The story goes that the patient was at a gas station and finished filling up his truck. He walked inside to pay for his gas and when he turned around to leave, he said that “his leg gave out on him” and he fell to the floor. He was able to stand back up, but he wasn’t able to put a lot of weight on his leg. So he hobbled back to his truck and sat backwards onto the seat, but he wasn’t able to lift his bad leg into the truck. The gas station attendant was watching all of this and ended up calling the ambulance.
When the patient arrived, he appeared comfortable. He had no complaints as long as we didn’t try to move his leg.
Getting him off the ambulance stretcher and onto the cart was a chore. His leg caused him a lot of pain. The pain seemed to be more localized to his hip than his knee. Just to be safe, we x-rayed both of them. To everyone’s surprise, the patient had a femoral neck fracture.
“But doc! It can’t be! All I did was turn around! I didn’t fall onto it. How could I have broken it just by twisting?”
I showed him a printout of the x-ray and drew an arrow at the fracture site.
“Great. Just GREAT! I have to be at work tonight!”
“Sorry, Mr. Dwyer, you’re going to need surgery to fix this. You won’t be able to go to work for at least a few weeks.” He just kept running his fingers through his hair.
So we ordered the preoperative testing – CXR, EKG, labs, UA. To everyone’s surprise, the patient’s EKG showed Wellens’ Syndrome.
“Um … you know how we had to do those tests to prepare you for surgery?”
“Well your EKG shows something abnormal as well. Have you been having chest pain lately?”
“Not today …”
“In the past few days?”
“Well you’re going to need an angiogram before you get your hip fixed. It looks like you may have a significant blockage in your heart.”
“Are you SERIOUS?!?!?” He pounded his fist on the bed. “I was FINE this morning.”
“You’re actually lucky we caught this. This EKG finding is typical of a heart blockage called ‘the widowmaker.’”
He shook his head back and forth, randomly looking about the room. I could tell that he wanted to say something, but that he didn’t know what to say. Finally, he blurted it out.
“I’ll tell you one thing, though, doc …”
“I’m NEVER going to that f$%king gas station again in my whole god-d@%m LIFE! … NEVER!”
That statement caught me so off guard that I couldn’t hold in a laugh.
The patient’s anger slowly turned to a smile. As he thought about what he said, he started laughing, too.
“Hey. F you, doc,” the patient said with a grin.
“Oh yeah? Looks like I’ll be ordering some Narcan for that pain of yours.”
“Ask your nurse,” I said with a wink and a nod as I left the room.
I don’t say things like this too often, but I don’t think he knows how lucky he was to have broken his hip that day.
This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.