Emery [bxb]

144

My patient was admitted with abdominal pain, present for many years, consistent with her known IBS. But we did a CT anyway and identified a spot on her kidney.

"It's probably cancer, right?" I consult with Emery as we make a salad for dinner. "Not so much salt, E."

"You said her only known medical problem is atrial fibrillation, right?"

"That does cause clots-"

"-which emoblize to organs. Is she on a blood thinner?"

"No-"

"Do you think it could be embolic? Also, cut them smaller, Brandon. Do I leave coin-sized chunks in the salad for you to choke on?"

"Shit. I think you may be right. And sorry..."

"What'd the CT scan say?" Emery's eyes water from the onions and he wipes them on his sleeve.

"It said to consider cancer embolus or atypical infection. I was thinking an MRI would be the next step."

"Just be mindful of what I said."

"I always am, Em."

Sure enough, the MRI shows that it's not a tumor, but rather embolus or an atypical infection. Since she exhibits no urine infection symptoms or fever, and the urinalysis and urine culture are negative, I diagnose her with emboli and put her on anticoagulation.