One day while doing EMGs, the tech came into the room with a perplexed look on his face. "Okay," he said. "The last patient is standing in the middle of the exam room wearing one shoe. He says he can't find his other shoe."
Attending: "Well, it couldn't have gone far, could it?"
So we went on a hunt for the patient's missing shoe. We went into the room and next to the one-shoed patient was a lone shoe lying on the floor. "There's your shoe," the attending said, happy to have solved the mystery so easily.
"No, that's not my shoe," the patient insisted.
Except on further inspection we determined that it was, in fact, the patient's other shoe. No, it didn't match the shoe he was currently wearing, although both me and the med student noticed earlier that he had been wearing non-matching shoes. More perplexing was that both shoes were for the left foot.
I'm not sure how the patient made it all the way here from home without realizing he was wearing two left shoes. But I'd say that's a pretty good positive test for a sensory peripheral neuropathy, maybe even better than the EMG.
Patient: "I've got a pair just like 'em at home."
I keep this button on my office desktop, just for those moments.ReplyDelete
Heh, that's good for a grin.Delete
I giggled too, Dr. Grumpy :)Delete
Haha, yeah, definitely positive for LE sensory neuropathy. And his initial insistence that it wasn't his shoe makes me hear a voice saying, "Next stop: the local psych facility."ReplyDelete
His last remark could be revelatory of someone with both delusionality (or dementia?) and a good sense of humor - it's not as rare a combo as some might think. (I know first-hand, since I work constantly on trying to keep a sense of humor, while the delusions come naturally.)
I hope they throw his hatless butt in jail!ReplyDelete
Damn, I was just about to post the "hatless" quote. Oh well. Time to head out in the direction of... you know, that place that sells chili.ReplyDelete