Agraphia Medical Tragicomedy



A few days ago our office's nurse cornered me "Zac, I don't know what to do about the patient over in room 2. She was diagnosed with an ammonia over at the urgent care yesterday and was sent home... she just told me she's having trouble walking, has difficulty breathing, feels nauseated, and has a horrible headache. Dr. S is in with another patient so I figured I'd ask you if you think we need to get him in there right away."

Now, hyperammonemia is no laughing matter. Especially when it presents with gait problems, vomiting, and a headache you start to worry about all sorts of stuff, including alcohol withdrawal, drug overdoses, and liver diseases. Warning bells were going off in my head; I asked the nurse if the patient was a drinker; lo and behold, she was.

Rather than seeing my other patient, I waited outside the room for Dr. S so as not to miss him. I gave him the brief synopsis, and he dropped what he was doing immediately to walk over to room 2.

As we entered the room, he started smiling. The patient was sniffling a bit but looked just fine otherwise. She was 62 with a walker.

Dr. S: So they diagnosed you with a pneumonia at urgent care, huh?
Patient: Yep, that's what I told your nice nurse.

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  1. That’s hilarious!

  2. where are you???

  3. Zac, what’s cracking in Tucson?

    I’ve eagerly followed your blog but to no avail these days

    Love to hear more anecdotes from you!

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