things are not always as they seem

My hospital specializes in a lot of shit.  Cardiology, neurology, orthopedics, etc etc etc.  Therefore, as an ER, we get a lot of medically complicated, seriously ill people in addition to the usual ER baloney.
Some days it feels like this is all we get.

So there I am minding my own business at the desk. I'm up for the next patient. One is coming by ambulance. I click on the computer to see whats coming in.  45 year near syncope. Hmmm.  Somebody vaso vageled?  Tey are dehydrated?  Whatever, I can handle it. The're young.  How bad can it be?

Of course, there is way more to the story. Turns out this woman has cardiomyopathy, diagnosed 1 month ago after having increased shortness of breath.  They were found to be in congestive heart failure. Their ejection fraction is 20%.  Had probably been in atrial fibrillation for a couple of years without treatment.  They must have had some episodes of v tach or very rapid heartbeat  because now they have an external defibrillator.

So the simple syncope turns into a big deal.  This is typical.  What looks to be simple is really way more complicated.  Often times when we get a call about an ambulance coming in from medic control, the information is a couple of sentences, failing to mention all of this other shit.  Like they are a quadriplegic or post heart transplant or mentally disabled from a group home.

Sometimes I think, whatever happened to sprains and lacerations and appys and what you would normally think comes into the ER?  They seem to be a thing of the past, replaced by by the MI who is on dialysis, a crack head and of course has no veins....