One day each week I have emergency room responsibilities.  In general the acuity is low, but we always have something of interest from a medical perspective.  On my most recent shift in the ER we diagnosed a huge liver tumor in a young 25 year old man; another young girl in liver failure who had an unknown HIV infection.  Her spouse was negative, and from what I could understand she had been involved in some prostitution in her past, probably against her will.  She is 24 years old.  There were the typical respiratory infections, pneumonias, and then a physician’s favorite emergency . . . “I have had pain all over my body for years.”  The pain all over my body diagnosis is usually accompanied by lots of moaning as the patient tries to convince me how bad they hurt.  I wish they would understand that I believe them, because then they usually proceed to tell me how many things hurt all over their body in an effort to convince me that they are really sick.  Unfortunately, it only gets me confused because when they tell me so many things, then I have trouble determining the main reason for which they have really have come.  Did they come in for their symptoms of abdominal pain, or was it the foot swelling, back pain, headaches, dizziness, cough, joint pains, blurry vision, fungal infection or rash?

At the risk of having a very narcissistic blog post, I thought I would share some pictures our friend Ryan Morigeau took of me working in the ER a month or two ago.  They are quite good.  He is very talented.  We had medical students from Germany and England working with us in the ER at that time, and they are in many of the pictures as well.