Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Wednesday, January 29, 2003
    A Cautionary Tale

    A local emergency room had called me about her visit yesterday, but hung up before I could get on the phone. Today she was my last appointment of the day.

    She had been burned. I didn't know how.

    "So, what was the cause of your accident?"

    Her entire face was burned (first-degree) and her neck was swathed in gauze.

    "The cap on my radiator was broken."

    My eyes popped open. "OH, no." I could already see the rest of the story unspooling in my head like a home movie... but of course I had to let her tell it.

    She had been going to the auto-supply store to get a new cap for her radiator. The first place she tried had not had one that fit her car, so she decided to save time at the next store by taking off the radiator cap and going into the store with it to show the clerk what she was looking for. So, she removed the cap with the engine running... she said someone had told her to do it that way, and that the water would stay down in the engine. (Query to anyone to knows about cars: is this correct? It doesn't sound right to me!)

    She had blisters all over her neck and chest, and her right breast, many of which were already peeling. She had been scalded when the water exploded out of the radiator.

    I changed her dressings, put some medicated burn cream on, and wrote a referral to the plastic surgeon. As I was working, I said, "If you ever have to remove a radiator cap again, put a rag over the cap and push down while you're turning."

    "I don't think I'll be doing this again," she said - dryly.



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