A THROBBING HEADACHE
UNLIKE ANYTHING ELSE
It was the worst headache of his life, the 25-year-old patient told the doctor in the emergency room of Highland Hospital in Rochester. It started five days earlier when the circus was in Connecticut. At first it wasn't a big deal. He would take a couple of aspirin, and it would disappear. But when the medicine wore off, the headache was still there. In fact, each time it seemed just a little worse. That morning, when he got out of bed, the pain was unbearable. He took aspirin, Advil, Tylenol. Nothing put a dent in it.The pain was sharp and on the right. It felt as if someone were slamming a door inside his head. He'd had the occasional headache but never something like this.
FIRST, WORST OR CURSED
ABNORMALITIES
The doctor ordered a painkiller and blood tests to look for signs of infection or inflammation. She also ordered a CT scan of the head to look for a tumor or evidence of blood. The blood tests were normal. The CT was not.
PRESSURE
NO RELIEF
Overnight the headache became worse, despite the use of several powerful painkillers. By morning the patient was exhausted from the pain and nearly incoherent from the narcotics. He never, however, developed symptoms of increased pressure in his brain.The neurologist speculated that this was a migraine and recommended he go home and follow up as an outpatient.
THE TINCTURE OF TIME
Dr. Bilal Ahmed, the internist taking over the patient's care that morning, first heard about the new patient from his team of residents outside the patient's door. They told him that he was a young circus worker who had been hit in the head by a zebra, had an abnormal CT and was probably going to surgery later in the day.
As they stood there, a nurse hurried out of the patient's room. ''He's got a rash,'' she told the doctors. The team went into the room, and Dr. Ahmed glanced at the patient now hidden beneath a pile of blankets. He introduced himself to the patient's girlfriend. As she started to speak, Dr. Ahmed held a finger to his lips. ''Don't say anything,'' he told her. ''I want to see for myself.''
''May I look?'' he asked the young man. A matted head of dark curls slowly emerged from beneath the mound of blankets. The patient sat up slowly, blinking in the dim light. His right eyelid was swollen and drooped drunkenly over the pupil so that only the lower ridge of the greenish brown iris was visible. The right side of his forehead was red, as if he had a sunburn on that half of his face. And there was a sprinkling of bumps over his eye and forehead.
Post a Comment