ATLANTA, GA – It was an unusually slow day and second-year medical student Bryan Orlando bugged his inpatient medicine team for a new patient to work-up, eager to hone in his skills. Annoyed by the constant pestering, the team spoke got a helpful tip from nursing and hooked Orlando up: the broken fax machine in the nurses station.
“Well, at least he’s diligent,” said charge nurse Amanda Baldwin, as she, several nurses, and Orlando’s medicine team watched him examine the fax machine with his stethoscope. “Look, look, he’s listening for bowel sounds.”
Staff on the floor were initially distracted when Orlando peppered the broken fax machine with loads of questions to elicit as good a history as possible. He even asked “¿Dolor?” in case the fax responded in Spanish. It didn’t respond. “I understand,” Orlando reassured the quiet fax machine. He awkwardly gave it a pat. “It’s hard to talk when you’re not feeling well.”
Orlando forgot to ask a sexual history. He did conclude somehow that the fax machine was DNR.
He recorded vital signs – room temperature, BP 0/0, HR 0, RR 0, and SaO2 0% – and shook his head: “I’m worried you’re septic. Or worse: dead.” Orlando worked through the physical exam – appropriately draping the fax to preserve modesty in front of other electronics – including a rectal exam. Stool guaiac was negative. Everyone looked on in horror; the machine was now covered in a glistening sheen of K-Y Jelly. Three hours had passed.
“Ummm… What do you think?” asked Corey Benson, Orlando’s senior medicine resident, at a loss for words. Just like everyone else.
“Still’s disease,” replied Orlando. “I’m not positive and I’ll have to read up on it more. But yes, Still’s disease.”
In other news, the unit secretary is on the phone with IT. IT wasn’t the only one puzzled: “What do you mean, the fax is broken and covered in lubricant?”