Patient, “Zeus,” a middle-aged male in good health, presented with severe headache that initiated suddenly as he was walking. Reported no prior head trauma or surgery, dental problems, or difficulty opening and closing jaw. Blood test indicated no thyroid disease, anemia, or infection. CT scan and MRI revealed no abnormalities. As physician was conferring with patient about pain medications, patient seized up and clutched at head. Small, armor-clad warrior (female) emerged from patient’s skull, identified self as “Athena,” stabbed physician in bicep, leapt off examination table, and exited the office. Patient expressed complete relief from headache; no wound appeared at exit point. Analgesics prescribed for patient as precaution. Physician administered tetanus shot to himself. Rachel: Can you dig up the diagnostic code for this? I couldn’t find it. Also, this may be a pre-existing condition.
Patient, “Cronus,” healthy, vigorous male, complained of abdominal pain and constipation. Unable to recall last time he ingested food or last bowel movement but estimated it as at least seven years. Palpitation suggested blockage in small intestine. Barium X-ray showed six lumps packed tightly in duodenum. Emetic was administered to patient, who vomited five infants and large stone. Patient claimed to be unaware of contents or when they were ingested. Infant vital signs normal. Patient put on high-fiber diet; infants transferred to child protective services.
Patient, “Demeter,” middle-aged female, presented with fatigue, lack of appetite, diminished libido, sleep disturbance, frequent crying spells. Reported that condition was interfering with job performance. Patient attributed mood to grief over loss of daughter during winter months as result of contentious custody battle. Further questioning revealed she didn’t get along with daughter when they were together. Check of melatonin levels suggested seasonal affective disorder. Fluorescent-light therapy prescribed. At six-week follow-up visit, patient reported improved mood; transformed into serpent and made sexual overtures toward physician.
Emaciated patient, “Tantalus,” was referred by mental-health specialist who was treating him for eating disorder. Patient claimed that every time he tried to grasp food it receded out of reach. Specialist initially diagnosed emotional disturbance tied to eating; patient was punishing himself out of perceived unworthiness to live. After convincing specialist of strong desire to eat, patient was referred for basic physical examination. Standard random-dot test revealed severe impairment of depth perception; patient was not reaching far enough for food. Corrective lenses prescribed. Two-week follow-up visit showed patient had gained 25 pounds; affect much improved.
Patient, “Dionysus,” brought to pediatric ER by mother for severe gastric distress, admitted to hospital for observation. Over 72-hour period, child’s health repeatedly improved and then diminished suddenly after bedside visit from mother. Mother very talkative and animated during ensuing visits from specialists; extremely critical of father; demonstrated little concern for state of patient. Blood test revealed son not biological child of mother. Head nurse reported suspicion of Munchausen by proxy syndrome. Mother responded by having nurse’s mouth grow shut and driving specialist mad. Patient discharged from hospital after stealing Percocet for recreational use.