Textbook Classic

Sometimes a patient walks in and is the exact textbook version of whatever their diagnosis is.  In the middle of January, I saw a patient walking out of the clinic wearing a sundress, flip flops, and no jacket (and for those of you who forget I'm from NJ, reminder: I do not live in Florida).  And in my head, I was like, "Wow, crazy person."  But then later the other med student in the office was like, "We had such a stereotypical hyperthyroidism patient today."  And I was like, "I SAW HER!"  (because amongst other things, hyperthyroidism raises your body temp.)

a clear-cut case of hyperthyroidism

But sometimes things are really not so textbook.  For example, to remember who is most at risk for gallstones, everyone thinks of the Four F's: Female, Fat, Forty, and Fertile.  One day in college I get a call that my lanky 20-year old brother was in the emergency room with terrible abdominal pain.  It turned out to be gallstones, and a LOT of them.  My brother is not female, certainly not fat (especially three years ago), not forty, and not fertile (at least not in the estrogen-heavy-between-menarche-and-menopause sense of the word). 

However, he had very recently gotten over a really intense infection and was on like 7 billion different antibiotics (I took some creative liberties there and exaggerated just a touch), and the gallstones were most likely caused by one of those.  Once he stopped taking all the medications, the gallstones disappeared.

wise like Yoda I am

All I'm saying is .... sometimes things happen exactly as you expect them to, and sometimes they don't.  (Yes, I know, I'm very wise.)