One for the Textbooks

"If you hear hoofbeats, it's probably not a zebra."

In medicine this phrase means anticipate the exotic, but expect the obvious.

In Family Medicine, my current rotation, I find myself chasing zebras daily...

High blood pressure, sweating, insomnia in a nervous woman? Probably just anxiety, but I had my money on a pheochromacytoma.

Sore knee in an 18 year old volleyball player? Most likely just twisted, but I swore it was gonoccal arthritis.

But, today, we had a woman who woke up this morning with an extremely tender neck and throat, and completely unable to swallow. Strep throat? Oh no.... We ended up sending her to the ER with the possibly fatal condition of epiglottitis. This is when the epiglottis swells, closing up the throat and eventually the airway. It is most often caused by a bacteria that is now vaccinated against, but this lady was 80 years old, so she missed the vaccine boat.

Epiglottitis is something we read about in textbooks all the time, but as it turns out, this was the first time my attending had ever actually seen a case. Guess my African safari skills finally paid off.