The Laying On of Hands

Today at conference we ended up going around the table and swapping stories like geezers comparing fish. Here, in no particular order, are some of my favorites.

Elderly, gaunt gentleman with a giant sternal scar from a CABG comes in with nausea, vomiting, and a mass pushing up like a grapefruit just below the lower edge of his sternum. I walked in and started to ask questions, nonchalantly examining his abdomen at the same time. He was going along while I noticed a large hernia, probably at the base of his old CABG incision, and gently applied steady pressure for twenty or thirty seconds. Pop! In it went, and his lump was gone. "Cured", I said. He stayed for a couple hours for observation and went home. Priceless.

An elderly granny, cute like only old people are cute, took her morning beta-blocker and promptly 'bradied down' into the thirties, starting to get loopy as her heart rate dropped. We came over to see her, and my intern, having just pimped me on the antidote to beta-blockers--glucagon--proceeded to fix her with one dose. Way, way cooler than atropine. From an intern. Big shoes to fill, big shoes.

One man, having a full-on, strength-sapping, one-sided-weakness-causing, speech-slurring, tragic stroke, sneezed. And was cured. No joke.

Scruffy, unshaven construction worker comes from the bar, not for trauma, or a fist laceration from someone else's tooth, or alcohol poisoning, but for supraventicular tachycardia, narrow peaks of anxiety ticking along regular as clockwork at about 160 or 180 sitting in bed. Joe, the attending from Chicago who's seen everything and works nights as if he's of the undead, walks in, nonchalantly. We prepare the adenosine, get a line. Joe says, head cocked to the side, "try something for me...bear down like you're going to the bathroom." So the scruffy guy valsalvas hard, and beep...beep...right down to about 75 or 80, normal sinus rhythm. He sticks there, too. Beautiful. About 1 in 4 SVT rhythms will break with a valsalva maneuver. Free, easy, all-natural, organic medicine.

Here's to the fun cases.

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