. After the fall, the patient experienced significant back pain and had been laying on a mattress in his basement. His physical examination was significant for superficial bed sores and back tenderness. His neurologic status was intact, although there is testimony that the patient developed increasing weakness in one leg before he left the ED. Spinal X-rays and CT showed fractures of the posterior body and posterior element of L1, the transverse processes of L2 and L3, and a fracture of T12 with moderate distraction of fracture fragments. The X-rays also showed findings consistent with ankylosing spondylitis.

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